当归养荣汤加味治疗气血亏虚型围绝经期干眼临床研究

Clinical study of modified Danggui Yangrong decoction in treatment on dry eye of perimenopausal women with qi and blood deficiency type

目的观察当归养荣汤加味治疗气血亏虚型围绝经期干眼的临床疗效。方法将60例气血亏虚型围绝经期干眼患者按照随机数字表法分为治疗组30例(60只眼)和对照组30例(60只眼),两组基础治疗均给予玻璃酸钠滴眼液点眼,治疗组在基础治疗上给予当归养荣汤加味口服治疗,疗程均为4周。观察治疗4周后的主要临床症状积分、泪液分泌试验(SIT)、泪膜破裂时间(BUT)和角膜荧光染色(FL)评分指标的变化。结果 (1)总有效率:治疗4周后,治疗组总有效率为86.67%,对照组总有效率为63.33%,2组比较差异有统计学意义(c2=6.294,P=0.012)。(2)临床症状积分:2组治疗后临床症状积分明显降低,治疗组明显低于对照组,2组比较差异有统计学意义(t=-8.683,P=0.000)。(3)干眼相关指标:治疗4周后,2组BUT较治疗前均有改善(t对照=9.521,t治疗=13.233,均P=0.000);治疗组SIT较治疗前明显改善(t=17.297,P=0.000),而对照组SIT较治疗前无明显差异(t=1.497,P=0.140);两组FL均较治疗前有改善(t对照=3.018,P=0.038,t治疗=9.002,均P=0.000);治疗4周后,BUT、SIT、FL比较,2组差异均有统计学意义(tBUT=16.670,tSIT=6.705,tFL=-5.388,均P=0.000)。结论当归养荣汤加味治疗气血亏虚型围绝经期女性干眼患者,BUT、SIT及FL三项客观指标及主观不适症状均有改善,该疗法在延长BUT、促进泪液分泌及减轻主观症状评分方面优于对照组。

OBJECTIVE To observe the clinical effect of modified Danggui Yangrong decoction in treatmen of perimenopausal dry eye with qi and blood deficiency type. METHODS Sixty cases on dry eye of perimenopausal women with qi and blood deficiency type were randomly divided into treatment group(TG,60 eyes) and control group(CG,60 eyes). Both groups were basically treated with sodium hyaluronate eye drops for 4 weeks, while the treatment group was given modified Danggui Yangrong decoction oral treatment on the basis of artificial tears. The scores of main clinical symptoms, Schirmer I test(SIT), tear break-up time(BUT) and corneal fluorescent staining(FL)scores were recorded after 4 weeks of treatment. RESULTS(1)Total effective rate:After 4 weeks of treatment, the total effective rate of the treatment group was 86.67%, and that of the control group was 63.33%. The difference between the two groups was statistically significant(c2=6.294, P =0.012).(2)Clinical symptom scores:after treatment, the clinical symptom scores of two groups were significantly decreased. The scores of treatment group were significantly lower than that of control group, and the difference between the two groups were statistically significant( t =-8.683, P =0.000).(3)Correlation index of dry eye:after 4 weeks of treatment, BUT were significantly improved in both groups(tCG= 9.521, tTG= 13.233, all P= 0.000),and SIT were significantly improved in treatment group(t= 17.297,P= 0.000), but there was no significant difference in SIT of the control group(t=1.497, P=0.140). Compared with before treatment,FL in both groups were improved(tCG=3.018, P= 0.038, tTG=9.002, all P= 0.000).After 4 weeks of treatment,, BUT, SIT and FL were significantly different between the two groups(tBUT=16.670,tSIT=6.705, tFL=-5.338, all P=0.000). CONCLUSIONS Modified Danggui Yangrong decoction in treatment of perimenopausal women with dry eye of qi and blood deficiency type could improve the three objective indexes(BUT, SIT, FL) and subjective symptoms. The treatment was better than the control group in prolonging BUT, promoting tear secretion and reducing subjective symptom scores.