中国中医眼科杂志2025，Vol.35Issue(9)：834-839,6.DOI:10.13444/j.cnki.zgzyykzz.2025.09.006
结膜瓣转位小梁切除术联合柴姜方对原发性开角型青光眼眼压控制的临床研究
Clinical Study on Transposition of Conjunctival Flap Trabeculectomy Combined with Chaijiang Formula for Intraocular Pressure Control in Primary Open-angle Glaucoma
摘要
Abstract
OBJECTIVE To evaluate the clinical efficacy of transposition of conjunctival flap trabeculectomy combined with Chaijiang Formula in controlling intraocular pressure(IOP)in primary open-angle glaucoma(POAG).METHODS A total of 72 patients(72 eyes)with POAG and poorly controlled IOP by medication,meeting indications for trabeculectomy,were enrolled at the Eye Hospital,China Academy of Chinese Medical Sciences from August 2022 to January 2024.They were randomly divided into an experimental group and a control group,with 36 cases(36 eyes)each.Ultimately,34 cases(34 eyes)in the experimental group and 33 cases(33 eyes)in the control group were included.The experimental group underwent Transposition of Conjunctival Flap Trabeculectomy-assisted trabeculectomy and received oral Chaijiang Formula from 3 days preoperatively to four weeks postoperatively.The control group underwent conventional trabeculectomy.IOP,filtration bleb status,best-corrected visual acuity(BCVA),surgical success rate,and postoperative complications were recorded and statistically analyzed preoperatively and at 7 days,28 days,three months,6 months,and 12 months postoperatively.RESULTS(1)IOP:The comparison of time effect and group effect on intraocular pressure before and after surgery in the two groups showed statistically significant differences(Ftime=164.437,Fgroup=17.083,both P=0.000);however,the interaction effect showed no statistically significant difference(P>0.05).IOP in both groups decreased significantly at all postoperative time points compared to preoperative levels,with statistically significant differences(experimental group:t7 d=-15.912,t28 d=-15.240,t3 mon=-11.120,t6 mon=-14.540,t12 mon=-12.986,all P=0.000;Control group:t7 d=-15.230,t28 d=-13.600,t3 mon=-7.165,t6 mon=-11.650,t12 mon=-9.271,all P=0.000).The experimental group exhibited significantly lower IOP than the control group at 28 days,3 months,6 months,and 12 months postoperatively(t28 d=-2.759,P=0.008;t3 mon=-2.671,P=0.020;t6 mon=-3.014,t12 mon=-3.379,both P=0.000).However,no statistically significant difference in IOP was observed between the experimental group and the control group at 7 days postoperatively(P>0.05).(2)Filtration bleb status:The number of functional filtration blebs in the experimental group was significantly higher than in the control group at 3,6 and 12 months(χ²3 mon=4.446,P=0.035;χ²6 mon=6.793,P=0.009;χ²12 mon=5.607,P=0.018)postoperatively.(3)BCVA:The comparison of time effect and group effect on BCVA before and after surgery in the two groups showed no statistically significant differences(both P>0.05);however,the interaction effect showed a statistically significant difference(Ftime×group=11.371,P=0.000).No significant differences in BCVA were observed between the two groups at any postoperative time point(P>0.05).(4)Surgical success rate:At 12 months postoperatively,the total success rate in the experimental group(91.18%)was higher than that in the control group(69.70%),with a statistically significant(χ²=4.941,P=0.026).(5)Postoperative complications:Complications occurred in 2 cases(5.88%)in the experimental group and 5 cases(15.15%)in the control group,with no statistically significant difference between groups(P>0.05).CONCLUSIONS Transposition of conjunctival flap trabeculectomy combined with Chaijiang Formula effectively reduces long-term postoperative IOP,maintains the function and morphology of functional filtration blebs,and improves the surgical success rate in patients with POAG.关键词
结膜瓣转位小梁切除术/柴姜方/原发性开角型青光眼/小梁切除术/滤过泡Key words
transposition of conjunctival flap trabeculectomy/Chaijiang formula/primary open angle glaucoma/trabeculectomy/filtering bleb分类
医药卫生引用本文复制引用
张伟道,陈杰,李欣,冯俊..结膜瓣转位小梁切除术联合柴姜方对原发性开角型青光眼眼压控制的临床研究[J].中国中医眼科杂志,2025,35(9):834-839,6.基金项目
1国家中医药管理局眼体同调同治重点研究室2中国中医科学院眼科医院院内课题(202004,1011632) （202004,1011632）
