中药养血生津明目汤联合0.1%玻璃酸钠雾化治疗干眼的临床疗效

Clinical effect of Yangxue Shengjin Mingmu decoction combined with 0.1%sodium hyaluronate by ultrasonic atomization in the treatment of dry eyes

目的探讨中药养血生津明目汤联合0.1%玻璃酸钠雾化治疗干眼的临床疗效。方法选择轻中度干眼患者100例(200眼),随机分为中药雾化组35例(70眼)、0.1%玻璃酸钠雾化组35例(70眼)和中药联合0.1%玻璃酸钠雾化组30例(60眼)。分别在治疗前、治疗5 d后、治疗10 d后3个时间点记录患者干眼相关评估指标,包括患者干眼评估问卷评分,采用干眼分析仪器keratometry采集首次非侵入泪膜破裂时间(NITBUTf)、平均泪膜破裂时间(NITBUTav)、干眼水平分级、非侵入泪河高度(NTMH)以及裂隙灯显微镜下角结膜染色评分。采用广义估计方程或混合效应模型以及重复测量方法进行组内不同时间及组间各项指标比较。结果经治疗后,3组治疗方案干眼评估指标包括NITBUTf、NITBUTav、NTMH、角膜染色评分、患者自觉症状等与治疗前相比均有改善,差异有统计学意义(P<0.05)。各组治疗10 d后NITBUTf、NITBUTav均优于治疗5 d后指标,但治疗5 d后NTMH数值高于治疗10 d后指标,差异有统计学意义(P<0.05)。治疗5 d后,中药联合0.1%玻璃酸钠雾化组和中药组效果指标差异无统计学意义,均优于0.1%玻璃酸钠雾化组(P<0.05);治疗10 d后,中药联合0.1%玻璃酸钠雾化组NITBUTf、NTMH均优于中药组和0.1%玻璃酸钠雾化组(P<0.05)。结论中药养血生津明目汤联合0.1%玻璃酸钠雾化短期内可有效治疗轻中度干眼,不仅能提高患者的泪膜稳定性,对干眼患者的自觉症状也有较好的改善作用,远期效果有待进一步观察。

Objective To investigate the clinical effect of Yangxue Shengjin Mingmu Decoction combined with 0.1%sodium hyaluronate by ultrasonic atomization in the treatment of dry eyes.Methods One hundred patients(200 eyes)with mild to moderate dry eyes were selected and randomly divided into three groups:traditional Chinese medicine(TCM)atomization group(35 cases,70 eyes),0.1%sodium hyaluronate atomization group(35 cases,70 eyes)and TCM combined with 0.1%sodium hyaluronate atomization group(30 cases,60 eyes).At three time points before treatment,5 days after treatment and 10 days after treatment,patients’dry eye evaluation indexes were recorded,including patients’dry eye evaluation questionnaire score,first noninvasive tear film break-up time(NITBUTf),average NITBUT(NITBUTav),dry eye level classification and noninvasive tear meniscus height(NTMH)measured by Keratograph,corneal and conjunctival staining score under slit lamp microscope.The generalized estimation equation or mixed effects model and repeated measurement method were used to compare various indicators within and between groups at different times.Results After treatment,the dry eye evaluation indexes including NITBUTf,NITBUTav,NTMH,corneal staining score,patients’conscious symptoms all improved in the three groups compared with those before treatment,with statistical significance(P<0.05).NITBUTf and NITBUTav after 10 days of treatment were better than the indexes after 5 days of treatment,but the value of NTMH after 5 days of treatment was higher than the indexes after 10 days of treatment,with statistical significance(P<0.05).Comparison of clinical effects among the three groups after 5 days of treatment showed that there was no statistical difference in all indexes between the group of TCM combined with 0.1%sodium hyaluronate atomization and the group of TCM,both of which were superior to the group of sodium hyaluronate atomization(P<0.05).The efficacy of 10-day treatment showed that NITBUTF and NTMH in the TCM combined with 0.1%sodium hyaluronate atomization group were better than TCM group and 0.1%sodium hyaluronate atomization group(P<0.05).Conclusion Yangxue Shengjin Mingmu Decoction combined with 0.1%sodium hyaluronate by ultrasonic atomization can effectively treat mild and moderate dry eye in a short term,not only can improve the stability of tear film,but also has a better effect on the symptoms of patients with dry eye,and the long-term effect remains to be further observed.