杞菊地黄汤内服联合睑板腺按摩对脂质缺乏型干眼症的临床效果及对泪液IL-1β、TGF-β1水平的影响  

Clinical effect of Qiju Dihuang Decoction orally combined with meibomian gland massage on dry eye with lipid deficiency and its effect on the levels of tear IL-1β and TGF-β1

作　　者：郑玛丽[1] 徐清妍 朱晓燕 郭连春 ZHENG Mali;XU Qingyan;ZHU Xiaoyan;GUO Lianchun(Ophthalmology Department,Xiamen Hospital of Traditional Chinese Medicine,Xiamen 361009,China)

机构地区：[1]福建省厦门市中医院眼科

出　　处：《中华灾害救援医学》2020年第3期155-159,共5页Chinese Journal of Disaster Medicine

摘　　要：目的探讨杞菊地黄汤内服联合睑板腺按摩对脂质缺乏型干眼症(lipid tear deficiency,LTD)的临床效果及对泪液白细胞介素-1β(interleukin-1β,IL-1β)、转化生长因子-β1(transforming growth factor-β1,TGF-β1)水平的影响。方法选取2018-02至2019-05于福建省厦门市中医院眼科就诊的LTD患者106例,按照随机数字表法分为对照组和观察组,各53例,对照组采用单纯睑板腺按摩治疗,观察组采用杞菊地黄汤内服联合睑板腺按摩治疗,均治疗4个疗程。分别于治疗前、后对两组患者进行如下指标检测:泪膜破裂时间(tear break-up time,TBUT)评分、基础泪液分泌试验(schirmer I test,SIT)评分、角膜荧光素染色(fluorescent,FL)评分、眼表疾病指数(ocular surface disease index,OSDI)评分、睑板腺分泌物性状(meibomian gland yielding liquid secretion,MGYSS)评分、眼睑睑缘形态(eyelid margin abnormality score,EMAS)评分,泪液IL-1β、TGF-β1水平变化,以及临床疗效和安全性评价。结果治疗后,两组患者TBUT、SIT、FL、OSDI、MGYSS以及EMAS评分均较治疗前降低,且观察组显著低于对照组,差异具有统计学意义(P<0.05);两组患者的泪液IL-1β水平均明显降低,而TGF-β水平均明显增高,且观察组泪液IL-1β水平显著低于对照组,TGF-β水平显著高于对照组,观察组治疗总有效率显著高于对照组,差异均具有统计学意义(P<0.05)。两组患者治疗期间均无明显不良反应发生。结论杞菊地黄汤联合睑板腺按摩治疗LTD患者可有效改善脂质分泌功能,促进泪液分泌,显著改善炎性因子TNF-α、IL-6的表达水平,有助于提高临床疗效。Objective To explore the clinical effect of Qiju Dihuang Decoction combined with meibomian gland massage on dry eyes with lipid deficiency and its effect on the levels of tear IL-1β and TGF-β1.Methods 106 cases of lipid tear deficiency(LTD)treated in our ophthalmology department from February 2018 to May 2019 were divided into the control group and the observation group,with 53 cases in each group.The control group was treated with meibomian gland massage alone,and the observation group was treated with Qiju Dihuang decoction combined with meibomian gland massage.After 4 courses of treatment,the following indicators were measured before and after treatment in the two groups:tear break-up time(TBUT)score,schirmer I test(SIT)score,corneal fluorescein staining(FL)score,ocular surface disease index(OSDI)score,meibomian gland yielding liquid secretion(MGYSS)score,eyelid margin abnormality score(EMAS)score,changes in tear IL-1β,TGF-β1 levels,and clinical efficacy and safety evaluation.Results After treatment,the TBUT,SIT,FL,OSDI,MGYSS,and EMAS scores of the two groups were lower than those before treatment,and the observation group was significantly lower than the control group,the differences were statistically significant(P<0.05);The levels of tear IL-1βin the later tears were significantly reduced,while the levels of TGF-βwere significantly increased,and the levels of tear IL-1βin the observation group were significantly lower than those in the control group,and the levels of TGF-βwere significantly higher than those in the control group.The efficiency of observation group was significantly higher than that of the control group,and the differences were statistically significant(P<0.05).There was no significant adverse reactions occurred during the treatment of the two groups of patients.Conclusions Qiju Dihuang Decoction combined with meibomian gland massage can effectively improve the function of lipid secretion,promote the secretion of tears,significantly reduce the level of TNF-α,IL-6,which is helpful to

关 键 词：脂质缺乏型干眼症 杞菊地黄汤 睑板腺按摩 转化生长因子-β1 白细胞介素-1Β 

分 类 号：R777.34[医药卫生—眼科]