睑板腺按摩结合中药熏蒸护理技术在干眼患者中的应用  

Application of Meibomian Gland Massage Combined with Traditional Chinese Medicine Fumigation Nursing Technology in Patients with Dry Eye

作　　者：胡修洁 杨雪梅 万美萍[1] HU Xiujie;YANG Xuemei;WAN Meiping(Qianjiang City Central Hospital,Qianjiang 433100,China;不详)

机构地区：[1]潜江市中心医院,湖北潜江433100

出　　处：《中外医学研究》2023年第25期96-101,共6页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨睑板腺按摩结合中药熏蒸护理技术在干眼中的应用价值。方法:选取2019年9月—2022年9月潜江市中心医院收治的106例干眼患者为研究对象,按随机数表法将其分为联合组与常规组,各53例(106眼)。常规组给予睑板腺按摩,联合组采用睑板腺按摩结合中药熏蒸护理技术。比较干预前后两组中医症状评分及角膜荧光染色(corneal fluorescein staining,CFS)评分、泪腺分泌试验(SchirmerⅠtest,SⅠt)、泪膜破裂时间(break-up time,BUT),并在干预前后检测泪液白介素-1β(interleukin-1β,IL-1β)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)及血清基质金属蛋白酶-2(matrix metallo-proteinase-2,MMP-2)、维甲酸诱导蛋白6(stimulated by retinoic acid 6,STRA6)、转化生长因子-β_(1)(transforming growth factor-β_(1),TGF-β_(1))水平。记录两组总体疗效及不良事件发生情况。结果:干预后,两组眼干涩不爽、视物昏花、睑弦赤痒评分低于干预前,且联合组低于常规组,差异有统计学意义(P<0.05)。干预后,两组CFS评分低于干预前,SⅠt、BUT高于干预前,且联合组CFS评分低于常规组,SⅠt、BUT高于常规组,差异有统计学意义(P<0.05)。干预后,两组泪液IL-1β、TNF-α水平低于干预前,且联合组低于常规组,差异有统计学意义(P<0.05)。干预后,两组血清MMP-2、STRA6水平低于干预前,TGF-β_(1)水平高于干预前,联合组血清MMP-2、STRA6水平低于常规组,TGF-β_(1)水平高于常规组,差异有统计学意义(P<0.05)。联合组总有效率高于常规组,差异有统计学意义(P<0.05)。联合组不良事件发生率与常规组比较,差异无统计学意义(P>0.05)。结论:睑板腺按摩结合中药熏蒸护理技术能减轻干眼患者的症状,提升泪膜稳定性,缓解炎症,提高总体疗效,其机制可能与抑制MMP-2、STRA6水平和促进TGF-β_(1)表达有关。Objective:To investigate the application value of meibomian gland massage combined with traditional Chinese medicine fumigation nursing technology in dry eye.Method:A total of 106 patients with dry eye admitted to Qianjiang City Central Hospital from September 2019 to September 2022 were selected and they were divided into the combined group and the conventional group according to random number table method,with 53 patients(106 eyes)in each group.The conventional group was given meibomian gland massage,and the combined group was given meibomian gland massage combined with traditional Chinese medicine fumigation nursing technology.The traditional Chinese medicine symptom score,corneal fluorescein staining(CFS)score,SchirmerⅠtest(SⅠt),break-up time(BUT)before and after intervention were compared between the two groups.The levels of interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α)and serum matrix metallo-proteinase-2(MMP-2),stimulated by retinoic acid 6(STRA6)and transforming growth factor-β_(1)(TGF-β_(1))were detected before and after intervention.Overall efficacy and adverse events were recorded in both groups.Result:After intervention,the scores of dry and uncomfortable eyes,dim vision,red eyelid string itching in two groups were lower than those before intervention,and the scores in the combined group were lower than those in the conventional group,the differences were statistically significant(P<0.05).After intervention,the CFS scores in the two groups were lower than those before intervention,SⅠt and BUT were higher than those before intervention,and CFS score in the combined group was lower than that in the conventional group,SⅠt and BUT were higher than those in the conventional group,the differences were statistically significant(P<0.05).After intervention,the levels of IL-1βand TNF-αin tears of the two groups were lower than those before intervention,and the levels in the combined group were lower than those in the conventional group,the differences were statistically significant(P<0.05

关 键 词：睑板腺按摩 中药熏蒸护理技术 干眼 泪膜稳定性 不良事件 

分 类 号：R248.9[医药卫生—中医临床基础]