沙参麦冬汤加减方联合针刺治疗LASIK术后干眼症的疗效观察

Therapeutic Effect of Modified Shashen Maidong Decoction Combined with Acupuncture Treating Xerophthalmia After LASIK

目的观察沙参麦冬汤加减联合针刺治疗准分子激光原位角膜磨镶术(LASIK)术后阴津不足型干眼症临床疗效.方法依据纳入和排除标准纳入有效病例60例120眼LASIK手术3月后确诊为干眼的患者,随机分为2组,各30例60只眼,对照组单纯使用人工泪液滴眼,治疗组在对照组治疗基础上加服沙参麦冬汤加减方及针刺,15 d为1个疗程,2个疗程后观察角膜荧光素染色情况(FL)情况、泪膜破裂时间(BUT)、泪液分泌试验(SIt)、裸眼视力及干眼自觉症状的改善情况.结果 2组治疗后第15天2组BUT、FL进行比较,差异无统计学意义(P>0.05);2组SIt情况比较,治疗组优于对照组(P<0.05).2组治疗后第30天SIt、BUT、FL、裸眼视力及自觉症状的改善治疗组均优于对照组(P<0.05).治疗组与对照组疗程结束时症状明显改善,总有效率分别为96.8%和86.7%,有显著性差异(P<0.05).结论中药配合针刺能有效改善LASIK术后干眼症患者的症状和体征,对治疗LASIK术后干眼症有一定优势.

OBJECTIVE To observe the clinical curative effect of the combination of modified Shashen Maidong decoction and acupuncture treating xerophthalmia characterized by deficiency of yin fluid after laser in situ keratomileusis (LASIK). METHODS According to inclusion and exclusion criteria, 60 effective cases were included, 120 eyes of patients diagnosed with xerophthalmia at 3 months after LASIK, which were randomly divided into two groups, 30 cases with 60 eyes respectively. The control group was treated with artificial tear drops alone while the treatment group was treated with modified Shashen Maidong decoction and acupuncture on the basis of the treatment in the control group, 15 days as a course. After two courses, we observed the corneal fluorescein staining (FL), tear film break up time (BUT), Schirmer I test (SIt), uncorrected visual acuity and the improvement of subjective symptoms. RESULTS After 15 days' treatment, the differences between BUT and FL in the two groups were not statistically significant ( P >0.05). The SIt results in the two groups were compared, which showed statistically significant difference (P<0.05 ) and indicated effect in the treatment group is better than that in the control group. After 30 days' treatment, compared with the control group, the treatment group was more effective in terms of SIt, BUT, FL, uncorrected visual acuity and the improvement of subjective symptoms (P<0.05 ). At the end of treatment, there were obvious improvements in both two groups, 96.8% for the treatment group and 86.7% for the control group, which showed a significant difference (P<0.05 ). CONCLUSION Chinese materia medica combined with acupuncture can improve the symptoms and signs of patients with xerophthalmia after LASIK and has unique therapeutic advantages.