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中华眼科医学杂志(电子版) ›› 2017, Vol. 07 ›› Issue (02) : 78 -83. doi: 10.3877/cma.j.issn.2095-2007.2017.02.005

所属专题： 文献；

论著

复方樟柳碱颞浅动脉旁皮下注射联合丹红离子导入治疗眼睑痉挛合并干眼的临床疗效
朱彦霞1,†(), 姜士军1, 蒋燕玲1, 李学民2   
  1. 1. 222000　江苏省连云港市第二人民医院眼科
    2. 100191　北京大学第三医院眼科
  • 收稿日期:2017-02-22 出版日期:2017-04-28
  • 通信作者: 朱彦霞
  • 基金资助:
    首都临床特色应用研究项目(Z141107002514042)

Clinical effect of subcutaneous injecting the compound anisodine besides the superficial temporal artery combined with danhong iontophoresis in treatment of blepharospasm with dry eye

Yanxia Zhu1,†(), Shijun Jiang1, Yanling Jiang1, Xuemin Li2   

  1. 1. Department of Ophthalmology, The Second People′s Hospital of Lianyungang, Lianyungang 222000, China
    2. Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China
  • Received:2017-02-22 Published:2017-04-28
  • Corresponding author: Yanxia Zhu
  • About author:
    Corresponding author: Zhu Yanxia, Email:
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引用本文：

朱彦霞, 姜士军, 蒋燕玲, 李学民. 复方樟柳碱颞浅动脉旁皮下注射联合丹红离子导入治疗眼睑痉挛合并干眼的临床疗效[J]. 中华眼科医学杂志(电子版), 2017, 07(02): 78-83.

Yanxia Zhu, Shijun Jiang, Yanling Jiang, Xuemin Li. Clinical effect of subcutaneous injecting the compound anisodine besides the superficial temporal artery combined with danhong iontophoresis in treatment of blepharospasm with dry eye[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2017, 07(02): 78-83.

目的

探讨复方樟柳碱颞浅动脉旁皮下注射联合丹红离子导入治疗眼睑痉挛合并干眼的临床疗效。

方法

收集2014年9月至2016年6月于连云港市第二人民医院眼科接受治疗的眼睑痉挛合并干眼的64例(75只眼)患者的临床资料。按照数字表法将患者随机分为对照组和治疗组。其中，对照组患者30例(34只眼)，治疗组患者34例(41只眼)。对照组患者口服甲钴胺胶囊，并联合玻璃酸钠滴眼液滴眼。治疗组患者在对照组治疗方法的基础上，同时使用复方樟柳碱颞浅动脉旁皮下注射联合丹红离子导入法进行治疗。两组患者在治疗前和治疗3个月后，分别行眼睑痉挛强度分级评估和Schirmer泪液分泌试验(SIt)、泪膜破裂时间(BUT)及角膜荧光素染色等干眼检查。SIt、BUT及角膜荧光素染色的检查结果均采用均数±标准差(±s)表示，采用独立样本t检验进行组间比较，并采用配对样本t检验进行治疗前后的比较。将眼睑痉挛强度分为4个等级，并采用Kruskal－Wallis H秩和检验对两组患者治疗前的眼睑痉挛强度分级分布情况进行比较。眼睑痉挛的治疗效果采用例数和百分数(%)表示，并采用χ2检验对总有效率进行比较。

结果

对照组患者治疗前的SIt、BUT及角膜荧光素染色的检查结果分别为(2.43±1.17)mm/5 min、(2.67±1.03)s及(5.10±1.71)分；治疗后分别为(10.00±2.99)mm/5 min、(9.10±2.44)s及(1.67±1.15)分。将对照组患者治疗前后的SIt、BUT及角膜荧光素染色的检查结果进行比较，差异有统计学意义(t＝9.12，10.26，5.48；P<0.05)。治疗组患者治疗前SIt、BUT及角膜荧光素染色的检查结果分别为(2.15±1.02)mm/5 min、(2.59±0.86)s及(5.12±1.55)分；治疗后分别为(13.02±3.22)mm/5 min、(12.00±2.20)s及(1.09±0.90)分。将治疗组患者治疗前后的SIt、BUT及角膜荧光素染色的检查结果进行比较，差异有统计学意义(t＝9.10，10.50，4.67；P<0.05)。将治疗组与对照组患者治疗前的SIt、BUT及角膜荧光素染色的检查结果进行比较，差异无统计学意义(t＝1.05，0.33，0.04；P>0.05)；将治疗组与对照组患者治疗后的SIt、BUT及角膜荧光素染色的检查结果进行比较，差异有统计学意义(t＝3.88，5.00，2.25；P<0.05)。治疗前，治疗组与对照组患者眼睑痉挛强度分级分布情况的差异无统计学意义(Hc＝0.10，P>0.05)。治疗后3个月，治疗组患者眼睑痉挛治疗的总有效率为94.12%，高于对照组的80.00%，且两组患者总有效率之间的差异有统计学意义(χ2＝6.94，P<0.05)。

结论

复方樟柳碱颞浅动脉旁皮下注射联合丹红离子导入法对眼睑痉挛合并干眼的患者有明显的治疗效果。

关键词: 眼睑痉挛, 干眼, 复方樟柳碱, 离子导入
Objective

To investigate the clinical effect of subcutaneous injecting the compound anisodine besides the superficial temporal artery combined with danhong iontophoresis in treatment of blepharospasm with dry eye.

