便携式干眼熏蒸仪中药熏蒸对干眼的短期疗效

Clinical efficacy of traditional Chinese herbs steam using potable dry eye steam instrument on dry eye

目的观察在家庭使用的条件下便携式干眼熏蒸治疗仪中药熏蒸对干眼患者的治疗效果。设计前瞻性比较性病例系列。研究对象2016-2017年北京同仁医院眼科门诊诊断干眼的患者96例,平均年龄(55.60±12.30)岁。方法将96例受试者随机分为两组,试验组及对照组,每组48例。试验组应用便携式干眼中药熏蒸仪,并加入珍芪滴眼液和眼用消炎熏剂雾化熏蒸治疗,每天1次,每次20分钟。对照组给予玻璃酸钠滴眼剂点眼,每日5次,每次1滴。观察用药4周受试者干眼症状及体征改善情况。疗效指数=(治疗前主观症状评分-治疗后主观症状评分)/治疗前主观症状评分×100%,疗效指数≥90%为临床显效,泪膜破裂时间(BUT)、SchirmerⅠ试验(SIt)、角膜染色均恢复正常;90%>疗效指数≥30%为临床有效,SIt、BUT、角膜染色3项中有1项以上改善者;疗效指数<30%为临床无效,SIt、BUT、角膜染色均无改善。主要指标总有效率(临床显效率+有效率)、症状评分、SIt、BUT、角膜荧光素染色评分。结果治疗前试验组与对照组在症状评分、SIt、BUT、角膜荧光素染色评分上均无显著差异。治疗4周时试验组的总有效率为79.17%,高于对照组的66.67%,但无显著性差异(P=0.168)。治疗4周时试验组BUT为(5.54±2.39)s,对照组为(4.56±2.09)s,试验组明显高于对照组(P=0.03)。试验组症状评分为2.75±1.94,对照组为3.67±2.02,试验组明显低于对照组(P=0.02)。结论使用便携式干眼熏蒸仪中药熏蒸疗法能有效治疗干眼,该疗法不亚于玻璃酸钠滴眼液点眼治疗。

Objective To observe the efficacy of portable dry eye steam instrument using traditional Chinese herbs in treating dry eye patients in a daily home used model. Design Perspective comparative case series. Participants Ninety-six dry eye patients were all from outpatient section in Tongren Hospital from 2016 to 2017, the average age was 55.60±12.30 years old. Methods Ninety-six patients with dry eye were randomly divided into two groups, the testing group and the control group, 48 patients in each group. The testing group was given steam treatment twenty minutes every day with Zhenqi eye drop and anti-inflammatory drugs. The control group was given sodium hyaluronate eye drop 5 times a day. The symptoms and signs were observed after 4 weeks. The clinical effective index= （subjective symptoms score before treatment-subjective symptoms score after treatment）/subjective symptoms score before treatmentx 100%. The significant clinical effectiveness means clinical effective index ≥90%, BUT, Sit, cornea fluorescence was recovered completely. The clinical effectiveness means 90% ≥ clinical effective index ≥ 30%, one of them includes BUT, Sit and cornea fluorescence was improved. No clinical effectiveness means clinical effective index 〈30%, any of them includes BUT, Sit and cornea fluorescence was not improved. Main Outcome Measures The total clinical effectiveness ratios（significant clinical effectiveness ＋ clinical effectiveness）, total scores of symptoms, Sit, BUT, cornea fluorescence score. Results There was no significant difference between testing group and control group in total scores of symptoms, Sit, BUT, cornea fluorescence score before any treatment was given. The clinical effectiveness ratio was 79.17% in testing group, and 66.67% in control group after 4 weeks treatment, no significant was found （P=0.168）. After 4 weeks treatment, the BUT was 5.54±2.39 s in testing group and 4.56±2.09 s in control group （P=0.03）. The total score of symp- tom was 2.75±1.94 in testing group and 3.67±2.02 in control group （P=0.02）. Conclusion Dry eye can be effectively treated by Chi- nese herb stream treatment, the effectiveness in Chinese herb stream treatment with Zhenqi on dry eye was found to be better than sodium hyaluronate eye drop only.