杞菊甘露饮三联疗法治疗肺肾阴虚型阻塞型睑板腺功能障碍相关干眼75例疗效评估

Effect evaluation of Qiju Ganlu Yin triple therapy in treating dry eye related to obstructive meibomian gland dysfunction of lung-kidney yin deficiency type

目的观察杞菊甘露饮治疗肺肾阴虚型轻中度阻塞型睑板腺功能障碍(OMGD)相关干眼的临床效果。方法采用随机数字表法将150例肺肾阴虚型轻中度OMGD相关干眼的患者分为对照组和观察组各75例。2组均采用0.1%普拉洛芬滴眼液、0.1%玻璃酸钠滴眼液点双眼和睑板腺按摩治疗。同时观察组采用杞菊甘露饮内服和外用熏蒸治疗,而对照组采用蒸馏水熏蒸治疗,2组均治疗4周。对比2组总体疗效及治疗前后眼表疾病指数(OSDI)评分、睑板腺评分、眼红分析、荧光素钠染色评分(FSS)、首次泪膜破裂时间(BUTf)、平均泪膜破裂时间(BUTav)、泪河高度(TMH)及中医证候积分的变化情况。结果治疗后,观察组的总有效率为90.41%,高于对照组65.75%(P<0.05);观察组的OSDI评分、睑板腺评分、眼红分析、FSS、中医证候积分均较对照组降低(P<0.05),BUTf、BUTav、TMH均提高(P<0.05)。结论杞菊甘露饮三联疗法可显著改善肺肾阴虚型轻中度OMGD相关干眼患者的主客观症状,补肺益肾、金水相生,恢复肺肾阴阳的平衡状态,促进泪液的分泌,改善眼表的微循环,恢复泪膜的稳态。

Objective To evaluate the clinical effect of"Qiju Ganlu Yin"in treating mild and moderate dry eyes related to obstructive meibomian gland dysfunction(OMGD)of lung-kidney yin deficiency type.Methods Using a random number table method,150 patients with mild and moderate dry eyes related to OMGD of lung-kidney yin deficiency type were divided into a control group and a treatment group with 75 cases each.Both groups were treated with 0.1%pranoprofen,0.1%sodium hyaluronate eye drops for both eyes and meibomian gland massage.Meanwhile,the treatment group was also given Qiju Ganlu Yin for oral taking and external fumigation,while the control group was fumigated with distilled water.Patients of two groups had 4 weeks of treatment.Then,the overall efficacy,ocular surface disease index(OSDI)score,meibomian gland score,ocular red analysis,fluorescein stain score(FSS),first tear film break-up time(TBUTf),average tear film break-up time(BUTav),lower tear meniscus height(TMH)and TCM syndrome score were observed and analyzed.Results After treatment,the total effective rate in the treatment group was 90.41%,which was significantly higher than 65.75%in the control group(P<0.05).Compared with the control group,OSDI score,the meibomian gland score,eye red analysis,FSS and traditional Chinese medicine(TCM)syndrome score in the treatment group were significantly reduced(P<0.05),while the BUTf,BUTav and TMH in the treatment group were significantly increased(P<0.05).Conclusion Qiju Ganlu Yin triple therapy can significantly improve the subjective and objective symptoms of mild and moderate dry eye in patients related to OMGD of lung-kidney yin deficiency type,invigorate the lung and the kidney,promote the mutual growth of gold and water,restore the balance of yin and Yang in the lung and kidney,promote the secretion of tear,improve the microcirculation of eye surface,and restore the homeostasis of eye surface.