Methods

The clinical data of 64 patients (75 eyes) with blepharospasm and dry eye treated in The Second People′s Hospital of Lianyungang were collected from September 2014 to June 2016. According to the digital table method, the patients were randomly divided into control group and treatment group. Among them, there were 30 cases (34 eyes) in the control group and 34 cases (41 eyes) in the treatment group. 30 cases (34 eyes) enrolled in the control group were treated with oral mecobalamin capsule and sodium hyaluronate eye drops. On the basis of the control group′s treatments, 34 cases (41 eyes) enrolled in the treatment group were treated by injecting the compound anisodine besides the superficial temporal artery combined with Danhong iontophoresis. Before and after treatment, two groups of patients were examined in classification of blepharospasm, SchirmerⅠtest (SIt), breakup time (BUT), and corneal fluorescent staining, respectively. SIt wetted length, BUT, and corneal fluorescein staining scores were presented as mean ± standard deviation(±s), and compared by independent samples t-test between two groups, and compared by paired samples t-test before and after treatment. The intensity of blepharospasm was divided into four grades, and the results were compared by Kruskal-Wallis H rank sum test. The therapeutic effect of blepharospasm was expressed as the number of cases and percentage (%), and the total effective rate was compared by chi square test.

Results

Before the treatment, the results of SIt, BUT and corneal fluorescent staining in the control group were (2.43±1.17) mm/5 min, (2.67±1.03) s and (5.10±1.71) points; after treatment, they were (10.00±2.99) mm/5 min, (9.10±2.44) s and (1.67±1.15) points, respectively. The results of SIt, BUT and corneal fluorescent staining were compared in the control group before and after treatment, and the differences were statistically significant (t=9.12, 10.26, 5.48; P<0.05). Before the treatment, the results of SIt, BUT and corneal fluorescent staining in the treatment group were (2.15±1.02) mm/5 min, (2.59±0.86) s and (5.12±1.55) points; after treatment, they were (13.02±3.22) mm/5 min, (12.00±2.20) s and (1.09±0.90) points, respectively. The results of SIt, BUT and corneal fluorescent staining were compared in the treatment group before and after treatment, and the differences were statistically significant (t=9.10, 10.50, 4.67; P<0.05). Before the treatment, comparing the results of SIt, BUT and corneal fluorescent staining between the treatment group and control group, and there were no statistically significant differences (t=1.05, 0.33, 0.04; P>0.05). However, comparing the results of SIt, BUT and corneal fluorescent staining between the treatment group and control group, after the treatment, and the differences were statistically significant (t=3.88, 5.00, 2.25; P<0.05). Before the treatment, there was no significant difference in the intensity distribution of blepharospasm between the two groups before treatment (Hc=0.10, P>0.05). But after the treatment, there was statistical difference in the total effective rate which was 94.12% in the treatment group and 80.00% in the control group (χ2=6.94, P<0.05).

Conclusion

Subcutaneous injecting the compound anisodine besides the superficial temporal artery combined with Danhong iontophoresis is efficient in the treatment of blepharospasm and dry eye.

Key words: Blepharospasm, Dry eye, Compound anisodine, Iontophoresis
表1 治疗组与对照组患者治疗前眼睑痉挛强度分级结果的比较
组别 Ⅰ级[%(例数/总例数)] Ⅱ级[%(例数/总例数)] Ⅲ级[%(例数/总例数)] Ⅳ级[%(例数/总例数)]
对照组 33.33(10/30) 26.67(8/30) 26.67(8/30) 13.33(4/30)
治疗组 35.29(12/34) 23.53(8/34) 26.47(9/34) 14.71(5/34)
Hc 0.10
P值 >0.05
表2 治疗组与对照组患者治疗后眼睑痉挛治疗效果的比较
组别 有效[%(例数/总例数)] 无效[%(例数/总例数)]
对照组 80.00(24/30) 20.00(6/30)
治疗组 94.12(32/34) 5.88(2/34)
χ2值 6.94
P值 <0.05
表3 治疗组与对照组患者治疗前后泪液分泌试验、泪膜破裂时间及角膜荧光素染色检查结果的比较(±s)
组别 眼数 泪液分泌试验(mm/5 min) 泪膜破裂时间(s) 角膜荧光素染色(分)
治疗前 治疗后 治疗前 治疗后 治疗前 治疗后
对照组 34 2.43±1.17 10.00±2.99 2.67±1.03 9.10±2.44 5.10±1.71 1.67±1.15
治疗组 41 2.15±1.02 13.02±3.22a 2.59±0.86 12.00±2.20a 5.12±1.55 1.09±0.90a
t值 ? 1.05 3.88 0.33 5.00 0.04 2.25
P值 ? >0.05 <0.05 >0.05 <0.05 >0.05 <0.05
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