目的：探讨曲伏前列腺素与甲磺酸倍他司汀联合治疗在开角型青光眼中的协同作用，特别是在眼压控制、视神经保护、炎症抑制及氧化应激方面的效果。方法：本研究为前瞻性、随机、对照、开放标签的单中心临床试验，纳入82例开角型青光眼患者，分别随机分为曲伏前列腺素单药组和联合治疗组。通过12个月的随访，观察两组患者的眼压（IOP）、视神经纤维层厚度（RNFL）、眼部血流动力学（PSV、EDV、RI、PI）、炎症因子（TNF-α、IL-6）以及生活质量和临床症状评分的变化。结果：联合治疗组在所有时间点的眼压显著低于单药组（p < 0.05），12个月时两组眼压差异更为显著。联合治疗组的RNFL减少速度显著低于单药组（p < 0.05），表明其对视神经的保护效果更好。血流动力学参数显示，联合治疗组的PSV和EDV在12个月时显著高于单药组，而RI和PI显著降低（p < 0.05）。在炎症因子方面，联合治疗组的TNF-α和IL-6浓度显著低于单药组（p < 0.05）。此外，联合治疗组的生活质量得分和VAS评分均显著优于单药组（p < 0.05）。结论：曲伏前列腺素与甲磺酸倍他司汀联合治疗在开角型青光眼患者中的协同作用显著，具有更好的眼压控制、视神经保护及炎症和氧化应激抑制效果，可为青光眼的综合治疗提供新的临床参考。

Objective: To investigate the synergistic effect of combined treatment with tafluprost and betahistine mesylate in open-angle glaucoma, particularly in terms of intraocular pressure (IOP) control, optic nerve protection, inflammation suppression, and oxidative stress reduction. Methods: This study was a prospective, randomized, controlled, open-label, single-center clinical trial that enrolled 82 patients with open-angle glaucoma. The patients were randomly divided into a tafluprost monotherapy group and a combination therapy group. Through 12 months of follow-up, changes in IOP, retinal nerve fiber layer (RNFL) thickness, ocular hemodynamics (PSV, EDV, RI, PI), inflammatory markers (TNF-α, IL-6), as well as quality of life and clinical symptom scores, were observed in both groups. Results: The IOP in the combination therapy group was significantly lower than in the monotherapy group at all time points (p < 0.05), with a more pronounced difference at 12 months. The rate of RNFL reduction was significantly slower in the combination therapy group compared to the monotherapy group (p < 0.05), indicating better optic nerve protection. Hemodynamic parameters showed that PSV and EDV were significantly higher in the combination therapy group at 12 months, while RI and PI were significantly lower (p < 0.05). In terms of inflammatory markers, TNF-α and IL-6 concentrations were significantly lower in the combination therapy group compared to the monotherapy group (p < 0.05). Furthermore, the quality of life scores and VAS scores were significantly better in the combination therapy group (p < 0.05). Conclusion: The combination treatment of tafluprost and betahistine mesylate demonstrates a significant synergistic effect in patients with open-angle glaucoma, offering superior IOP control, optic nerve protection, and suppression of inflammation and oxidative stress. This provides new clinical insights for comprehensive glaucoma management.