直流电导入维生素B12治疗视频终端综合征导致的蒸发过强型干眼症疗效观察

Research Progress of Introduction of Vitamin B12 by Direct Current on the Treatment of Evaporative Dry Eye Caused by Video Terminal Syndrome

目的探讨维生素B12直流电导入治疗视频终端综合征(visual display terminal,VDT)导致的蒸发过强型干眼(evaporative dry eye,EDE)的疗效。方法将60例患者随机分为治疗组和对照组各30例。对照组采用0.3%玻璃酸钠眼药水每天4次滴双眼,中药外熏治疗方药每日1次,睑板腺按摩治疗每周1次,治疗组在此基础上加用直流电导入维生素B12治疗每日1次,7 d为1个疗程,4个疗程结束后,分别于就诊当日及给药后的3 d、7 d、1个月进行严格对照,根据临床常用干眼检查项目进行分级,并根据评分标准进行评估并记录。再观察对比两组结果进行统计学比较分析。结果研究组60只眼,显效50只眼,有效10只眼,无效0只眼,显效率83.33%,有效率100%;对照组60只眼,显效43只眼,有效15只眼,无效2只眼,显效率71.66%,有效率96.66%,两组显效率对比差异有统计学意义,有效率对比差异无统计学意义。泪膜破裂时间(break-up time,BUT)、泪液分泌长度测定(tear secretion test,SIT)、脂质层厚度(lipid layer thinckness,LLT)、睑板腺评分结果进行前后对比分析P<0.05,差异均有统计学意义。结果两组治疗前BUT为(2.05±0.18)mm和(1.91±0.16)mm,差异无统计学意义,治疗后BUT为(9.92±1.42)mm和(8.72±0.41)mm,差异有统计学意义,SIT治疗前为(2.13±0.22)mm和(2.03±0.26)mm,差异无统计学意义,治疗后SIT为(8.72±0.14)mm和(10.93±1.33)mm,差异有统计学意义,LLT治疗前为(45.13±5.22)nm和(57.46±5.26)nm,两组对比差异无统计学意义,治疗后LLT为(65.83±8.42)nm和(81.63±7.41)nm,差异有统计学意义,睑板腺功能治疗前为(1.7±0.8)分和(2.8±0.8)分,治疗后为(1.2±0.7)分和(3.6±0.7)分,两组对比差异有统计学意义,左、右眼的眼表疾病(OSDI)指数治疗前为(45.7±2.8)分和(44.2±3.7)分,治疗后为(13.8±0.8)分和(20.6±0.7)分,对比差异有统计学意义。结论直流电导入维生素B12治疗视频终端综合征导致的蒸发过强型干眼症有效。

Objective To investigate the efficacy of introduction of vitamin B12 by direct current in the treatment of evaporative dry eye(EDE)caused by visual display terminal syndrome(VDT). Methods 60 patients were randomly divided into treatment group and control group with 30 cases each. The control group was treated with 0.3% sodium hyaluronate eye drops 4 times a day,Chinese herbal fumigation treatment once a day,meibomian gland massage treatment once a week. On this basis,the treatment group was treated with introduction of vitamin B12,once a day,7 days as a course of treatment. At the end of the four courses of treatment,statistics were made on the day of treatment,3 days,7 days and one mouth after administration,according to the clinical commonly used dry eye examination items were graded,and evaluated and recorded according to the scoring standard. Then observed and compared the results of the two groups for statistical analysis. Results In the treatment group(60 eyes),50 eyes were markedly effective,10 eyes were effective,0 eye were ineffective,the markedly effective rate was 83.33%,and the effective rate was 100%. In the control group(120 eyes),43 eyes were markedly effective,15 eyes were effective,and 2 eyes were ineffective,and the markedly effective rate was 71.66%. In the control group,the markedly effective rate was 71.66%,and the effective rate was 96.66%,there was significant difference in the markedly effective rate between the two groups,but there was no significant difference in the effective rate between the two groups. The results of tear film break-up time(BUT),tear secretion test(SIT),lipid layer thickness(LLT)and meibomian gland score were compared before and after treatment with statistical difference(P<0.05). There was no statistical difference in BUT between the two groups before treatment(2.05±0.18)mm and(1.91±0.16)mm,BUT were(9.92±1.42)mm and(8.72±0.41)mm after treatment with statistical difference. There was no statistical difference in SIT between the two groups before treatment(2.13±0.22)mm and(2.03±0.26)mm,and after treatment SIT was(8.72±0.14)mm and(10.93±1.33)mm with statistical difference. There was no statistical difference in LLT between the two groups before treatment(45.13±5.22)nm and(57.46±5.26)nm,and after treatment LLT was(65.83±8.42)nm and(81.63±7.41)nm with statistical difference. Meibomian gland function before treatment were(1.7±0.8) points and(2.8±0.8) points,after treatment were(1.2±0.7)points and(3.6±0.7)points,the difference between the two groups was statistically significant. The OSDI scores of left and right eyes were(45.7±2.8)points and(44.2±3.7)points before treatment,and(13.8±0.8)points and(20.6±0.7)points after treatment,with statistical significance. Conclusion Introduction of vitamin B12 by direct currenti is effective in the treatment of evaporative dry eye caused by video terminal syndrome.