Vajpayee R B, Dhakal B P, Gupta S K, Sachdev M S, Satpathy G, Honavar S G, Panda A
Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Aust N Z J Ophthalmol. 1996 May;24(2):131-5. doi: 10.1111/j.1442-9071.1996.tb01567.x.
The management protocol for herpetic stromal keratitis (HSK) is still controversial. We have attempted to compare the relative efficacy of topical dexamethasone 0.01% and flurbiprofen 0.03% in combination with topical acyclovir 3% in HSK.
In this institutional, prospective, randomized, controlled, double-blind study, 45 clinically diagnosed cases of HSK were randomly distributed into three coded treatment groups--topical placebo, dexamethasone 0.01%, and flurbiprofen 0.03% each in tapering frequency and in combination with acyclovir 3% ointment five times per day for four weeks. Therapeutic response was assessed every third day for four weeks. Decoding of the treatment groups was done at the conclusion of the study and data analysed.
Four-week success rate was 93.3% (14 of 15) in the dexamethasone-acyclovir treatment group, 66.7% (10 of 15) in the flurbiprofen-acyclovir treatment group and 20% (3 of 15) in the placebo-acyclovir treatment group.
While dexamethasone in combination with acyclovir gives the best results in HSK with minimal side-effects, the role of topical flurbiprofen seems promising.
疱疹性基质性角膜炎(HSK)的治疗方案仍存在争议。我们试图比较0.01%的局部用 dexamethasone和0.03%的氟比洛芬与3%的局部用阿昔洛韦联合使用对HSK的相对疗效。
在这项机构性、前瞻性、随机、对照、双盲研究中,45例临床诊断为HSK的病例被随机分为三个编码治疗组——局部用安慰剂组、0.01%的dexamethasone组和0.03%的氟比洛芬组,每组用药频率逐渐递减,并与3%的阿昔洛韦软膏联合使用,每天5次,持续4周。在4周内每3天评估一次治疗反应。研究结束时对治疗组进行解码并分析数据。
dexamethasone - 阿昔洛韦治疗组的4周成功率为93.3%(15例中的14例),氟比洛芬 - 阿昔洛韦治疗组为66.7%(15例中的10例),安慰剂 - 阿昔洛韦治疗组为20%(15例中的3例)。
虽然dexamethasone与阿昔洛韦联合使用在HSK治疗中效果最佳且副作用最小,但局部用氟比洛芬的作用似乎很有前景。