摘要
目的分析过敏性结膜炎的临床分布特征,探讨应用0.1%盐酸奥洛他定滴眼液联合0.1%普拉洛芬滴眼液治疗过敏性结膜炎的初步效果。方法收集2009年11月至2010年11月山东省济南市第二人民医院眼科294例（588只眼）过敏性结膜炎患者的临床资料,按照数字表法随机分为对照组147例（294只眼）和实验组147例（294只眼）。对照组患者采用0.1%奥洛他定滴眼液进行治疗,2次/d,1-2滴/次,连续用药14 d;实验组采用0.1%普拉洛芬滴眼液联合0.1%奥洛他定滴眼液进行治疗,普拉洛芬滴眼液滴眼4次/d,1-2滴/次;奥洛他定滴眼液滴眼2次/d,1-2滴/次,两种药物间隔5 min。两组患者滴药前后症状评分、体征评分及总评分的比较采用两因素重复测量方差分析;两组患者治疗有效率的比较采用卡方检验。结果 294例（588只眼）过敏性结膜炎患者中,季节性过敏性结膜炎84例（168只眼）,发病率为28.57%;常年性过敏性结膜炎104例（208只眼）,发病率为35.37%;春季结膜炎26例（52只眼）,发病率为8.84%;特应性角结膜炎8例（16只眼）,发病率为2.72%;巨乳头性结膜炎18例（36只眼）,发病率为6.12%;接触性结膜炎54例（108只眼）,发病率18.37%。患者症状评分结果为：对照组治疗前症状评分为（10.20±2.86）分,治疗后为30 min为（8.80±3.11）分,治疗后7 d为（4.85±2.23）分,治疗后14 d为（3.85±2.19）分,治疗后各时间段与治疗前比较,差异有统计学意义（t1=4.02,17.89,21.37;P1〈0.05）;实验组治疗前症状评分为（10.80±2.53）分,治疗后为30 min为（8.15±2.65）分,治疗后7 d为（3.93±1.91）分,治疗后14 d为（2.72±1.99）分,治疗后各时间段与治疗前比较,差异有统计学意义（t2=8.77,26.28,30.43;P2〈0.05）。实验组症状评分低于对照组,差异有统计学意义（F=10.20,P〈0.05）。实验组症状评分下降幅度高于对照组,差异有统计学意义（F=6.30,P〈0.05）。患者体征评分结果为：对照组治疗前体征评分为（11.75±3.28）分,治疗后为30 min为（11.30±3.04）分,治疗后7 d为（7.04±2.20）分,治疗后14 d为（5.40±2.10）分,治疗后7 d和14 d与治疗前比较,差异有统计学意义（t1=14.46,19.77;P1〈0.05）;实验组治疗前体征评分为（11.04±4.13）分,治疗后30 min为（10.67±2.82）分,治疗后7 d为（4.46±1.96）分,治疗后14 d为（2.57±1.79）分,治疗后7 d和14 d与治疗前比较,差异有统计学意义（t2=17.45,22.81;P2〈0.05）。实验组体征评分低于对照组,差异有统计学意义（F=15.43,P〈0.05）。实验组体征评分下降幅度高于对照组,差异有统计学意义（F=8.21,P〈0.05）。患者总评分结果为：对照组治疗前总评分为（21.95±3.01）分,治疗后为30 min为（20.10±3.59）分,治疗后7 d为（11.89±3.96）分,治疗后14 d为（9.25±4.18）分,治疗后各时间段与治疗前比较,差异有统计学意义（t1=4.79,24.52,29.90;P1〈0.05）;实验组治疗前总评分为（21.84±3.34）分,治疗后30min为（19.82±3.11）分,治疗后7 d为（8.39±3.39）分,治疗后14 d为（5.29±3.56）分,治疗后各时间段与治疗前比较,差异有统计学意义（t2=5.37,34.27,41.11;P2〈0.05）。实验组总评分低于对照组,差异有统计学意义（F=12.84,P〈0.05）。实验组总评分下降幅度高于对照组,差异有统计学意义（F=7.20,P〈0.05）。患者疗效的统计结果为：对照组和实验组在治疗7 d后的有效率分别为51.70%和65.99%,差异有统计学意义（χ2=6.19,P〈0.05）;治疗14 d后有效率分别为72.11%和85.71%,差异有统计学意义（χ2=8.17,P〈0.05）。结论 0.1%盐酸奥洛他定滴眼液联合0.1%普拉洛芬滴眼液对缓解过敏性结膜炎症状与体征具有显著效果,可提高治疗的有效率,缩短用药时间,无严重不良反应的发生。
Objective To evaluate the outcome of patients with allergic conjunctivitis after a combination treatment with olopatadine and pranoprofen eye drops in comparison with olopatadine monotherapy. Methods A total of 294 patients （588 eyes） with allergic conjunctivitis were randomized to receive a monotherapy （n= 147） or a combination therapy （n = 147 ） in the Department of Ophthalmology, Jinan Eye Hospital between November,2009 and November,2010. In the monotherapy group,patients were treated with 0.1% olopatadine eye drops twice a day for 14 days. In the combination therapy group, patients were treated with 1% olopatadine eye drops twice a day and 0.1% pranoprofen eye drops four times a day for 14 days. The major demographic and clinical variables ,the changes in symptom （including ocular itching and hyperemia） and pathology scores before and after treatment, and the effectiveness rate were comparatively analyzed for the two groups of patients. Results There were no significant differences in the average age, male to female ratio, and proportions of seasonal allergic conjunctivitis, perennial allergic conjunctivitis, vernal keratoconjunctivitis, atopic keratoconjunctivitis and giant papillary conjunctivitis （ P 〉 0.05 ）. The average symptom score was （ 10.20 ± 2. 86 ）, （ 8. 80 ± 3. 11 ）, （ 4. 85 ± 2. 23 ） and （ 3. 85 ± 2. 19 ） in the monotherapy group and was （ 10.80 ±2.53 ）, （ 8. 15 ±2.65 ）, （ 3.93 ± 1.91 ） and （ 2.72 ± 1.99 ） in the combination treatment group, respectively, before treatment and 30 rain,7 days and 14 days after treatment. The average pathology score was （ 11.75±3.28 ）, （ 11.30± 3.04 ）, （7.04± 2.20 ） and （5.40 ± 2.10 ） in the monotherapy group and （11.04±4. 13）, （10. 67±2.82）, （4.46±1.96） and （2.57±1.79） in the combination treatment group, respectively, before treatment and 30 min,7 days and 14 days after treatment. The overall total score was （21.95± 3.01）, （20.10 ± 3.59 ）, （ 11.89±3.96 ） and （9.25 ±4. 18 ） in the monotherapy group and was （21.84± 3.34）, （ 19.82± 3.11 ）, （8.39± 3.39） and （5.29±3.56）, respectively before treatment and 30 min,7 clays and 14 days after treatment. Both monotherapy and combination therapy significantly decreased the symptom, pathology and overall scores in a time-dependent manner （ P〈0. 05） , but the degree of the decrease was significantly higher in the combination therapy group than in the monotherapy group （P〈0.05）. Conclusions Olopatadine and pranoprofen eyes drops in combination may offer a safety and effective treatment for allergic conjunctivitis.
出处
《中华眼科医学杂志（电子版）》
2014年第4期17-23,共7页
Chinese Journal of Ophthalmologic Medicine(Electronic Edition)
作者简介
（Email：nieqiaoli@sohu．com）
