玻璃酸钠联合环孢素A治疗混合型干眼症的疗效观察

Clinical effect of sodium hyaluronate and cyclosporine A eye drops for combination treatment of mixed dry eye syndrome

目的:观察0.3%玻璃酸钠滴眼液联合1%环孢素A滴眼液治疗混合型干眼症的临床效果。方法:将2018-02/2019-02于本院被确诊为混合型干眼症患者60例120眼采用随机数字表法分为2组,每组30例60眼,两组患者均接受眼睑热敷清洁和睑板腺按摩等常规治疗,研究组采用0.3%玻璃酸钠滴眼液联合1%环孢素A滴眼液进行治疗,对照组单纯采用0.3%玻璃酸钠滴眼液进行对照治疗。分析两组患者治疗前,治疗1、3mo患者的主观感受评分、泪液分泌试验(SⅠt)、泪膜破裂时间(BUT)、角膜荧光素染色评分(CFS)的结果。结果:治疗前,对照组的主观感受评分(13.52±2.15)分、SⅠt(5.22±2.23)mm/5min、BUT(5.02±1.58)s、CFS评分(2.82±0.81)分与研究组的主观感受(13.75±3.05)分、SⅠt(5.54±2.89)mm/5min、BUT(5.14±1.84)s、CFS评分(2.73±0.45)分比较无差异。治疗1mo后,对照组的主观感受评分(12.22±2.64)分、SⅠt(7.94±2.15)mm/5min、BUT(5.32±1.34)s、CFS评分(2.68±0.27)分与研究组的主观感受评分(11.42±2.06)分、SⅠt(8.63±2.78)mm/5min、BUT(5.46±1.45)s、CFS评分(2.58±0.69)分均较治疗前有好转。两组间主观感受评分、SⅠt有差异,但BUT和CFS评分无差异。治疗3mo后,对照组的主观感受评分(11.57±2.98)分、SⅠt(8.44±2.35)mm/5min、BUT(5.92±1.75)s、CFS评分(1.92±0.44)分,研究组的主观感受评分(9.23±2.34)分、SⅠt(10.45±2.65)mm/5min、BUT(8.69±1.78)s、CFS评分(1.59±0.79),组间比较均有差异(P<0.05)。结论:0.3%玻璃酸钠滴眼液联合1%环孢素A滴眼液治疗混合型干眼症具有显著的疗效。

AIM: To analyze the efficacy of sodium hyaluronate and cyclosporine A eye drops in treating patients with mixed dry eye disease. METHODS: Among patients diagnosed with dry eye who presented to our hospital between February 2018 to February 2019, 60(120 eyes) cases were divided into 30(60 eyes) in each control and treatment group by random number table method. Both groups received routine treatment with the methods of eyelid hot compress cleaning and meibomian gland massage. The treatment group received combined application of sodium hyaluronate eye drop(0.3%) and cyclosporine A eye drop(1%), while control group received carbomer eye drops used alone at four times daily. And dry eye symptom score, Schirmer I test(SⅠt), tear film break-up time(BUT) and corneal fluorescein staining(CFS) results were obtained before treatment, at the 1 and 3 mo after initiation of treatment. RESULTS: No statistically differences were observed in any of the indexes between the control group(dry eye symptom score: 13.52±2.15, SⅠt: 5.22±2.23, BUT: 5.02±1.58, CFS:2.82±0.81) and the treatment group(dry eye symptom score: 13.75+3.05, SⅠt: 5.54+2.89, BUT: 5.14+1.84, CFS: 2.73±0.45) before initiating treatment. One month later, the dry eye symptom score of the control group(12.22±2.64) and the treatment group(11.42±2.06) improved after treatment;the SⅠt of the control group(7.94±2.15) and the treatment group(8.63±2.78) also improved after treatment, and result of the treatment group was better than that of the control group, and the difference was statistically significant;the BUT of the control group(5.32±1.34) and the treatment group(5.46±1.45) were better after treatment, but the difference was not statistically significant. After 3 mo treatment, the dry eye symptom score, SⅠt, BUT and CFS of the control group were 11.57±2.98, 8.44±2.35, 5.92±1.75, 1.92±0.44, respectively, and the dry eye symptom score, SⅠt, BUT and CFS of the control group were 9.23±2.34, 10.45±2.65, 5.92±1.75, 8.69±1.78, 1.59±0.79, respectively(P<0.05).CONCLUSIONS: Combination therapy of sodium hyaluronate eye drop and cyclosporine A eye drops treatments are effective for the treatment of mixed dry eye syndrome.