温肾逍遥汤对围绝经期干眼患者泪液分泌功能及性激素水平的影响  

Clinical research on warming kidney xiaoyao decoction influencing tear secretion and sex hormone level of perimenopausal dry eye

作　　者：杨华[1] 高健生[1] 李华 尹连荣[1] YANG Hua;GAO Jiansheng;LI Hua(Eye Hospital,China Academy of Chinese Medical Sciences,Beijing 100040,China)

机构地区：[1]中国中医科学院眼科医院,北京100040

出　　处：《中国中医眼科杂志》2021年第5期326-330,340,共6页China Journal of Chinese Ophthalmology

基　　金：中国中医科学院自主选题研究项目(ZZ070869)。

摘　　要：目的评价温肾逍遥汤对围绝经期干眼患者泪液分泌功能及性激素水平的影响。方法采用随机双盲双模拟的前瞻性研究,纳入2013年3月—2016年6月门诊围绝经期干眼患者60例(120只眼),随机分为治疗组及对照组,每组30例(60只眼)。治疗组口服温肾逍遥汤颗粒,灭菌用水点眼,对照组口服安慰剂颗粒,聚乙二醇滴眼液点眼。28 d为1个疗程,治疗1个疗程。治疗前后分别进行角膜荧光素钠染色(FL)评分、泪液分泌试验(SIT)、泪膜破裂时间(BUT)、性激素水平、眼部症状及全身症状(KI评分)检查。结果 (1)总有效率:治疗组为86.67%,对照组为60.00%,2组比较差异有统计学意义(χ^(2)=5.963,P=0.030)。(2)症状积分:治疗后组间比较,t=2.286,P=0.026,差异有统计学意义;治疗前后比较,差异均有统计学意义(t治疗组=5.475,t对照组=7.906,均P=0.000)。(3)全身症状指标:治疗后组间KI改善值比较,t=2.129,P=0.038,差异有统计学意义。(4)干眼指标:治疗后组间比较,治疗组优于对照组,差异均有统计学意义(tBUT=-3.017,P=0.003;tSIT=-2.680,P=0.008;tFL=4.933,P=0.000)。治疗前后组内比较,治疗组(tBUT=-9.323,tSIT=-10.554,tFL=18.416,均P=0.000),对照组(tBUT=-4.752,tSIT=-5.185,tFL=13.218,均P=0.000),差异均有统计学意义。(5)性激素水平:治疗后组间比较,治疗组E2升高水平高于对照组(t=2.298,P=0.044),治疗前后组内比较,治疗组E2(t=2.577,P=0.028),差异有统计学意义,而其他指标及对照组E2均无统计学意义(P>0.05)。结论温肾逍遥汤能够明显改善围绝经期女性的泪液分泌功能及性激素水平,其治疗围绝经期干眼的疗效优于人工泪液。OBJECTIVE To evaluate the clinical effect of warming kidney xiaoyao decoction in function of tear secretion and sex hormone level of perimenopausal dry eye. METHODS A randomized, double-blind, double-dummy prospective study was conducted to include patients. We divided 60 patients(120 eyes) with perimenopausal dry eye from Mar 2013 to June 2016 consistent with diagnostic criteria, warming kidney xiaoyao decoction and Sterile Water were applied in the treatment group, placebo and polyethylene glycol eye drops were applied in the control group. The course of treatment lasted 28 days. Sodium corneal fluoresce in staining,Schirmer I, tear film break-up time(BUT), eye symptoms,constitutional symptom scores and sex hormone level, were recorded before and after treatment. RESULTS(1) The total effective rate: The total effective rates were 86.67% in the treatment group, 60.00% in the control group, with statistically significant difference(χ^(2)=5.963,P=0.030).(2) Symptom scores:After treatment, the difference was statistically significant(t=2.286, P=0.026);Between before and after treatment, there were significant differences in the treatment group(t=5.475, P=0.000) and the control group(t=7.906, P=0.000).(3) Systemic symptom index: The improvement value of KI after treatment between the two groups, was statistically significant(t=2.129, P=0.038).(4) Dry eye index: After treatment, BUT, SIT, FL in the treatment group were better than those in the control group, the differences were statistically significant(tBUT=-3.017, P=0.003;tSIT=-2.680, P=0. 008;tFL=4.933, P=0.000). Compare between before and after treatment, BUT(t=-9.323,P= 0. 000),SIT(t=-10.554, P=0.000), FL(t=18.416, P=0.000) in the treatment group, BUT(t=-4.752,P=0.000), SIT(t=-5.185, P=0.000), FL(t=13.218, P=0.000) in the control group were significantly different.(5) Sex hormone levels: After treatment, the difference of E2 level between two groups was statistically significant(t=2.298, P=0.044). Between before and after treatment, the difference of E2 level

关 键 词：围绝经期 干眼症 温肾逍遥汤 

分 类 号：R777.34[医药卫生—眼科]