|
|
双氯芬酸钠联合玻璃酸钠治疗干眼的Meta分析
|
Abstract:
目的：系统分析双氯芬酸钠滴眼液联合玻璃酸钠滴眼液与单纯玻璃酸钠滴眼液治疗干眼的临床疗效对比。方法：利用计算机检索PubMed、Cochrane Library、万方数据库、中国知网等数据库，检索文献发表时间从2013-01至2021-01。独立完成对检索到的文献的筛选、评价和数据提取，对治疗后BUT、SIT、FL及干眼症状评分的数据应用Excel软件进行归纳统计，使用RevMan5.4软件完成Meta分析。结果：最终总纳入7篇文献，均为中文文献，共包括患者738例；Meta分析结果显示：双氯芬酸钠滴眼液联合玻璃酸钠滴眼液治疗干眼后能有效延长泪膜破裂时间(BUT) [MD = 2.07, 95% CI (1.06~3.07), P < 0.00001]，联合治疗后的泪液分泌量(Schirmer I test, SIT) [MD = 2.92, 95% CI (1.38~4.47), P < 0.00001]明显优于单纯应用玻璃酸钠滴眼液，并且能降低角膜荧光染色评分/分(FL)以及干眼症状评分。结论：双氯芬酸钠滴眼液联合玻璃酸钠滴眼液在治疗干眼的总体临床疗效上更具优势。
Objective: The clinical effect of diclofenac sodium eye drops combined with sodium hyaluronate eye drops and sodium hyaluronate eye drops in the treatment of dry eyes was compared systematically. Methods: PubMed, Cochrane Library, Wanfang database and CNKI were searched by computer, and the publication time was from January 2013 to January 2021. The screening, evaluation and data extraction of the retrieved literature were completed independently. The data of BUT, SIT, FL and dry eye symptom score after treatment were summarized and statistically analyzed using Excel software, and meta-analysis was completed using RevMan5.4 software. Results: A total of 7 litera-tures were included, all in Chinese, including 738 patients. The results of meta-analysis showed that diclofenac sodium eye drops combined with sodium hyaluronate eye drops could effectively prolong the tear film rupture time after the treatment of dry eyes (BUT) [MD = 2.07, 95% CI (1.06~3.07), P < 0.00001]. The tear secretion (Schirmer I test, SIT) [MD = 2.92, 95% CI (1.38~4.47), P < 0.00001] af-ter combined treatment was significantly better than sodium hyaluronate eye drops alone, and could reduce corneal fluorescence staining score/score (FL) and dry eye symptom score. Conclusion: Diclofenac sodium eye drops combined with sodium hyaluronate eye drops have more advantages in the overall clinical efficacy of dry eye.
| [1] | Vandermeer, G., Chamy, Y. and Pisella, P.J. (2018) Comparison of Objective Optical Quality Measured by Double-Pass Aberrometry in Patients with Moderate Dry Eye: Normal Saline vs. Artificial Tears: A Pilot Study. Journal Fran？ais d’Ophtalmologie, 41, 238-245. https://doi.org/10.1016/j.jfo.2017.12.001 |
| [2] | Craig, J.P., Nichols, K.K., Akpek, E.K., et al. (2017) TFOS DEWS II Definition and Classification Report. The Ocular Surface, 15, 276-283. https://doi.org/10.1016/j.jtos.2017.05.008 |
| [3] | Mertzanis, P., Abetz, L., Rajagopalan, K., et al. (2005) The Relative Burden of Dry Eye in Patients’ Lives: Comparisons to a U.S. Normative Sample. Investigative Ophthalmology & Visual Science, 46, 46-50.
https://doi.org/10.1167/iovs.03-0915 |
| [4] | 赵堪兴, 杨培增. 眼科学[M]. 第8版. 北京: 人民卫生出版社, 2013. |
| [5] | Rouen, P.A. and White, M.L. (2018) Dry Eye Disease: Prevalence, Assessment, and Management. Home Healthcare Now, 36, 74-83. https://doi.org/10.1097/NHH.0000000000000652 |
| [6] | 刘祖国, 谢立信, 孙旭光, 等. 干眼临床诊疗专家共识(2013年) [J]. 中华眼科杂志, 2013, 49(1): 73-75. |
| [7] | Jurja, S., Negreanu-Pirjol, T., Vasile, M., et al. (2022) Comparative Antioxidant Activity of Various Ophthalmic Product Types for Artificial Tears under Dif-ferent Experimental Conditions. Experimental and Therapeutic Medicine, 23, Article No. 330. https://doi.org/10.3892/etm.2022.11259 |
| [8] | Marshall, L.L. and Roach, J.M. (2016) Treatment of Dry Eye Disease. The Consultant Pharmacist, 31, 96-106.
