中西医药物治疗巩膜炎的研究进展
Review on Treatments of Scleritis with Chinese Medicine and Western Medicine

作者: 李超然 , 张殷建 :上海中医药大学附属龙华医院,眼科,上海;

关键词: 巩膜炎火疳中西医治疗Scleritis Episcleritis Chinese and Western Medicine Treatment

摘要: 巩膜炎(scleritis),中医称之为“火疳”,为巩膜组织的炎性反应疾病。因巩膜组织由胶原纤维和少量弹性纤维交错致密排列而成,细胞成分和血管较少,导致该疾病并不常见。然而,由于巩膜代谢缓慢,一旦患病,病程往往迁延难愈。在药物治疗上主要有非甾体抗炎药、甾体抗炎药、皮质类固醇药、免疫抑制剂、生物制剂、中药提取物及中药汤剂。本文归纳了上述药物治疗巩膜炎的给药方式及各自临床疗效,分析其中利弊,为临床医疗工作人员提供医疗证据。

Abstract: Scleritis, also called “episcleritis” in Traditional Chinese Medicine, is an inflammation of sclera tissues. As sclera tissues are compactly composed of collagen fibers and a few of elastic fibers with few cellular constituents and vessels, this disease is uncommon. However, once happened, it has a lingering course due to the slow metabolism of sclera. Drugs mainly include non-steroidal anti-in- flammatory drugs, steroidal anti-inflammatory drugs, corticosteroids, immunosuppressive agent, biological agent, herbal extracts and herbal decoction of Traditional Chinese Medicine. This paper reviewed the administration methods and their clinical effects in treating scleritis with drugs mentioned above, analyzed their advantages and disadvantages, and provided medical evidences for clinical medical staff.

文章引用: 李超然 , 张殷建 (2015) 中西医药物治疗巩膜炎的研究进展。 中医学, 4, 63-68. doi: 10.12677/TCM.2015.43011

参考文献

[1] Ahn, S.J., Oh, J.Y., Kim, M.K., et al. (2010) Clinical features, predisposing factors, and treatment outcomes of scleritis in the Korean population. Korean Journal of Ophthalmology, 24, 331-335.
http://dx.doi.org /10.3341/kjo.2010.24.6.331

[2] 方严, 魏文斌, 陈积中 (2005) 巩膜病学. 北京科技文献出版社, 北京, 163-165.

[3] Jabs, D.A., Mudun, A., Dunn, J.P., et al. (2000) Episcleritis and scleritis: Clinical features and treatment results. American Journal of Ophthalmology, 130, 469-476.

[4] Gangaputra, S., Newcomb, C.W., Liesegang, T.L., et al. (2009) Methotrexate for ocular inflammatory diseases. Ophthalmology, 116, 2188-2198.
http://dx.doi.org /10.1016/j.ophtha.2009.04.020

[5] 刘思伟, 杨戈, 张林, 等 (2005) 巩膜炎治疗的一种新方法: 干扰素的应用. 国际眼科杂志, 4, 693-695.

[6] Sen, H.N., Sangave, A., Hammel, K., et al. (2009) Infliximab for the treatment of active scleritis. Canadian Journal of Ophthalmology, 44, e9-e12.
http://dx.doi.org /10.3129/i09-061

[7] Levy-Clarke, G., Jabs, D.A., Read, R.W., et al. (2014) Expert panel recommendations for the use of anti-tumor necrosis factor biologic agents in patients with ocular inflammatory disorders. Ophthalmology, 121, 785-796.
http://dx.doi.org /10.1016/j.ophtha.2013.09.048

[8] Damento, G., Kavoussi, S.C., Materin, M.A., et al. (2014) Clinical and histologic findings in patients with uveal melanomas after taking tumor necrosis factor-α inhibitors. Mayo Clinic Proceedings, 89, 1481-1486.
http://dx.doi.org /10.1016/j.mayocp.2014.08.012

