| Objective: By observing the efficiency of compound muyanning decoction(plus or minus with syndrome)on acute phase protein and ACA-Ig G in peripheral blood of patients with HLA-B27 positive anterior uveitis,to explore its clinical efficacy and mechanism.Methods: Forty cases with HLA-B27 positive anterior uveitis were randomly divided into two groups: control group was given tobramycinmison eye drops,pranoprofen eye drops and compound tropicamide eyedrops,according to the degree of ocular inflammation and the pupil state of the patients,the times of medication were gradually decreased.The treatment group was treated with eye drops combined with compoud muyanning decoction.The visual function,ocular inflammation score,acute phase protein and ACA-Ig G of 20 eyes in each group were observed before treatment and 7d ? 14 d ?21d and 28 d after treatment.SPSS 20.0 software was used for statistical analysis.Result: 1.There was no significant difference in visual function between two groups before treatment(p > 0.05).On the 7d ? 14 d ? 21 d and 28 d after treatment,the visual function of the treatment group was improved continuously,there was significant difference in each time period in the treatment group,and there was significant difference between the treatment group and the control group(p < 0.001 or p < 0.05);The visual function of the control group was also improved after treatment,however,the changes were more obvious at 7d and 14d(p < 0.001),but there was no significant difference between 21d?28d and 14d(p > 0.05).2.There was no significant difference in inflammatory score,c-reactive protein and hypersensitive c-reactive protein between the two groups before treatment(p > 0.05).After 7d ?14d ? 21 d and 28 d,the three indicators of the treatment group decreased continuously,there were significant differences between the two groups(p < 0.001 or p < 0.05),and the three indicators of the control group also decreased after treatment,but the changes were moreobvious on the 7d and 14d(p < 0.001),there was no significant difference between 21d?28d and 14d(p > 0.05).3.There was no significant difference in fibrinogen between two groups before treatment(p>0.05).On the 7d ? 14 d ? and 28 d after treatment,the fibrinogen in the treatment group decreased continuously,there was significant difference among the time periods within the group,and there was significant difference between the treatment group and the control group on14 d and 28 d after treatment(p<0.05);Fibrinogen was also decreased in the control group after treatment,however,the changes of fibrinogen were more obvious on 28d(p < 0.001),and there was no significant difference in fibrinogen level between 7d?14d and before treatment.(p > 0.05).4.There was no significant difference in ACA-Ig G between the two groups before treatment(p > 0.05).On the 7d ?14d ?and 28 d after treatment,the ACA-Ig G of the treatment group decreased continuously,there was significant difference among the time periods within the group,and there were significant differences between the treatment group and the control group on the 14 d ? and 28 d after treatment(p<0.05),the ACA-Ig G in the control group did not decrease significantly after treatment,there was no significant difference between before and after treatment on the 7d ?14d?and28d(p > 0.05).5.For patients with different TCM syndromes of HLA-B27 positive anterior uveitis,after 1 treatment cycle,the difference in efficacy between the treatment group and the control group was statistically significant in Feng Shi Jia Re type、burning-heat in the liver and gallbladder type and wind-heat type of liver meridian.(P < 0.001 or P < 0.05).Conclusion: 1.The changes of visual function,inflammation score,c-reactive protein,hypersensitive c-reactive protein,fibrinogen and ACA-Ig G in HLA-B27 positive anterior uveitis group treated with traditional Chinese medicine and routine western medicine were significantly better than those incontrol group,the total effective rate is higher than the western medicine treatment alone.2.Compound muyanning decoction can effectively improve the visual function of patients with HLA-B27 positive anterior uveitis,reduce the inflammatory reaction of eyes,improve clinical symptoms and signs,and the curative effect is more lasting than that of the control group,the mechanism may be related to decrease acute phase protein,ACA-Ig G and regulate the release of inflammatory mediators.3.In this study,feng shi jia re type was the most common type of TCM syndromes,followed by burning-heat in the liver and gallbladder type and wind-heat type of liver meridian,with fire excess from yin deficiency type taking the least proportion.Among the first three common syndromes,the TCM treatment group was superior to the western medicine treatment group. |
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