https://doi.org/10.4140/TCP.n.2016.96 |
| [9] | 刘荣, 李娜, 师玉红, 等. 联合应用玻璃酸钠滴眼液与双氯芬酸钠滴眼液治疗干眼症的效果分析[J]. 当代医药论丛, 2015, 13(3): 195-196. |
| [10] | 李娟. 双氯芬酸钠联合玻璃酸钠治疗干眼症的疗效探究[J]. 中国实用医药, 2020, 15(16): 132-133. |
| [11] | 毛蕾, 刘春兰, 周琼. 双氯芬酸钠滴眼液联合玻璃酸钠滴眼液治疗干眼症的疗效[J]. 实用临床医学, 2016, 17(1): 51-52. |
| [12] | 王丹, 万奇, 杜慧斌, 等. 双氯芬酸钠眼液联合玻璃酸钠眼液治疗干眼的临床分析[J]. 中医眼耳鼻喉杂志, 2018, 8(4): 209-213. |
| [13] | 申英伟. 双氯芬酸钠滴眼液联合玻璃酸钠滴眼液治疗干眼的临床观察[J]. 临床研究, 2021, 9(36): 96-97. |
| [14] | 肖楚钦. 双氯芬酸钠联合玻璃酸钠治疗干眼症的疗效探究[J]. 北方药学, 2019, 16(10): 35-36. |
| [15] | 谢科军. 玻璃酸钠联合双氯芬酸钠治疗干眼症的疗效分析[J]. 健康研究, 2013, 33(5): 361-363. |
| [16] | Huang, C.H., Liu, Z.G., Zhang, M.C., et al. (2021) Efficacy of a Recombinant Bovine Basic Fibroblast Growth Factor Gel for the Treatment of Moderate Dry Eye: A Multicenter Randomized Double-Blind Parallel Controlled Clinical Trial. Chinese Journal of Ophthalmology, 57, 930-938. |
| [17] | 蒋鹏飞, 黎冬冬, 彭俊, 等. 干眼症患者泪液炎症因子与症状体征相关性研究[J]. 国际眼科杂志, 2020, 20(4): 699-702. https://doi.org/10.3980/j.issn.1672-5123.2020.4.27 |
| [18] | O’Neil, E.C., Henderson, M., Massaro-Giordano, M. and Bunya, V.Y. (2019) Advances in Dry Eye Disease Treatment. Current Opinion in Ophthal-mology, 30, 166-178. https://doi.org/10.1097/ICU.0000000000000569 |
| [19] | Small, R.E. (1989) Diclofenac Sodium. Clinical Pharmacology, 8, 545-58. |
| [20] | Shirai, K. and Saika, S. (2015) Ocular Surface Mucins and Local Inflamma-tion—Studies in Genetically Modified Mouse Lines. BMC Ophthalmology, 15, Article No. 154. https://doi.org/10.1186/s12886-015-0137-5 |
| [21] | Altman, R., Bosch, B., Brune, K., et al. (2015) Advances in NSAID Development: Evolution of Diclofenac Products Using Pharmaceutical Technology. Drugs, 75, 859-877. https://doi.org/10.1007/s40265-015-0392-z |
| [22] | 田歌, 钟舒阳, 彭崇信, 等. 氯雷他定联合双氯芬酸钠滴眼液治疗过敏性结膜炎的临床价值[J]. 国际眼科杂志, 2021, 21(3): 421-425. |
| [23] | Chiambaretta, F., Creuzot-Garcher, C., Pilon, F., et al. (2004) Intérêt d’une nouvelle formulation de diclofénac sans conservateur pour la surface oculaire [Ocular Tolerance of a New Formulation of Nonpreserved Diclofenac]. Journal Fran？ais d’Ophtalmologie, 27, 739-744. https://doi.org/10.1016/S0181-5512(04)96208-0 |
| [24] | Jafariazar, Z., Jamalinia, N., Ghorbani-Bidkorbeh, F., et al. (2015) Design and Evaluation of Ocular Controlled Delivery System for Diclofenac Sodium. Iranian Journal of Phar-maceutical Research, 14, 23-31. |
| [25] | 赵永峰. 滋肾养肝润目汤联合玻璃酸钠滴眼液治疗角结膜干燥症临床疗效[J]. 西部中医药, 2019, 32(9): 85-88. |
| [26] | 高鹏, 王建民. 不同人工泪液缓解白内障超声乳化术后干眼症状的效果[J]. 国际眼科杂志, 2019, 19(9): 1475-1478. |
| [27] | 李晓静, 赵桂秋, 姜楠. 人工泪液与重组人表皮生长因子衍生物眼液对翼状胬肉术后干眼疗效观察[J]. 中国实用眼科杂志, 2010, 28(3): 286-288. |
| [28] | 薛慧. 玻璃酸钠滴眼液联合贝复舒滴眼液治疗干眼症的疗效观察[J]. 中国现代药物应用, 2021, 15(1): 196-198. |
| [29] | 刘祖国. 干眼[M]. 北京: 人民卫生出版社, 2017. |
| [30] | 陆海, 马一平. 干眼症的临床治疗进展[J]. 天津药学, 2020, 32(4): 62-66. |
| [31] | 周丽颖. 干眼诊疗简况[J]. 实用中医内科志, 2016, 30(2): 102-103, 122. |