[9] Bogdanic-Werner, K., Fernandez-Sanz, G., Alejandre, A.N., et al. (2013) Rituximab therapy for refractory idiopathic scleritis. Ocular Immunology & Inflammation, 21, 329-332.
http://dx.doi.org /10.3109/09273948.2013.788724

[10] Athanasiadis, Y., Tsatsos, M., Sharma, A., et al. (2013) Subconjunctival triamcinolone acetonide in the management of ocular inflammatory disease. Journal of Ocular Pharmacology & Therapeutics the Official Journal of the Association for Ocular Pharmacology & Therapeutics, 29, 516-522.
http://dx.doi.org /10.1089/jop.2012.0208

[11] Rachitskaya, A., Mandelcorn, E.D. and Albini, T.A. (2010) An update on the cause and treatment of scleritis. Current Opinion in Ophthalmology, 21, 463-467.
http://dx.doi.org /10.1097/ICU.0b013e32833f1060

[12] Zamir, E., Read, R.W., Smith, R.E., Wang, R.C. and Rao, N.A. (2002) A prospective evaluation of subconjunctival injection of triamcinolone acetonide for resistant anterior scleritis. Ophthalmology, 109, 798-805.
http://dx.doi.org /10.1016/S0161-6420(01)01018-1

[13] Albini, T.A., Ehud, Z., Read, R.W., Smith, R.E., See, R.F. and Rao, N.A. (2005) Evaluation of subconjunctival triamcinolone for nonnecrotizing anterior scleritis. Ophthal-mology, 112, 1814-1820.

[14] Roufas, A., Jalaludin, B., Gaskin, C. and McCluskey, P. (2010) Subconjunctival triam-cinolone treatment for non-ne- crotising anterior scleritis. British Journal of Ophthalmology, 94, 743-747.
http://dx.doi.org /10.1136/bjo.2009.164962

[15] Sohn, E.H., Wang, R., Read, R., Roufas, A., Teo, L., Moorthy, R., et al. (2011) Long-term, multicenter evaluation of subconjunctival injection of triamcinolone for non-necrotizing, noninfectious anterior scleritis. Ophthalmology, 118, 1932-1937.
http://dx.doi.org /10.1016/j.ophtha.2011.02.043

[16] 周云清 (2011) 雷公藤片治疗巩膜炎的临床疗效分析. 中国医药指南, 12, 137-138.

[17] 邢杰, 曹丽杰, 赵艳辉 (2007) 雷公藤片治疗巩膜炎18例. 临床军医杂志, 2, 176.

[18] 卞伟国 (2013) 雷公藤片治疗巩膜炎的疗效. 求医问药: 学术版, 1, 356.

[19] 邱敏 (2014) 雷公藤片的临床应用及不良反应文献研究评析. 临床医药文献电子杂志, 4, 566-567.

[20] 赵俊生 (2013) 华蟾素局部注射为主治疗结节性表层巩膜炎. 中国当代医药, 1, 179-180.

[21] 王婷婷, 徐国兴 (2009) 华蟾素诱导兔晶状体上皮细胞凋亡的研究. 中华眼科杂志, 8, 752-755.

[22] 王捷, 李宁泽, 刘志敏 (2001) 鱼腥草注射液超声雾化熏眼治疗外眼病的疗效观察. 中医药学报, 1, 20.

[23] 巨磊 (2010) 中西医结合治疗巩膜炎39例临床观察. 江苏中医药, 10, 37-39.

[24] 魏国英 (2009) 中西医结合治疗前巩膜炎21例临床观察. 内蒙古中医药, 14, 20.

[25] 孔祥蕴 (2004) 中西医结合治疗浅层巩膜炎34例. 河南中医, 5, 48.

[26] 童牧 (2001) 中西医结合治疗深层巩膜炎. 吉林中医药, 1, 42-43.

[27] 李杰 (2007) 小柴胡汤临床治验. 陕西中医, 9, 1239.

分享
Top