养阴疏肝法联合玻璃酸钠滴眼液治疗干眼症临床观察

Clinical observation of nourishing yin and dispersing stagnated liver qi method combined with hyaluronic acid sodium eye drops on dry eye syndrome

目的:观察养阴疏肝法联合玻璃酸钠滴眼液治疗干眼症的临床疗效。方法:采用随机对照研究,选取2014年7月至2016年2月期间在我院就诊且确诊的干眼症患者60例120眼,随机分为单纯玻璃酸钠滴眼液对照组30例60眼和玻璃酸钠滴眼液联合养阴疏肝中药口服组(治疗组)30例60眼,连续治疗2mo后,比较两组治疗前后的临床症状、泪液基础分泌试验(Schirmer Ia)、泪膜破裂时间(BUT)及角膜荧光素染色(FL)程度。结果:治疗组总有效率为93.33%(95%CI=77.90%~99.20%),对照组为66.67%(95%CI=49.80%~83.87%),两组综合疗效比较(u=1.758 9,P=0.078 6),差异接近临界状态。结论:采用养阴疏肝法联合玻璃酸钠滴眼液中西医结合治疗干眼症疗效优于单纯应用玻璃酸钠滴眼液治疗,其收益为OR=0.14(95%CI=0.03~0.72),NNT=4(95%CI=2.13~15.58)。

Objective： To observe the clinical effect of nourishing yin and dispersing stagnated liver qi method combined with hyaluronic acid sodium eye drops on dry eye syndrome. Methods： Using randomized controlled research,60 cases of selected patients,whose 120 eyes were diagnose as dry eye syndrome and treated from July 2014 to February 2016 in our hospital,were divided randomly into two groups. 30 cases（ 60 eyes） of control group were treated purely with hyaluronic acid sodium eye drops,while 30 cases（ 60 eyes） of treatment group were treated with hyaluronic acid sodium eye drops comboned with oral traditional Chinese medicine for nourishing yin and dispersing stagnated liver qi. After continuous treatment for 2 months,the clinical symptoms,tear secretion basic test（ Schirmer Ia）,tear film break-up time（ BUT） and corneal fluorescein staining（ FL） degree before and after treatment were compared in two groups. Results： The total effective rate of treatment group was 93. 3%（ 95% CI =77. 90% - 99. 20%）,while the total effective rate of control group was 66. 7%（ 95% CI = 49. 80% - 83. 87%）.Compared the comprehensive efficacy in two groups（ u = 1. 7589,P = 0. 0786）,the difference approached the critical state. Conclusion： The effect of integrated traditional Chinese and western medicine of nourishing yin and dispersing stagnated liver qi method combined with hyaluronic acid sodium eye drops on dry eye is better than that of pure hyaluronic acid sodium eye drops. Its benefit is OR = 0. 14（ 95% CI = 0. 03 to 0. 72） and NNT = 4（ 95%CI = 2. 13 to 15. 58）.