自拟清热润目汤联合朱氏风池三针法配合眼周取穴对老年睑板腺功能障碍致干眼的治疗效果  

Curative effect of self-made Qingre Runmu Decoction combined with Zhu′s Fengchi Three Acupuncture and periocular acupuncture in the elderly with xerophthalmia caused by meibomian gland dysfunction

作　　者：朱艳霞[1] 李新[1] 应佳[1] Zhu Yanxia;Li Xin;Ying Jia(Department of Ophthalmology,Lishui Central Hospital,Lishui,Zhejiang 323000,China)

机构地区：[1]丽水市中心医院眼科,浙江丽水323000

出　　处：《中国药物与临床》2024年第13期817-821,共5页Chinese Remedies & Clinics

基　　金：浙江省中医药科技计划项目(2022ZB404)。

摘　　要：目的探究自拟清热润目汤联合朱氏风池三针法配合眼周取穴对老年睑板腺功能障碍致干眼的治疗效果。方法将2021年8月至2023年8月浙江省丽水市中心医院眼科收治的109例老年睑板腺功能障碍致干眼患者作为研究对象。根据患者接受的不同治疗方式进行分组,将接受常规西药治疗的患者纳入A组(53例),将接受西药治疗和自拟清热润目汤联合朱氏风池三针法配合眼周取穴治疗的患者纳入B组(56例),2组均治疗3个月。对比2组患者的治疗有效性、干眼程度[国际标准眼表疾病指数(OSDI)]、睑板腺功能(睑脂排出能力、眼睑分泌物性状)、角膜染色情况、非入侵泪膜破裂时间和并发症发生率(角膜溃疡、角膜穿孔、继发细菌感染)。结果B组的治疗有效率(95%)高于A组(81%)(P<0.05);B组患者的干眼程度[正常(63%)、轻度干眼(32%)、中度干眼(5%)、重度干眼(0)]低于A组[正常(41%)、轻度干眼(47%)、中度干眼(8%)、重度干眼(4%)](P<0.05);B组患者的睑脂排出能力正常率(73%)高于A组(51%),眼睑分泌物性状正常率(68%)高于A组(47%)(P<0.05);B组患者的角膜染色评分(4.6±0.7)分低于A组(6.5±0.8)分,非入侵泪膜破裂时间(11.0±1.3)s长于A组(10.3±1.1)s(P<0.05);B组并发症发生率(13%)与A组(8%)差异无统计学意义(P>0.05)。结论自拟清热润目汤联合朱氏风池三针法配合眼周取穴对老年睑板腺功能障碍致干眼的疗效显著,可有效缓解干眼症状、恢复眼睑功能、增强泪膜稳定性。Objective To investigate the therapeutic effect of the combination of self-developed Qingre Runmu Decoction,Zhu′s Fengchi three acupuncture,and acupuncture points around the eyes on dry eye caused by meibomian gland dysfunction in the elderly.Methods From August 2021 to August 2023,a total of 109 el-derly patients with xerophthalmia caused by meibomian gland dysfunction were enrolled in ophthalmology depart-ment of the hospital.According to different treatment methods,the patients were divided into group A(53 cases,routine western medicine)and group B(56 cases,self-made Qingre Runmu Decoction combined with Zhu′s Fengchi three acupuncture and periocular acupuncture on basis of group A).All patients were treated for 3 months.The treatment effectiveness,xerophthalmia degree[Ocular Surface Disease Index(OSDI)based on interna-tional standards],meibomian gland function(eyelid discharge capacity,eyelid secretion characters),corneal stain-ing,non-invasive break-up time and incidence of complications(corneal ulcer,corneal perforation,secondary bac-terial infection)were compared between the two groups.Results The treatment efficacy of group B was higher than that of group A(95%vs 81%,P<0.05).The xerophthalmia degree in group B[normal(63%),mild(32%),moderate(5%),severe(0)]was milder than that in group A[normal(41%),mild(47%),moderate(8%),severe(4%);P<0.05].The normal rate of eyelid discharge capacity(73%)and eyelid secretion characters(68%)in group B were higher than those in group A(51%,47%;P<0.05).The score of corneal staining in group B was lower than that of group A[(4.6±0.7)points vs(6.5±0.8)points],and non-invasive break-up time was longer than that of group A[(11.0±1.3)s vs(10.3±1.1)s;P<0.05].There was no significant difference in incidence of complications between group B and group A(13%vs 8%,P>0.05).Conclusion The self-developed Qingre Runmu Decoction combined with Zhu′s Fengchi Three Acupuncture and periocular acupuncture has a significant effect on treating dry eyes caused by meibomian gland dysfunction

关 键 词：自拟清热润目汤 朱氏风池三针法 老年人 睑板腺功能障碍 干眼病 

分 类 号：R276.7[医药卫生—中医五官科学]