目的 探讨复明颗粒联合盐酸卡替洛尔滴眼液治疗开角型青光眼的临床疗效。方法 选取2022年6月—2024年6月首都医科大学附属北京友谊医院收治的开角型青光眼患者108例，按随机数字表法分为对照组和治疗组，每组各54例。对照组给予盐酸卡替洛尔滴眼液，1滴/次，2次/d。在对照组基础上，治疗组口服复明颗粒，1袋/次，3次/d。两组治疗4周。观察两组临床疗效，比较治疗前后两组患者的眼压、视野平均缺损（MD）和标准对数视力（lgMAR视力），17条目青光眼生活质量量表（Glau-QoL17）和简式抑郁-焦虑-压力量表（DASS-21）评分，眼动脉血流指标平均血流速度（V_m）、搏动指数（PI）和阻力指数（RI），及血清基质金属蛋白酶-2（MMP-2）、内皮素-1（ET-1）和肿瘤坏死因子-α（TNF-α）水平。结果 治疗后，治疗组总有效率明显高于对照组（94.44% vs 81.48%，P＜0.05）。治疗后，两组眼压、视野MD和lgMAR视力均显著降低（P＜0.05），且治疗组下降更明显（P＜0.05）。治疗后，两组患者Glau-QoL17评分显著升高，而DASS-21评分显著降低（P＜0.05），且治疗组评分明显好于对照组（P＜0.05）。治疗后，两组患者眼动脉V_m显著加快，而PI、RI显著降低（P＜0.05），且治疗组眼动脉血流指标变化明显好于对照组（P＜0.05）。治疗后，两组血清MMP-2、ET-1和TNF-α水平均明显低于同组治疗前（P＜0.05），且治疗组血清因子水平明显低于对照组（P＜0.05）。结论 在盐酸卡替洛尔滴眼液基础上联合复明颗粒治疗开角型青光眼的安全性良好，能有效促进患者眼部血流调节与眼压控制，降低炎症损伤及眼组织功能障碍，使患者情绪状态和生活质量得到明显改善。

Objective To investigate the clinical efficacy of Fuming Granules combined with Carteolol Hydrochloride Eye Drops in treatment of open-angle glaucoma. Methods Patients (108 cases) with open-angle glaucoma in Beijing Friendship Hospital, Capital Medical University from June 2022 to June 2024 were divided into control and treatment group according to random number table method, and each group had 54 cases. Patients in control group were administered with Carteolol Hydrochloride Eye Drops, 1 drop/time, twice daily. Patients in treatment group were po administered with Fuming Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluations were evaluated, and the intraocular pressure, visual field MD, and lgMAR visual acuity, the scores of Glau-QoL17 and DASS-21, ophthalmic artery blood flow indicators V_m, PI and RI, the levels of MMP-2, ET-1 and TNF-α in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was significantly higher than that in the control group (94.44% vs 81.48%, P < 0.05). After treatment, intraocular pressure, visual field MD and lgMAR visual acuity were significantly reduced in two groups (P < 0.05), and the decrease was more significant in the treatment group (P < 0.05). After treatment, the Glau-QoL17 score in two groups was significantly increased, while the DASS-21 score was significantly decreased (P < 0.05), and the score in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the Vm of ophthalmic artery in two groups was significantly accelerated, while PI and RI were significantly decreased (P < 0.05). The changes of ophthalmic artery blood flow indicators in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the serum MMP-2, ET-1, and TNF-α levels in two groups were significantly lower than those in the same group before treatment (P < 0.05), and the serum factor levels in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion The combination of Carteolol Hydrochloride Eye Drops and Fuming Granules has good safety in treatment of open-angle glaucoma, which can effectively promote blood flow regulation and intraocular pressure control, reduce inflammation damage and eye tissue dysfunction, and significantly improve patients’ emotional state and quality of life.

R988.1

首都卫生发展科研专项课题资助（2022-2-20211）