杞菊地黄丸联合普拉洛芬和玻璃酸钠滴眼液对干眼症患者泪膜稳定性及血清STRA6、TGF-β1水平的影响

Effects of Qiju Dihuang Pills Combined with Pranoprofen and Sodium Hyaluronate Eye Drops on Tear Film Stability and Serum STRA6 and TGF-β1 Levels in Patients with Dry Eye Syndrome

目的:观察杞菊地黄丸联合普拉洛芬和玻璃酸钠滴眼液对干眼症患者泪膜稳定性及血清维甲酸诱导蛋白6(STRA6)、转化生长因子-β1(TGF-β1)水平的影响。方法:干眼症患者126例随机分为观察组64例和对照组62例。对照组患者给予普拉洛芬滴眼液联合玻璃酸钠滴眼液治疗,观察组在对照组基础上加用杞菊地黄丸。两组均连续治疗4周。分别于治疗前后比较两组患者泪膜破裂时间(BUT)、泪液分泌试验(SIt)及角膜荧光着色评分,以及血清STRA6、TGF-β1水平变化,评价两组疗效及药品不良反应发生情况。结果:观察组治疗总有效率显著高于对照组(P<0.05)。治疗2周、治疗4周后,两组患者BUT、SIt和血清TGF-β1水平均较治疗前显著升高(P<0.05),角膜荧光着色评分和血清STRA6水平则较前显著降低(P<0.05);且治疗2周、治疗4周观察组上述指标均显著优于对照组(P<0.05)。两组药品不良反应发生率差异无统计学意义(P>0.05)。结论:杞菊地黄丸联合普拉洛芬和玻璃酸钠滴眼液治疗干眼症安全有效,可有效促进泪液分泌,减缓泪膜破裂时间,提高泪膜稳定性,其作用机制可能与抑制STRA6水平表达,而激活TGF-β1水平表达有关。

Objective:To observe the effect of Qiju Dihuang pills combined with pranoprofen and sodium hyaluronate eye drops on tear film stability and serum levels of retinoic acid-inducible protein 6(STRA6)and transforming growth factor-β1(TGF-β1)in patients with dry eye syndrome.Methods:A total of 126 patients with dry eye were randomly divided into an observation group of 64 cases and a control group of 62 cases.The control group was given praprofen eye drops combined with sodium hyaluronate eye drops,and the observation group was given Qiju Dihuang pills on the basis of the control group.Both groups were treated continuously for 4 weeks.Before and after treatment,the tear break-up time(BUT),tear secretion test(SIt),corneal fluorescence staining score,as well as the changes of serum STRA6 and TGF-β1 levels were compared between the two groups,and the curative effect and the occurrence of adverse drug reactions in the two groups were evaluated.Results:The total effective rate of treatment in the observation group was significantly higher than that in the control group(P<0.05).After 2 weeks and 4 weeks of treatment,the levels of BUT,SIt and serum TGF-β1 in the two groups were significantly higher than those before treatment(P<0.05),while the corneal fluorescence staining score and serum STRA6 level were significantly lower than those before treatment(P<0.05);the above indexes in the observation group were significantly better than those in the control group after 2 weeks and 4 weeks of treatment(P<0.05).There was no significant difference in the incidence of adverse drug reactions between the two groups(P>0.05).Conclusion:Qiju Dihuang pills combined with pranoprofen and sodium hyaluronate eye drops are safe and effective in the treatment of dry eye,can effectively promote tear secretion,slow tear film breakup time,and improve tear film stability,and its mechanism may be related to the inhibition of STRA6 level expression,and activated TGF-β1 level expression.