益肾调肝方治疗围绝经期女性肾虚肝郁型干眼症疗效及对早期眼表变化的影响  

Efficacy of Yishen Tiaogan Decoction(益肾调肝方)on Perimenopausal Women with Dry Eye of Kidney Deficiency and Liver Depression Syndrome and Its Influence on Early Changes in Ocular Surface

作　　者：李晴[1] 张远龙 杨光[1] LI Qing;ZHANG Yuanlong;YANG Guang(First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin 300381,China;Tianjin Eye Hospital,Tianjin 300380,China)

机构地区：[1]天津中医药大学第一附属医院,国家中医针灸临床医学研究中心,天津300381 [2]天津市眼科医院,天津300380

出　　处：《中华中医药学刊》2025年第1期214-217,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：天津市中医药管理局中西医结合科研项目(2021066)。

摘　　要：目的研究益肾调肝方治疗围绝经期女性肾虚肝郁型干眼症的疗效及对早期眼表变化的影响。方法选取2021年2月—2023年3月医院收治的120例围绝经期肾虚肝郁型干眼症女性患者,按随机数字表法分为对照组与研究组,各60例。对照组给予玻璃酸钠滴眼液治疗,研究组基于玻璃酸钠滴眼液给予益肾调肝方(生地黄15 g,白芍12 g,香附12 g,龟板10 g,山萸肉10 g,丹皮10 g,青皮10 g,泽泻10 g,枸杞子9 g,菊花5 g,沙参5 g,川楝子5 g)治疗,两组持续治疗4周。比较两组治疗后的中医症状评分,眼表功能[泪膜破裂时间(break-up time,BUT)、泪液基础分泌试验(Schirmer I test,SIT)、角结膜荧光素染色(fluorescent,FL)评分],疗效,泪液炎症因子[白介素6(interleukin,IL)-6、IL-33]水平及不良反应情况。结果治疗后对照组中医症状评分为(4.89±0.74)分,研究组为(1.60±0.35)分,两组症状评分低于治疗前(P<0.05),且研究组症状评分低于对照组(P<0.05)。治疗后对照组BUT为(5.64±1.15)s、SIT为(7.76±1.35)mm/5 min、FL评分为(2.38±0.49)分,研究组分别为(10.08±1.29)s、(11.25±2.26)mm/5 min、(0.85±0.14)分,两组眼表功能优于治疗前(P<0.05),且研究组BUT、SIT高于对照组,FL低于对照组(P<0.05)。对照组治愈15例、好转24例、无效21例,研究组分别为35例、22例、3例,两组疗效等级分布有统计学意义(Z=-5.044,P<0.05),研究组有效率(95.00%,57/60)高于对照组(65.00%,39/60)(P<0.05)。治疗后对照组泪液IL-6水平为(17.26±3.71)pg/mL、IL-33为(11.49±2.18)pg/mL,研究组分别为(15.13±3.30)pg/mL、(10.30±1.85)pg/mL,两组泪液因子水平低于治疗前(P<0.05),且研究组水平低于对照组(P<0.05)。治疗期间对照组未发现不良反应,研究组出现1例腹泻,症状较轻可自行缓解,两组不良反应无统计学意义(χ^(2)=1.008,P>0.05)。结论益肾调肝方能有效缓解围绝经期女性肾虚肝郁型干眼症患者临床症状,改善眼表功能,提高疗效,减Objective To explore the efficacy of Yishen Tiaogan Decoction(益肾调肝方)on perimenopausal women with dry eye of kidney deficiency and liver depression syndrome and its influence on early changes in ocular surface.Methods One hundred and twenty perimenopausal women with dry eye of kidney deficiency and liver depression syndrome admitted to the hospital from February 2021 to March 2023 were selected,and randomly assigned into two groups,each with 60 cases.The control group received sodium hyaluronate eye drops.Based on this,the study group was given Yishen Tiaogan Decoction.The treatment in both groups lasted for 4 weeks.Then the TCM symptom scores,ocular surface function[tear film break-up time(BUT),Schirmer I test(SIT),cornea corneal fluorescein(FL)staining],clinical efficacy,the levels of inflammatory factors[interleukin(IL)-6,IL-33]and adverse reactions were compared between two groups after treatment.Results TCM syndrome scores showed a decline in both groups after treatment(P<0.05),and the score was(1.60±0.35)point in the study group,which was lower than that[(4.89±0.74)point]in the control group(P<0.05).There was an improvement in BUT,SIT and FL score in both groups after treatment(P<0.05),and the three parameters were(10.08±1.29)s,(11.25±2.26)mm/5 min and(0.85±0.14)point in the study group,which were all better than those[(5.64±1.15)s,(7.76±1.35)mm/5 min and(2.38±0.49)point]in the control group,with statistical difference(P<0.05).In the control group,15 cases were cured,24 cases were improved and 21 cases were ineffective.In the study group,35 cases were cured,22 cases were improved and 3 cases were ineffective.The efficacy grade distribution yielded statistical difference between two groups(Z=-5.044,P<0.05).The overall efficacy rate was 95.00%(57/60)in the study group,which was higher than that(65.00%,39/60)in the control group(P<0.05).Serum levels of inflammatory factors showed a decrease in both groups after treatment(P<0.05).The serum levels of IL-6 and IL-33 were(15.13±3.30)pg/mL and(10.

关 键 词：干眼症 围绝经期女性 肾虚肝郁 益肾调肝方 疗效 早期眼表变化 

分 类 号：R259.914.12[医药卫生—中西医结合]