杞菊地黄汤加味配合羟糖甘滴眼液治疗肝肾阴虚型干眼临床研究

Clinical study ofQiju-Dihuang decoction combined with tears naturale on dry eye of liver and kidney

目的：探讨杞菊地黄汤加味配合羟糖甘滴眼液治疗肝肾阴虚型干眼的临床疗效。方法收集2010年1月至2013年8月湖北省房县人民医院眼科、房县中医医院眼科干眼患者60例，按就诊顺序将患者随机分为2组，每组30例。对照组局部点用羟糖甘滴眼液，治疗组在对照组基础上加服杞菊地黄汤，均治疗8周。治疗结束后比较两组患者临床症状、体征，以及泪膜破裂时间（BUT）、基础泪液分泌试验（S1T）、角膜荧光素染色评分（FL）的变化。结果治疗后，治疗组总有效率为73.33%（22/30），对照组为46.67%（14/30），两组总有效率比较差异有统计学意义（χ2＝4.44，P＜0.05）。治疗后，治疗组BUT、SIT、FL评分，对照组BUT、FL评分均较同组治疗前明显改善（t值分别为4.200、4.374、9.098，2.147、6.627，P＜0.05或P＜0.01），且治疗组治疗后BUT、S1T的升高与FL的降低情况均优于对照组（t值分别为2.75、2.43、3.05，P＜0.05或P＜0.01）。结论杞菊地黄汤加味配合羟糖甘滴眼液治疗可明显改善肝肾阴虚型患者的干眼症状，延长BUT，增加泪液分泌量，减轻眼角结膜损害，疗效优于单纯使用羟糖甘滴眼液治疗。

Objective To investigate the clinical effect ofQiju-Dihuang decoction combined with tears naturale（hypromellose 2910,dextran 70 and glycerol eye drops）on dry eye of liver and kidneyYin deficiency patterns.Methods Sixty patients with dry eye in Fangxian People’s Hospital and Fangxian Hospital of TCM from Jan. 2010 to Aug. 2013 were divided into a control group（30 patients）and a treatment group（30 patients） randomly according to registration order. The patients in the control group were treated with tears naturale, while patients in the treatment group were additionally treated withQiju-Dihuang decoction orally on the basis of the control group. Both groups were treated for 8 weeks. After treatment, the clinical symptoms and signs were compared and the changes of breakup time of tear film（BUT）, Schirmer test I（S1T）and corneal fluorescein staining（FL）score were measured in both groups.Results The total effective rates in the treatment group and in the control group were 73.33%（22/30）and 46.67%（14/30）, respectively. The difference was statistically significant（χ2=4.44,P〈0.05）. After treatment, the BUT, S1T and FL score of the treatment group and the control group was significantly improved than those before in both groups（t=4.200, 4.374, 9.098, 2.147, 6.627,P〈0.05 orP〈0.01）, and the degrees of BUT, S1T score increased and FL score decreased in the treatment group were superior to those in the control group（t=2.75, 2.43, 3.05,P〈0.05 orP〈0.01）. ConclusionsQiju-Dihuang decoction combined with tears naturale can obviously improve dry eye of liver and kidneyYin deficiency patterns, increase tear secretion, and reduce the damage of canthus and conjunctiva. Its curative effect was superior to simple tears naturale.