复方王不留行片联合人工泪液治疗更年期女性眼干燥症的疗效观察

Curative effect of compound recipe wangbuliuxing tablets with artificial tears for dry eye in climacteric women

目的观察复方王不留行片联合人工泪液治疗更年期女性眼干燥症的临床疗效,探讨雌激素在眼干燥症治疗中的作用机制。方法选取2010年4月至12月在新乡医学院眼科医院门诊就诊的更年期女性眼干燥症患者40例80眼,随机分为两组:治疗组20例40眼局部滴用人工泪液复方右旋糖酐70滴眼液每日4～6次,同时口服复方王不留行片;对照组20例40眼仅局部滴用复方右旋糖酐70滴眼液每日4～6次。探讨用药后各组患者的临床眼干燥症问卷调查、泪液分泌试验I(Schirmer Itest,SIt)、泪膜破裂时间(break up time,BUT)和角膜荧光素染色(corneal fluorescein staining,CFS)情况。结果治疗4周后两组患者局部及全身均未出现不良反应。治疗组患者在治疗前后各项检查的比较差异均有统计学意义(眼干燥症症状评分比较:t=12.66,P<0.01;SIt:t=-10.43,P<0.01;BUT:t=-5.70,P<0.01;CFS:t=13.66,P<0.01)。对照组患者在治疗前后各项检测指标的比较显示眼干燥症症状评分、BUT、CFS差异均有统计学意义(眼干燥症症状评分比较t=6.49,P<0.01;BUT:t=-4.27,P<0.01;CFS:t=5.25,P<0.01),局部应用人工泪液使患者的眼干燥症症状以及BUT、CFS检查结果好转;治疗前后SIt的比较差异无统计学意义(t=-0.46,P>0.05)。两组患者治疗后各项检查结果的比较表明,两组患者在经过不同的治疗后眼干燥症症状评分、BUT、CFS的比较差异均有统计学意义(眼干燥症症状评分比较t=-2.17,P<0.05;BUT:t=1.95,P<0.05;CFS:t=-2.33,P<0.05);SIt比较差异亦有统计学意义(t=7.32,P<0.01)。治疗组中显效6眼,好转28眼,无效6眼,有效率为85%;对照组中显效0眼,好转26眼,无效14眼,有效率为65%,两组总有效率比较差异有统计学意义(P<0.05)。结论复方王不留行片与人工泪液的联合应用更好地改善了更年期女性眼干燥症患者的症状。

Objective To observe the curative effect of compound recipe wang- buliuxing tablets with artificial tears for dry eye in climacteric women, and discuss the mechanism of estrogen for dry eye. Methods Forty women patients （ 80 eyes） with dry eyes in Ophthalmologic hospital clinic of Xinxiang Medical College from April to De- cember 2010 were selected, all cases were fell in binocular eyes and divided into two groups randomly. The patients in treatment group （20 cases, 20 eyes） were treated with artificial tear and compound recipe dextran 70 eye drops, from 4 times to 6 times per day, at the same time, compound recipe wangbuliuxing tablets was orally given. The pa- tients in control group were only treated with compound recipe dextran partly, from 4 times to 6 times per day. The clinical dry eyes questionnaires, Schirmer I test （ Sit）, break up time （BUT） and corneal fluorescein staining （CFS） were examined and ob- served after treatment in two groups. Results After 4 weeks of treatment, there was no adverse reaction in two groups. There were significant differences in every examined index and its difference between before and after treatment in treatment group （ Sit： t = - 10.43,P 〈 0.01;BUT：t = -5.70,P 〈 0.01 ;CFS： t = 13.66,P 〈0.01 ; Symptoms： t = 12. 55 ,P 〈 0.01 ）. There were significant differences in symptom scoring, BUT and CFS between before and after treatment in control group （ Symptoms： t = 6.49, P 〈 0.01 ; BUT： t = - 4.27, P 〈 0.01 ; CFS： t = 5.25, P 〈 0.01 ）, but there was no difference in Sit （ t = - 0. 46, P 〉 0.05 ）. There were significant differences in symptoms scoring, BUT, CFS and Sit between two groups （ Symptoms： t = - 2.17 ,P 〈 0.05 ; BUT： t = 1.95 ,P 〈 0. 05 ; CFS： t = - 2.33, P 〈 0.05 ; Sit： t = 7.32, P 〈 0.01 ）. In treatment group and control group, the obvious curative effects were in 6 eyes and 0 eye, improved in 28 eyes and 25 eyes, had no effect in 5 eyes and 14 eyes, the effective rate was 85% and 55% , respectively, there was statistical difference in effective rate between two groups （P 〈 0.05 ）. Conclnsion The compound recipe wangbuliuxing tablets with artificial tears can better improve the dry eye symptoms of climacteric women.