疏肝健脾法联合中药电离子透入对青年干眼患者视功能、泪液分泌和泪液中IL-1β、TNF-α表达的影响  

Effect of soothing liver and activating spleen combined with iontophoresis on the visual function,tear secretion,IL-1β and TNF-α levels of young patients with dry eye syndrome

作　　者：姚贤凤[1] 王利民[1] 陈梅[1] YAO Xian-Feng;WANG Li-Min;CHEN Mei(Department of Ophthalmology,the First Affiliated Hospital of Guiyang College of Traditional Chinese Medicine,Guiyang 550002,Guizhou Province,China)

机构地区：[1]贵阳中医学院第一附属医院眼科,贵州省贵阳市550002

出　　处：《眼科新进展》2019年第2期149-152,共4页Recent Advances in Ophthalmology

基　　金：贵州省科技计划课题基金资助(编号:2012LKZ7055)~~

摘　　要：目的研究疏肝健脾法联合中药电离子透入对青年干眼患者视功能、泪液分泌和泪液中白细胞介素-1β(interleukin-1β,IL-1β)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平的影响。方法选取2016年7月至2018年2月本院收治的100例(200眼)干眼患者作为研究对象,按照随机数字表法将患者随机分为对照组与研究组,每组50例,对照组患者采用逍遥散联合玻璃酸钠滴眼液滴眼治疗,研究组患者采用逍遥散联合中药(决明子)电离子透入治疗。比较两组临床疗效、不良反应情况以及治疗前后视功能、泪液分泌情况和泪液中IL-1β、TNF-α表达水平。结果研究组治疗后总有效率显著(90. 00%)高于对照组(74. 00%)(P <0. 05)。两组治疗前视功能评分比较无明显差异[(67. 92±9. 12)分、(68. 23±8. 26)分](P> 0. 05);两组治疗后视功能评分均高于治疗前,且研究组治疗后视功能评分高于对照组[(84. 56±7. 23)分、(78. 36±7. 24)分](P <0. 05)。研究组与对照组治疗前角膜荧光素染色(FL)评分及泪液分泌试验(SIT)、泪膜破裂时间(BUT)水平比较无明显差异;两组治疗后FL评分低于治疗前,SIT、BUT水平高于治疗前,且研究组治疗后FL评分低于对照组[(0. 91±0. 28)分、(1. 55±0. 26)分],SIT、BUT水平高于对照组[(9. 53±1. 74) mm、(8. 86±1. 58) mm;(11. 25±1. 14) s、(8. 24±1. 58) s](均为P <0. 05)。研究组与对照组治疗前泪液中IL-1β、TNF-α水平比较无明显差异,两组治疗后泪液中IL-1β、TNF-α水平均低于治疗前,且研究组治疗后泪液中IL-1β、TNF-α水平均低于对照组[(27. 23±7. 74)μg·L^(-1)、(35. 86±8. 58)μg·L^(-1);(20. 41±2. 58)ng·L^(-1)、(25. 25±3. 26) ng·L^(-1)](均为P <0. 05)。研究组不良反应总发生率(10. 00%)低于对照组(16. 00%),差异无统计学意义(P> 0. 05)。结论疏肝健脾法联合中药电离子透入治疗青年肝郁脾虚型干眼患者可显著提高临床疗效,改善视功能,增加泪液分Objective To investigate the effect of soothing liver and activating spleen combined with iontophoresis on the visual function,tear secretion,interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)levels of young patients with dry eye syndrome.Methods Totally 100 patients(200 eyes)with dry eye syndrome of liver qi stagnation and spleen deficiency type admitted to our hospital from February 2017 to February 2018 were selected and divided into two groups according to the random number table methods,50 patients in each group.Patients in the control group were treated with Xiaoyao San combined with sodium hyaluronate eye drops,while patients in the study group were treated with Xiaoyao San and iontophoresis.Then the clinical efficacy,adverse reactions,visual function,tear secretion and the expression of IL-1βand TNF-αwere observed and compared in the two group.Results The total effective rate of the study group was significantly higher than that of the control group(90.00%vs.74.00%,P<0.05).The scores of preoperative visual function between the two groups had no difference[(67.92±9.12)vs.(68.23±8.26)](P >0.05),which were lower than that postoperative data(P<0.05).And the postoperative score in the study group(84.56±7.23)were higher than that in the control group(78.36±7.24)(P<0.05).There was no difference in the corneal fluorescein staining(FL)score,SchirmerⅠtest(SⅠT)and tear break-up time(BUT)before treatment.After the treatment,the FL score was decreased,while the SⅠT and BUT were increased in both groups,and both changes were more obvious in the study group than in the control group[(0.91±0.28)vs.(1.55±0.26),(9.53±1.74)mm vs.(8.86±1.58)mm,(11.25±1.14)s vs.(8.24±1.58)s](all P<0.05).There was no difference in the levels of IL-1βand TNF-αin the tears before treatment,and their levels after treatment were lower than the postoperative data after treatment(P<0.05),and the study group was lower than the control group after treatment[IL-1β:(27.23±7.74)μg·L^-1 vs.(35.86±8.58)μg·L^-1;TNF-α:(20

关 键 词：逍遥散 决明子 电离子透入 干眼 临床疗效 

分 类 号：R777.34[医药卫生—眼科]