杞菊地黄汤联合玻璃酸钠滴眼液对肝肾阴虚型干眼症患者眼表功能和泪液MMP-2、MMP-9水平的影响

Effects of Qiju Dihuang Decoction Combined with Sodium Hyaluronate Eye Drops on Ocular Surface Function and Tear MMP-2 and MMP-9 Levels in Patients with Dry Eye of Liver and Kidney Yin Deficiency Type

目的:观察杞菊地黄汤联合玻璃酸钠滴眼液治疗肝肾阴虚型干眼症的疗效及对眼表功能和泪液基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)的影响。方法:病例来源于2018年6月~2021年3月期间就诊于湖南省直中医医院眼科门诊的干眼症患者,共98例。采用随机数字表法分为对照组和实验组,两组均49例。对照组给予玻璃酸钠滴眼液治疗,实验组在对照组基础上接受杞菊地黄汤治疗,两组均治疗4周。对比两组疗效、中医证候积分、眼表功能和泪液MMP-2、MMP-9水平变化,观察两组治疗期间不良反应发生率。结果:实验组的临床总有效率高于对照组(P<0.05)。实验组治疗4周后眼部干涩不爽、畏光、双目频眨、口干少津、白眼泛红、舌红、苔薄、脉细证候积分均低于对照组(P<0.05)。实验组治疗4周后角膜荧光素染色(FL)评分低于对照组,泪膜破裂时间(BUT)、泪液分泌试验(SIT)水平高于对照组(P<0.05)。实验组治疗4周后泪液MMP-2、MMP-9水平低于对照组(P<0.05)。两组间不良反应发生率无统计学差异(P>0.05)。结论:杞菊地黄汤联合玻璃酸钠滴眼液治疗肝肾阴虚型干眼症,可促进患者症状缓解,改善眼表功能,降低泪液MMP-2、MMP-9水平,安全可靠。

Objective:To observe the efficacy of Qiju Dihuang Decoction Combined with sodium hyaluronate eye drops in the treatment of dry eye with liver and kidney yin deficiency and its effects on ocular surface function and tear matrix metalloproteinase-2(MMP-2)and matrix metalloproteinase-9(MMP-9)levels.Methods:A total of 98 patients with dry eye who were treated in the Outpatient Department of Hunan Provincial Hospital of Traditional Chinese Medicine from June 2018 to March 2021 were selected.They were divided into control group and experimental group randomly,49 cases in both groups.The control group was treated with sodium hyaluronate eye drops,and the experimental group was treated with Qiju Dihuang Decoction on the basis of the control group.Both groups were treated for 4 weeks.The curative effect,TCM syndrome score,ocular surface function and tear MMP-2 and MMP-9levels of the two groups were compared,and the incidence of adverse reactions during treatment was observed.Results:The total clinical effective rate of the experimental group was higher than that of the control group(P<0.05).4 weeks after treatment,the syndrome scores of dry eyes,photophobia,frequent blinking of eyes,dry mouth,redness of white eyes,red tongue,thin fur and fine pulse in the experimental group were lower than those in the control group(P<0.05).4 weeks after treatment,the tear film rupture time(BUT)and tear secretion test(SIT)levels in the experimental group were higher than those in the control group,and the score of corneal conjunctival fluorescein staining(FL)was lower than that in the control group(P<0.05).4 weeks after treatment,the levels of MMP-2 and MMP-9 in tears in the experimental group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Qiju Dihuang Decoction Combined with sodium hyaluronate eye drops can promote the relief of symptoms,improve eye surface function and reduce the levels of MMP-2 and MMP-9 in tears.