熊胆开明片联合曲伏前列素滴眼液治疗原发性开角型青光眼的临床研究

目的 探讨熊胆开明片联合曲伏前列素滴眼液治疗原发性开角型青光眼的临床疗效。方法 选择2020年8月—2022年4月开封市中心医院收治的原发性开角型青光眼患者150例（292眼），采用随机数字表法将所有患者分为对照组（75例，147眼）和治疗组（75例，145眼）。对照组患者滴眼曲伏前列素滴眼液，1滴/次，每晚1次。治疗组患者在对照组基础上口服熊胆开明片，4片/次，3次/d。两组均治疗30d。观察两组临床疗效，比较两组的眼压、视野、眼部血流动力学、氧化应激、视觉相关生活质量（VRQL）评分、视觉诱发电位。结果 治疗后，治疗组的总有效率为92.41%，高于对照组的总有效率80.27%，组间比较差异有显著性（P＜0.05）。治疗后，两组眼压、视野缺损均显著下降（P＜0.05），治疗后，治疗组的眼压、视野缺损均显著小于对照组（P＜0.05）。治疗后，两组收缩期血流峰值速度（PSV）、舒张末期血流速度（EDV）均显著升高，阻力指数（RI）显著下降（P＜0.05）；治疗后治疗组患者的PSV、EDV明显高于对照组，RI明显低于对照组（P＜0.05）。治疗后，两组P100波振幅显著升高，P100波潜伏期显著下降（P＜0.05）；治疗后治疗组的P100波振幅高于对照组，P100波潜伏期低于对照组（P＜0.05）。治疗后，两组行走、读写、暗适应、驾驶、家务劳动、室外活动评分和总分均显著升高（P＜0.05），治疗后治疗组患者行走、读写、暗适应、驾驶、家务劳动、室外活动评分和总分均明显高于对照组（P＜0.05）。治疗后，两组超氧化物歧化酶（SOD）水平明显升高，丙二醛（MDA）、晚期蛋白氧化产物（AOPP）水平明显下降（P＜0.05），治疗后治疗组的SOD水平明显高于对照组，MDA、AOPP水平明显低于对照组（P＜0.05）。结论 熊胆开明片联合曲伏前列素滴眼液治疗原发性开角型青光眼，可降低眼压，减轻视野缺损，改善氧化应激、视觉诱发电位和眼部血流动力学，提升视觉相关生活质量，安全有效。

Clinical study on Xiongdan Kaiming Tablets combined with Travoprost Eye Drops in treatment of primary open-angle glaucoma

Objective To explore the therapeutic effect of Xiongdan Kaiming Tablets combined with Travoprost Eye Drops in treatment of primary open-angle glaucoma. Methods Patients (150 cases, 292 eyes) with primary open-angle glaucoma in Kaifeng Central Hospital from August 2020 to April 2022 were divided into the control group (75 cases, 147 eyes) and treatment group (75 cases, 145 eyes) according to random number table method. Patients in the control group were eyedrop administered with Travoprost Eye Drops, 1 drop/time, once a night. Patients in the treatment group were po administered with Xiongdan Kaiming Tablets on the basis of the control group, 4 tablet/time, three times daily. Patients in two groups were treated for 30 d. After treatment, the clinical efficacies were evaluated, and the intraocular pressure, visual field, ocular hemodynamics, oxidative stress, VRQL score, and visual evoked potential in two groups were compared. Results After treatment, the total effective rate of the treatment group was 92.41%, which was higher than that of the control group (80.27%), and there was a significant difference between the groups (P<0.05). After treatment, the intraocular pressure and visual field defects in two groups were significantly decreased (P<0.05). After treatment, the intraocular pressure and visual field defects in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the PSV and EDV in two groups were significantly increased, while the RI in two groups was significantly decreased (P<0.05). After treatment, the PSV and EDV in the treatment group were significantly higher than those in the control group, while the RI in the treatment group was significantly lower than those in the control group (P<0.05). After treatment, the amplitude of P100 wave in two groups were significantly increased, but the latency of P100 wave in two groups were significantly decreased (P<0.05). After treatment, the amplitude of P100 wave in the treatment group was higher than that in the control group, while the latency of P100 wave in the treatment group was lower than that in the control group (P<0.05). After treatment, the total scores and the scores of walking, reading and writing, dark adaptation, driving, housework, and outdoor activities in the two groups were significantly higher (P<0.05). After treatment, the scores and total scores of walking, reading and writing, dark adaptation, driving, housework, and outdoor activities in the treatment group were significantly higher than those in the control group (P<0.05). After treatment, the levels of SOD in two groups were significantly increased, while the levels of MDA and AOPP in two groups were significantly decreased (P<0.05). After treatment, the levels of SOD in the treatment group were significantly higher than those in the control group, while the levels of MDA and AOPP in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Xiongdan Kaiming Tablets combined with Travoprost Eye Drops has clinical curative effect in treatment of primary open-angle glaucoma, can reduce intraocular pressure, alleviate visual field defect, improve oxidative stress, visual evoked potential and ocular hemodynamics, and improve visual related quality of life, with good safety.