中药溻渍治疗肝肾亏虚证干眼患者的临床观察  

Clinical Efficacy of Treating Dry Eye(Syndrome of Liver and Kidney Deficiency)with External Application of TCM Decoction

作　　者：姚玙 郭浩[1] 霍勤[1] YAO Yu;GUO Hao;HUO Qin(Department of Ophthalmology,The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou Henan 450000)

机构地区：[1]河南中医药大学第一附属医院眼科,河南郑州450000

出　　处：《世界中西医结合杂志》2023年第4期778-782,786,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：河南省中医药科学研究专项课题(2022ZY1028)。

摘　　要：目的 探讨中药溻渍治疗肝肾亏虚证干眼的临床价值。方法 选取2020年1月—2021年10月期间河南中医药大学第一附属医院收治的104例肝肾亏虚型干眼患者开展试验,按随机数字表法分为对照组和研究组,每组各52例。对照组给予人工泪液(玻璃酸钠滴眼液)治疗,研究组在对照组基础上自拟补肝益肾润目方中药溻渍,两组患者均治疗4周。比较两组患者临床疗效、治疗前后主要症状评分、干眼相关试验结果、视功能相关生活质量(25-item national eye institute visual function questionnaire, NEI-VFQ-25)评分变化及治疗安全性,治疗结束随访3个月,统计比较两组患者干眼复发率。结果 治疗后研究组临床总有效率94.23%(49/52)明显高于对照组78.85%(41/52),差异有统计学意义(P<0.05)。治疗后两组患者主要症状干涩感、异物感、疲劳感、烧灼感评分均较治疗前降低,差异有统计学意义(P<0.05);且研究组低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者泪液分泌试验(Schirmer′s Test, SIT)、泪膜破裂时间试验(Break-up time, BUT)较治疗前增高,角膜荧光素染色试验(Fluorescein staining, FL)评分较治疗前降低,差异有统计学意义(P<0.05);且研究组SIT、BUT高于对照组,FL评分低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者NEI-VFQ-25各部分评分均较治疗前升高,差异有统计学意义(P<0.05);且研究组高于对照组,差异有统计学意义(P<0.05)。治疗后研究组不良反应发生率7.69%(4/52)与对照组3.85%(2/52)比较,差异无统计学意义(P>0.05)。随访3个月,研究组复发率1.92%(1/52)低于对照组13.46%(7/52),差异有统计学意义(P<0.05)。结论 中药溻渍治疗干眼肝肾亏虚证安全、有效,有利于缓解眼部不适症状,提高泪膜稳定性与泪液分泌量,复发率低,可显著改善患者视功能相关生活质量。Objective To explore the clinical value of external application of TCM decoction in the treatment of dry eye with the syndrome of liver and kidney deficiency.Methods A total of 104 patients with dry eye(syndrome of liver and kidney deficiency)treated in the First Affiliated Hospital of Henan University of Chinese Medicine from January 2020 to October 2021 were selected and assigned into control and observation groups(n=52)according to the random number table method.The control group was treated with artificial tears(sodium hyaluronate eye drops)and the observation group with artificial tears and external application of self-made Bugan Yishen Runmu Prescription.Both groups were treated for 4 weeks.The clinical efficacy and safety were compared between the two groups.The main symptom scores,Schirmer I test(SIT)score,break-up time(BUT),fluorescein staining(FL)score,and 25-item National Eye Institute Visual Function Questionnaire(NEI-VFQ-25)score were recorded before and after treatment.The recurrence rate of dry eye in the three-month follow-up was compared between the two groups.Results The total effective rate of the observation group was 94.23%(49/52),which was higher than that(78.85%,41/52)of the control group(P<0.05).After treatment,the scores of dryness,foreign body sensation,fatigue,and burning in the two groups declined compared with those before treat-ment,and the scores in the observation group were lower than those in the control group(P<0.05).The treatment in both groups raised the SIT and BUT scores and lowered the FL score and the observation group had higher SIT and BUT scores and lower FL score than the control group after treatment(P<0.05).The NEI-VFQ-25 scores in both groups after treatment elevated compared with those before treatment,and the observation group had higher NEI-VFQ-25 score than the control group(P<0.05).The incidence of adverse reactions in the observation group was 7.69%(4/52),which had no significant difference from that(3.85%,2/52)in the control group(P>0.05).During the follow-up

关 键 词：干眼 肝肾亏虚证 补肝益肾润目法 中药溻渍 视功能相关生活质量 

分 类 号：R779.1[医药卫生—眼科]