芪明颗粒联合易贝滴眼液对白内障术后干眼的糖尿病患者炎性因子和免疫水平的影响  

Effects of qiming granules combined with yibei eye drops on inflammatory factors and immune levels in diabetic patients with dry eye after cataract surgery

作　　者：郭宇[1] 申勇智 刘丽娜 王丽坤[1] 杜鹏 GUO Yu;SHEN Yongzhi;LIU Lina;WANG Likun;DU Peng(Department of Ophthalmology,the Second Affiliated Hospital of Hebei North University,Zhangjiakou,075100,Hebei,China;Department of Ophthalmology,Xuanhua District People’s Hospital,Zhangjiakou 075100,Hebei,China;Department of Ophthalmology,the Fourth Hospital of Zhangjiakou,Zhangjiakou 075000,Hebei,China)

机构地区：[1]河北北方学院附属第二医院眼科,河北张家口075100 [2]宣化区人民医院五官科,河北张家口075100 [3]张家口市第四医院眼科,河北张家口075000

出　　处：《贵州医科大学学报》2021年第2期227-231,242,共6页Journal of Guizhou Medical University

基　　金：河北省科技厅健康医疗与生物医药专项重点研发计划项目(172777116)。

摘　　要：目的观察芪明颗粒联合易贝滴眼液对白内障术后干眼的糖尿病患者炎性因子和免疫水平的影响。方法白内障术后发生干眼的糖尿病患者172例(172眼),随机均为对照组(n=43,玻璃酸钠眼液治疗)与联合组(n=43,易贝+芪明颗粒治疗)、易贝组(n=43,易贝滴眼液治疗)、芪明组(n=43,芪明颗粒治疗),连续治疗4周;比较4组患者治疗总有效率及治疗前后的干眼症评分、泪液分泌试验(SIt)、泪膜破裂时间(BUT)及角膜荧光染色(FS)检测值,比较4组患者治疗前后眼泪中肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)的水平的及外周血CD3^+、CD4^+、CD8^+及CD4^+/CD8^+。结果联合组的治疗总有效率高于易贝组、芪明组及对照组(P<0.05);治疗后,4组患者干眼症状评分、FS评分、泪液中TNF-α和IL-6水平、外周血的CD8+均低于治疗前,BUT、Sit及外周血CD3^+、CD4^+、CD4^+/CD8^+高于治疗前,联合组变化显著大于易贝组、芪明组及对照组,差异有统计学意义(P<0.05)。结论芪明颗粒联合易贝滴眼液治疗糖尿病白内障术后干眼疗效优于单一的芪明颗粒或易贝滴眼液,其机制可能与抑制术后眼部炎症反应及改善免疫水平有关。Objective To observe the effect of qiming granules combined with yibei eye drops on inflammatory factors and immune levels in diabetic patients with dry eye after cataract surgery.Methods One hundred and seventy two diabetic patients( 172 eyes) with dry eyes after cataract surgery were randomly divided into control group( n = 43, sodium hyaluronate treatment) and combination group( n = 43,yibei + qiming granule treatment),yibei group( n = 43,yibei eye drop treatment),qiming group( n = 43,qiming granule treatment). The treatment lasted continuously for 4 weeks. The total treatment efficacy rate,the score of dry eye symptom,Schirmer I test( SIt),tear film breakup time( BUT) and corneal fluorescence staining( FS) detection values were compared before and after treatment in 4 groups. The levels of tumor necrosis factor-α( TNF-α) and interleukin-6( IL-6) in tears,the percentages of CD3^+,CD4^+,CD8^+,and the ratio of CD4^+/CD8^+in peripheral blood were compared before and after treatment in four groups. Results The total effective rate of treatment in the combined group was higher than that of the yibei,qiming,and the control groups( P < 0. 05). After treatment,the scores of dry eye symptom,FS score,the levels of tear TNF-α and IL-6,peripheral blood CD8+were lower than those before treatment,in contrast,BUT,SIt,and peripheral blood CD3^+,CD4^+,CD4^+/CD8^+were higher than those before treatment. The changes in the combination group were significantly greater than the yibei,qiming and the control groups( P < 0. 05). Conclusion Qiming granule combined with yibei eye drops is better than a single qiming granule or yibei eye drops in treating dry eyes of diabetic patients after cataract surgery.The mechanism may be related to the suppression of postoperative ocular inflammation and improvement of immune level.

关 键 词：糖尿病 白内障 免疫 芪明颗粒 易贝眼液 干眼 

分 类 号：R776.1[医药卫生—眼科]