激素替代疗法治疗围绝经期干眼症的临床疗效观察

Observation of the effect of hormone replacement therapy on xerophthalmia of perimenopausal female

目的：观察激素替代疗法对围绝经期干眼症患者的治疗效果，为激素替代疗法治愈干眼症提供临床依据。方法选择围绝经期干眼症患者120例（240眼），按随机数字表法分为对照组60例（120眼）和治疗组60例（120眼），对照组给予羟糖苷滴眼液点眼，治疗组给予羟糖苷滴眼液点眼，同时口服替勃龙片连续服用，分别观察治疗后1、3、6、12个月的主观症状、基础泪液分泌、泪膜破裂时间、角膜荧光染色的结果并记录。结果基础泪液分泌量治疗后1个月，对照组为（5．22±2．05）mm，治疗组为（8．0±1．94）mm，差异有统计学意义（t ＝2．96，P ＜0．05），治疗后3个月，对照组为（6．67±2．34）mm，治疗组为（9．00±2．18）mm，差异有统计学意义（t ＝2．19，P ＜0．05），治疗后6个月，对照组为（7．67±2．35）mm，治疗组为（10．56±2．70）mm，差异有统计学意义（t ＝2．42，P ＜0．05），治疗后12个月，对照组为（9．00±2．18）mm，治疗组为（11．44±2．51）mm，差异有统计学意义（t ＝2．59，P ＜0．05）。治疗后1个月，对照组泪膜破裂时间为（5．14±2．79）s，治疗组为（8．29±2．06）s，差异有统计学意义（t ＝2．40，P ＜0．05），治疗后3个月，对照组为（6．29±2．98）s，治疗组为（9．43±1．81）s，差异有统计学意义（t ＝2．38，P ＜0．05），治疗后6个月，对照组为（7．43±2．88）s，治疗组为（10．29±1．80）s，差异有统计学意义（t ＝2．23，P ＜0．05），治疗后12个月，对照组为（9．57±2．23）s，治疗组为（12．43±1．27）s，差异有统计学意义（t ＝2．95，P ＜0．05）。治疗后1个月，对照组角膜荧光染色为（7．86±2．79）分，治疗组为（4．00±1．73）分，差异有统计学意义（t ＝3．10，P ＜0．05），治疗后3个月，对照组为（5．57±3．26）分，治疗组为（2．14±1．57）分，差异有统计学意义（t ＝2．51，P ＜0．05），治疗后6个月，对照组为（4．00±2．83）分，治疗组为（1．00±1．00）分，差异有统计学意义（t ＝2．65，P ＜0．05），治疗后12个月，对照组为（2．14±1．86）分，治疗组为（0．29±0．49）分，差异有统计学意义（t ＝2．55，P ＜0．05）。结论激素替代治疗对围绝经期干眼症患者的主观症状、基础泪液分泌、泪膜破裂时间、角膜荧光染色均改善明显，具有重要的临床价值。

Objective To observe the effect of hormone replacement therapy for perimenopausal female patients with xerophthalmia,to provide clinical basis for hormone replacement therapy to cure xerophthalmia.Methods 120 cases with perimenopausal xerophthalmia （240 eyes）were randomly divided into control group （60 cases, 120 eyes）and treatment group （60 cases,120 eyes）.The control group was treated by glycerol eye drops,the treat-ment group was treated by drug dragon piece and glycerol eye drops.The basal tear secretion,tear film break-up time, corneal fluorescein stain after treatment 1,3,6,12 months were observed,and the results were recorded.Results 1 month after treatment,the level of basal tear secretion in the control group was （5.22 ±2.05）mm,which in the treatment group was （8.0 ±1.94）mm,the difference between two groups was statistically significant（t =2.40,P 〈0.05）.3 months after treatment,the level of basal tear secretion in the control group was （6.67 ±2.34）mm,which in the treatment group was （9.00 ±2.18）mm,the difference between two groups was statistically significant（t =2.19, P 〈0.05）.6 months after treatment,the level of basal tear secretion in the control group was （7.67 ±2.35）mm, which in the treatment group was （10.56 ±2.70）mm,the difference between the two groups was statistically signifi-cant（t =2.42,P 〈0.05 ）.12 months after treatment,the level of basal tear secretion in the control group was （9.00 ±2.18）mm,which in the treatment group was （11.44 ±2.51）mm,the difference between the two groups was statistically significant（t =2.59,P 〈0.05）.1 month after treatment,the tear film break-up time in the control group＆amp;nbsp;was （5.14 ±2.79）s,which in the treatment group was （8.29 ±2.06）s,the difference between the two groups was significant（t =2.40,P 〈0.05 ）.3 months after treatment,the tear film break-up time in the control group was （6.29 ±2.98）s,which in the treatment group was （9.43 ±1.81）s,the difference between the two groups was statis-tically significant（t =2.38,P 〈0.05）.6 months after treatment,the tear film break-up time in the control group was （7.43 ±2.88）s,whichin the treatment group was （10.29 ±1.80）s,the difference between two groups was statistical-ly significant（t =2.23,P 〈0.05）.12 months after treatment,the tear film break-up time in the control group was （9.57 ±2.23）s,which in the treatment group was （12.43 ±1.27）s,the difference between the two groups was sta-tistically significant（t =2.95,P 〈0.05）.1 month after treatment,the results of corneal fluorescein staining in the control group was （7.86 ±2.79）points,which in the treatment group was （4.00 ±1.73）points,the difference between two groups was statistically significant（t =3.10,P 〈0.05）.3 months after treatment,the results of corneal fluorescein staining in the control group was （5.57 ±3.26 ）points,which in the treatment group was （2.14 ± 1.57）points,the difference between two groups was statistically significant（t =2.51,P 〈0.05）.6 months after treat-ment,the results of corneal fluorescein staining in the control group was （4.00 ±2.83）points,which in the treatment group was （1.00 ±1.00）points,the difference between two groups was statistically significant（t =2.65,P 〈0.05）. 12 months after treatment,the results of corneal fluorescein staining in the control group was （2.14 ±1.86）points, which in the treatment group was （0.29 ±0.49）points,the difference between two groups was statistically significant （t =2.55,P 〈0.05）.Conclusion Hormone replacement therapy in patients with xerophthalmia,perimenopausal subjective symptoms of patients with dry eyes,basic tear secretion tear break-up time,corneal fluorescein staining re-sults were obviously improved,it has important clinical value.