中药熏服治疗肝郁脾虚型干眼症的临床疗效观察

Clinical Observation on the Curative Effect of Chinese Medicine Decoction Fumigation Followed by Oral Use in the Treatment of Xerophthalmia with Liver Depression and Spleen Deficiency Syndrome

【目的】探究中药煎汤先熏蒸后内服联合羟丙甲纤维素滴眼液治疗肝郁脾虚型干眼症的治疗效果。【方法】将66例(132眼)肝郁脾虚型干眼症患者随机分为治疗组和对照组,每组各33例。2组患者均给予羟丙甲纤维素滴眼液的人工泪液滴眼治疗,在此基础上,对照组给予中药汤剂内服治疗,治疗组给予中药汤剂先熏蒸眼部再内服治疗,疗程为2周。观察2组患者治疗前和治疗2周后泪膜破裂时间(break-up time,BUT)、基础泪液分泌试验(SchirmerⅠtest,SIT)、角膜荧光素染色(fluorescein staining,FL)评分的变化情况,并评价2组患者的临床疗效及安全性。【结果】(1)治疗2周后,治疗组的总有效率为93.9%(31/33),对照组为72.7%(24/33),组间比较,治疗组的疗效明显优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的BUT、SIT及FL评分均较治疗前改善(P<0.01),且治疗组对BUT、SIT及FL评分的改善作用均明显优于对照组,差异均有统计学意义(P<0.05或P<0.01)。(3)研究过程中,2组患者均无明显的不良反应情况发生。【结论】中药熏服联合羟丙甲纤维素滴眼液治疗肝郁脾虚型干眼症患者安全有效,可减少人工泪液滴眼次数,有效改善患者临床症状。

Objective To investigate the therapeutic effect of Chinese medicine decoction fumigation followed by oral administration in combination with external use of hydroxypropyl methylcellulose eye drop in treating xerophthalmia of liver depression and spleen deficiency syndrome.Methods Sixty-six xerophthalmia patients(132 eyes)with liver depression and spleen deficiency syndrome were randomly divided into treatment group and control group,with 33 cases in each group.Patients in the two groups were given artificial tear eye drop therapy with hydroxypropyl methylcellulose eye drop,and additionally,the control group was given oral administration of Chinese medicine decoction,while the treatment group was given Chinese medicine decoction oral administration following fumigation,the course of treatment lasting 2 weeks.Before and 2 weeks after treatment,the changes of tear film break-up time(BUT),SchirmerⅠtest(SIT)and corneal fluorescein staining(FL)scores in the two groups were observed.After treatment,the clinical efficacy and safety of the two groups were evaluated.Results(1)After 2 weeks of treatment,the total effective rate of the treatment group was 93.9%(31/33)and that of the control group was 72.7%(24/33),and the intergroup comparison showed that the efficacy of the treatment group was significantly superior to that of the control group,the difference being statistically significant(P<0.05).(2)After treatment,the BUT,SIT and FL scores in both groups were improved compared with those before treatment(P<0.01),and the effect of improvement in the treatment group was significantly superior to that in the control group,the differences being statistically significant(P<0.05 or P<0.01).(3)During the study,there were no significant adverse reactions occurring in the two groups.Conclusion Chinese medicine decoction fumigation and oral administration combined with hydroxypropyl methylcellulose eye drop are safe and effective in treating xerophthalmia patients with liver depression and spleen deficiency syndrome,and the combined therapy is effective in reducing the medication frequency of artificial tear eye drop and improving the clinical symptoms of the patients.