中药熏蒸疗法治疗干眼的临床应用

Clinical Application of Traditional Chinese Medicine Fumigation Therapy in Dry Eyes

目的:研究中药熏蒸疗法治疗干眼症的临床效果。方法:前瞻性对照研究。选取2018年1月至2020年12月于绍兴市中医院眼科诊治的干眼患者98例(196眼),依照随机数字表法分为2组:对照组49例(98眼),滴用玻璃酸钠滴眼液治疗;观察组49例(98眼),应用干眼中医学基础理论及中药作用机理实施中药熏蒸治疗。分别记录治疗前、治疗30 d后泪液分泌量(SⅠt)、泪膜破裂时间(BUT)及角膜荧光素染色(FL)结果。组间数据比较采用独立样本t检验及非参数秩和检验。结果:观察组与对照组治疗前SⅠt、BUT、FL评分等差异无统计学意义。观察组治疗后SⅠt(t=-2.78,P=0.006)、BUT(t=-2.89,P=0.005)、FL评分(Z=2.69,P=0.007)均明显优于对照组,差异有统计学意义。观察组和对照组患者临床治疗总有效率分别为93.9%和77.6%,2组差异有统计学意义(Χ^(2)=5.33,P=0.021)。结论:在临床治疗干眼中,基于中医学基础理论及中药作用机理所制定的中药熏蒸疗法能够有效改善患者干眼症状,提升治疗效果。

Objective:To study the clinical effect of traditional Chinese medicine fumigation therapy on dry eyes.Methods:This study was a prospective controlled study.A total of 98 patients(196 eyes)with dry eye in Shaoxing Hospital of Traditional Chinese Medicine from January 2018 to December 2020 were randomly divided into 2 groups according to the random number table method.49 patients(98 eyes)in control group were treated with sodium hyaluronate eye drops,while the other 49 patients(98 eyes)in the observation group were treated with traditional Chinese medicine fumigation using the basic theory of xerophthalmia and the mechanism of Chinese medicine.Tear secretion(SchirmerⅠTest,SⅠt),break-up time(BUT)and corneal fluorescein staining(FL)were recorded before and 30 days after treatment.Independent sample t test and nonparametric rank sum test were used for comparison between groups.Results:Before treatment,there were no statistical differences in SⅠt,BUT,FL staining scores between the observation group and the control group.After treatment,the SⅠt(t=-2.78,P=0.006),BUT(t=-2.89,P=0.005),FL staining scores(Z=2.69,P=0.007)of the observation group were significantly better than those of the control group,with statistical significance.The total clinical effective rate of observation group and control group was 93.9%and 77.6%,respectively,and the difference was statistically significant(Χ^(2)=5.33,P=0.021).Conclusions:In the clinical treatment of dry eyes,fumigation therapy with traditional Chinese medicine based on the basic theory of traditional Chinese medicine and medication mechanism can effectively improve the symptoms of dry eye and improve the therapeutic effect.