消渴明目方治疗糖尿病性干眼症效果观察

Observation on Effect of Xiaoke Mingmu Decoction(消渴明目方)in Diabetic Dry Eye

目的观察消渴明目方对糖尿病性干眼症患者临床症状和泪液中基质金属蛋白酶-9(MMP-9)表达水平的影响。方法纳入该院2018年7月—2019年7月96例糖尿病性干眼症患者(192只眼)进行研究,采用随机数字表法将受试者分为观察组、对照组各48例(96只眼),对照组在糖尿病治疗的基础上予以羧甲基纤维素钠滴眼,观察组在对照组的基础上辅以消渴明目方口服。比较两组患者治疗4周后临床疗效及治疗前、治疗4周后症状积分,临床指标[基础泪液分泌量(SIT)、泪膜破裂时间(BUT)、角膜荧光染色(FL)、角膜知觉],泪液生化指标[MMP-9、肿瘤坏死因子-α(TNF-α)]水平变化。结果治疗4周后,观察组治疗总有效率高于对照组(P<0.05);两组症状积分均较治疗前降低,且观察组低于对照组(P<0.05);两组SIT、BUT、FL、角膜知觉评分均较治疗前降低,且观察组低于对照组(P<0.05);两组泪液MMP-9、TNF-α均较治疗前降低,且观察组低于对照组(P<0.05)。结论消渴明目方治疗糖尿病性干眼症疗效确切,可缓解炎性刺激,改善临床症状。

Objective To observe the effects of Xiaoke Mingmu Decoction(消渴明目方)on clinical symptoms and expression level of matrix metalloproteinase-9(MMP-9)in the tears of patients with diabetic dry eye.Methods A total of 96 patients with diabetic dry eye(192 eyes)who were admitted to our hospital from July 2018 to July 2019 were included in the study.The sub⁃jects were divided into observation group and control group by using the random number table method,with 48 cases(96 eyes)in each group.The control group received sodium carboxymethyl cellulose eye drops on the basis of basic treatment of diabetes,and the observation group was supplemented with oral administration of Xiaoke Mingmu Decoction on the basis of control group.The clinical efficacy after 4 weeks of treatment,as well as symptom scores,clinical indicators[Schirmer I test(SIT),breakup time of tear film(BUT),corneal fluorescence staining(FL),corneal sensitivity]and tear biochemical indicators[MMP-9,tumor necrosis factor-α(TNF-α)]before treatment and after 4 weeks of treatment were compared between the two groups.Results After 4 weeks of treatment,the total effective rate of treatment in observation group was higher than that in control group(P<0.05).The symptoms scores of the two groups were lower than those before treatment,and the scores in observation group were lower than those in control group(P<0.05).The scores of SIT,BUT,FL and corneal sensitivity in the two groups were all lower than those before treatment,and the scores in the observation group were lower than those in the control group(P<0.05).The levels of MMP-9 and TNF-αin the tear of the two groups were lower than those before treatment,and the levels in the observation group were lower than those in the control group(P<0.05).Conclusion Xiaoke Mingmu Decoction has an exact efficacy in treating dia⁃betic dry eye,and it can relieve inflammatory irritation and improve clinical symptoms.