龙胆泻肝汤联合结膜瓣遮盖治疗真菌性角膜溃疡的临床观察

目的探讨龙胆泻肝汤加减方联合结膜瓣遮盖治疗真菌性角膜溃疡的临床效果。方法 84例（84只眼）真菌性角膜溃疡的患者随机分成2组。对照组行常规药物治疗及结膜瓣遮盖联合术,中药治疗组在对照组的基础上添加口服龙胆泻肝汤加减方（免煎剂）。观察2组患者患眼的症状改善、溃疡愈合及视力情况。结果治疗后2组患者的角膜刺激症状和视力有一定程度改善。中药治疗组46例中,治愈36例,好转8例,无效2例,治愈率78.26%,总有效率95.65%;对照组38例中,治愈21例,好转10例,无效7例,治愈率55.26%,总有效率81.58%;2组差异有统计学意义（Mann-Whitney U检验,Z=-2.393,P=0.017）。随访12~18个月,中药治疗组治愈患者未见复发,对照组治愈患者复发2例。结论在常规药物联合结膜瓣覆盖的基础上增加龙胆泻肝汤加减方治疗,可以提高对真菌性角膜溃疡的治疗效果。

Clinical observation of Longdan Xiegan Decoction combined with conjunctival flap covering for fungal corneal nicer

OBJECTIVE To investigate the clinical effect of Longdan Xiegan decoction combined with con- junctival flap covering in the treatment of fungal corneal ulcer. METHODS Eighty-four cases （84 eyes） of fungal corneal ulcer were randomly divided into 2 groups. The control group received conventional drug treatment and con- junctival flap covering combined operation, orally Longdan Xiegan Decoction of Chinese medicine treatment group on the basis of the control group. Symptoms and ulcer and visual acuity were observed in two groups. RESULTS Corneal irritation symptoms and eyesight of two groups＇ patients improved to some degree after treatment. Chinese medicine treatment group of 46 cases, 36 cases were cured, 8 cases improved, 2 cases ineffective, the cure rate was 78.26%, the total efficiency of 95.65%; control group of 38 cases, 21 cases were cured, 10 cases improved, 7 cases ineffective, cure rate was 55.26%, the total efficiency of 81.58%; The difference was statistically significant （Mann- Whitney U test, Z=2.393 ,P=0.017）. Follow up of 12 months to 18 months, Chinese medicine treatment group cured patients had no recurrence, the control group cured 2 patients relapsed. CONCLUSIONS Based on conventional drugs combined with conjunctival flap covering by increasing Longdan Xiegan Decoction on the treatment, could im- prove the effect of the 0treatment of fungal corneal ulcer.