Comparison Of Effectness Of Michelle's Scheme And Triamcinolone Acetomide Retrobular Injection On Thyroid Associated Ophthalmopathy

Objective: Compare the effectness of Michelle scheme and Triamcinolone acetomide retrobular injection on Thyroid associated ophthalmopathy (TAO). To provide a better method for TAO in active course.Methods: A total of 50 TAO patients in active course (unilateral 11 eyes, bilateral 39 eyes) were selected according to clinic activity score (CAS). The patients were divided into two groups in random. In Michelle scheme group, 20mg of prednisone pallets and 0.15g of Ranitidine capsule (2 times/ day)were taken after having meal on 2 , 3 , 5 , 7 morning per week, 20 milligrams Dexamethasone dissolved in 5% glucose(100ml) were taken by vein drop on 3 morning per week, continue for two months. In another group, 20mg Triamcinolone acetomide were taken by retrobular injection once a week for 7 weeks. All the patients took the endocrine professional training at the same time. The clinical effects were compared at the end of the treatment, 1 month and 3 month after the course of treatment.Result: 1)CAS was both reduced (the average score were 3.35±0.86mm and 3.46±0.86mm) after treatment in two groups. The two methods had no significantly difference in reducing CAS (X~2=0. 56, P>0.05).2)The values of patients , degree of exophthalmus and palpebral fissure height in group B were both decreased 1 month and 3 months after therapy, and the average differential values of exophthalmus were 1.04±0.84mm and 1.04±0.85mm(P<0.01),while the average differential values of palpebral fissure height were 1.02±0.86mm and 1.04±0.85mm(P<0.01).3) Through the two stages, the total efficiency of patients visual acuity in group A were 63.2% and 61.1% respectively. The comparison of visual acuity between two gourps was statistically significant (P<0.05).4) Among patients undergone therapy of Michelle's scheme, two women appeared menstrual disorder, five patients suffered central obesity and weight gain. While in the other group, the intraocular pressure of one patient increased.Conclusion: Our therapy scheme can decrease clinical activity sore of TAO,relive the symptoms of ocular surface. In different period, the two methods had significantly difference in visual acuity,degree of exophthalmus and palpebral fissure height(P < 0.05). Each therapy scheme applies to different individual of specific sign.