2型糖尿病证候与干眼关系的临床研究  

Clinical research of relationship between type II diabetes and dry eye

作　　者：宋立[1] 杨亨[1] 

机构地区：[1]北京中医药大学东直门医院眼科,北京100700

出　　处：《中国中医眼科杂志》2009年第4期191-194,共4页China Journal of Chinese Ophthalmology

摘　　要：目的评价2型糖尿病患者不同证候分型的泪膜功能及证型间干眼发生率的差异。方法对122例2型糖尿病患者进行泪膜功能评价、干眼发生率比较。所有病例按照糖尿病证型分为阴虚热盛证、湿热困脾证、气阴两虚证、阴阳两虚并血瘀水停证、血瘀脉络证5组,分别进行干眼症状询问、全身症状询问、泪膜破裂时间(BUT)测定、角膜荧光素染色、基础泪液分泌试验(SchirmerI试验,SIt),根据上述检查结果进行干眼评分,并统计是否符合干眼诊断。结果各组在性别、年龄组成上差异无统计学意义(P>0.05);各组间干眼综合评分,阴虚热盛证分值较高;各组干眼发生率的比较,阴虚热盛证干眼发生率较高;各组BUT检查,阴虚热盛证时间较短;各组基础泪液分泌(SIt)检测,血瘀脉络证SIt较少;各组角膜染色率差异无统计学意义(P>0.05);各组干眼症状比较,阴虚热盛证干眼症状阳性率较高。其中阴虚热盛证与阴阳两虚、血瘀水停证在干眼综合评分及干眼的发生率方面比较差异有统计学意义(P<0.01)。而阴虚热盛证与气阴两虚证之间的差异均无统计学意义。结论阴虚热盛证及气阴两虚证的2型糖尿病患者更容易发生干眼。OBJECTIVE To evaluate the tear film function of type II diabetic patients with different syndrome types and the dry eye incidence of different syndrome types. METHODS Totally 122 patients were studied, which were divided into five groups： Qi and Yin deficiency, damp-heat encumbering the spleen, blood stasis in collateral channels, Yin deficiency and heat excess, Yin and Yang deficiency with blood stasis and water retention. They were asked about dry eye symptoms, systemic symptoms. Tear film function was evaluated by dry eye syndrome, tear breaking up time （BUT）, corneal fluorescein staining （FL）, Schirmer I test （Sit）. Dye eye score was calculated with the results of these tests. RESULTS These groups had no statistical significant difference in gender, age composition（P〉0.05）, Yin deficiency and Heat excess showed higher dry eye scores, shorter BUT, more dry eye syndrome positive rate and more patients diagnosed as dry eye, but similar FL rate. Blood stasis in collateral channels showed less Sit （P〉0.05）. There was extremely significant difference in dry eye scores and incidence between Yin deficiency and heat excess and Yin and Yang deficiency with blood stasis and water retention （P〈0.01）. Yet there was no significant difference between Qi and Yin deficiency and Yin deficiency and heat excess. CONCLUSIONS Type Ⅱ diabetic patients with Yin deficiency and heat excess and Qi and Yin deficiency tend to develop dry eye.

关 键 词：2型糖尿病 干眼 泪膜功能 证候分型 

分 类 号：R777.34[医药卫生—眼科] R587.1[医药卫生—临床医学]