老年结膜松弛症中医证素分布的相关性研究  

Correlation study on distribution characteristics of Traditional Chinese Medicine syn⁃drome elements in elderly conjunctivochalasis

作　　者：文杭 李福凤[2] 刘江 宋正宇 项敏泓[3] WEN Hang;LI Fufeng;LIU Jiang;SONG Zhengyu;XIANG Minhong(Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院,上海200010 [2]上海中医药大学,上海201203 [3]上海中医药大学附属普陀医院,上海200062

出　　处：《中国中医眼科杂志》2023年第6期538-542,共5页China Journal of Chinese Ophthalmology

基　　金：国家自然科学基金项目(82074495);国家自然科学基金青年孵育项目(SGKJ-202111)。

摘　　要：目的研究老年结膜松弛症(CCh)中医证素分布特点及其与眼表之间的关联性,以求进一步诠释CCh的病因病机。方法纳入2019年2月—2020年1月上海中医药大学附属普陀医院诊断为CCh的60岁及以上患者250例,均以右眼纳入研究。采用CCh流行病学调查表进行临床流行病学调查,利用上海中医药大学自主研发的“便携式中医智能镜”获取CCh中医证素,并行统计学分析。结果(1)CCh临床分级与眼表疾病指数量表(OSDⅠ)评分的关系:Ⅰ级OSDⅠ评分为(12.15±3.97)分,Ⅱ级为(20.9±3.82)分,Ⅲ级及以上为(27.42±4.35)分,且差异有统计学意义(F=140.42,P=0.000)。(2)CCh临床分级与泪膜破裂时间(BUT)的关系:BUT<10 s的患者分别为Ⅰ级21例(77.8%),Ⅱ级121例(72.9%),Ⅲ级52例(91.2%),且差异有统计学意义(χ^(2)=8.175,P=0.017)。(3)CCh临床分级与基础泪液分泌试验(SⅠT)的关系:SⅠT<10 mm的患者分别为Ⅰ级20例(74.1%);Ⅱ级98例(59.0%);Ⅲ级48例(84.2%),且差异有统计学意义(χ^(2)=12.800,P=0.002)。(4)CCh病位证素研究:病位证素分布于肝、脾、肾三脏,以肾最为多见,其中单一病位证素的共64例,分别为病位于肝29例,病位于脾20例,病位于肾15例。病位证素组合以两病位证素组合为主,为肝+脾、肝+肾、脾+肾共113例,三病位证素组合为肝+脾+肾共34例.(5)CCh病性证素研究:CCh病性证素出现的频率依次为阴虚(34%)>气虚(30%)>气滞(18%)>痰湿(9%)>阳虚(9%)。病性证素组合以气虚+阴虚最多(99例),其次为阴虚+气滞(48例),气虚+气滞(48例)。结论老年CCh中医证素分布病位证素以肾为主,病性证素以阴虚为主,采用中医智能设备可客观、有效、准确地获取CCh中医证素分布特征,可用于指导临床辨证分型。OBJECTIVE To explore the distribution characteristics of Traditional Chinese Medicine(TCM)syndrome elements in elderly conjunctivochalasis(CCh)and their correlation with ocular surface,in order to further interpret the pathogenesis of CCh.METHODS From February 2019 to January 2020,250 patients aged 60 years and above diagnosed with CCh at Putuo Hospital affiliated to Shanghai University of TCM were collected,and the right eye was included in the study.Clinical epidemiological investigation was conducted using the epidemiological investigation form of CCh,and TCM syndrome elements of CCh were obtained using the"portable TCM intelligent mirror"developed by Shanghai University of TCM,followed by statistical analysis.RESULTS(1)Relationship between clinical grading of CCh and ocular surface disease index(OSDI)score:The OSDI scores were(12.15±3.97)points for gradeⅠ,(20.9±3.82)points for gradeⅡ,and(27.42±4.35)points for gradeⅢor higher,and the difference was statistically significant(F=140.42,P=0.000).(2)Relationship between clinical grading of CCh and tear film break up time(BUT):The number of patients with BUT<10 s were 21 cases(77.8%)for gradeⅠ,121 cases(72.9%)for gradeⅡ,and 52 cases(91.2%)for gradeⅢ,and the difference was statistically significant(χ^(2)=8.175,P=0.017).(3)Relationship between clinical grading of CCh and schirmerⅠtest(SⅠT):The number of patients with SⅠT<10 mm were 20 cases(74.1%)for gradeⅠ,98 cases(59.0%)for gradeⅡ,and 48 cases(84.2%)for gradeⅢ,and the difference was statistically significant(χ^(2)=12.800,P=0.002).(4)Study on location syndrome elements of CCh:Location syndrome elements were distributed in the liver,spleen,and kidney,with the kidney being the most common.Among them,there were 64 cases of single location syndrome elements,including 29 cases located in the liver,20 cases located in the spleen,and 15 cases located in the kidney.The combination of location syndrome elements was mainly composed of two location syndrome elements,including liver and spleen,liver

关 键 词：结膜松弛症 中医证素 眼部症状 眼部体征 

分 类 号：R276.7[医药卫生—中医五官科学]