金栀清目方联合妥布霉素地塞米松眼膏治疗睑板腺功能障碍性干眼75例

Clinical effect of Jinzhi Qingmu prescription combined with tobramycin and dexamethasone ophthalmic ointment in treatment of dry eye disease caused by meibomian gland dysfunction:An analysis of 75 cases

目的:探讨金栀清目方联合妥布霉素地塞米松眼膏治疗脾胃湿热型睑板腺功能障碍性干眼的临床效果。方法:选取脾胃湿热型睑板腺功能障碍性干眼患者150例为研究对象,将其随机分为治疗组和对照组,每组各75例。对照组采用妥布霉素地塞米松眼膏治疗,治疗组在对照组基础上加用金栀清目方治疗,2组疗程均为4周。观察2组中医证候评分及眼表指标[泪膜破裂时间(BUT)、角膜荧光素钠染色(FLT)结果、泪液分泌试验(SIT)结果]的改善情况,并评定综合疗效及安全性。结果:总有效率治疗组为98.67%(74/75),对照组为90.67%(68/75),2组比较,差异有统计学意义(P<0.05);2组中医证候各项评分及总积分、BUT、FLT、SIT治疗前后组内比较及治疗后组间比较,差异均有统计学意义(P<0.01);不良反应总发生率治疗组为2.66%(2/75),对照组为12.00%(9/75),2组比较,差异有统计学意义(P<0.05)。结论:金栀清目方联合妥布霉素地塞米松眼膏可减轻睑板腺功能障碍性干眼患者眼部不适症状及伴随症状,改善眼表指标,提高疗效,且联合中药有利于减轻西药的不良反应,值得临床推广。

Objective:To investigate the clinical effect of Jinzhi Qingmu prescription combined with tobramycin and dexamethasone ophthalmic ointment in the treatment of dry eye disease caused by meibomian gland dysfunction with spleen-stomach damp-heat syndrome.Methods:A total of 150 patients with dry eye disease caused by meibomian gland dysfunction with spleen-stomach damp-heat syndrome were enrolled as subjects and randomly divided into treatment group and control group,with 75 patients in each group.The patients in the control group were given tobramycin and dexamethasone ophthalmic ointment,while those in the treatment group were given Jinzhi Qingmu prescription in addition to the treatment in the control group,and the course of treatment was 4 weeks for both groups.The two groups were observed in terms of the improvement in traditional Chinese medicine(TCM)syndrome score and ocular surface parameters[tear break-up time(BUT),corneal fluorescein sodium staining(FLT)results,and Schirmer I test(SIT)results],and overall response and safety were evaluated.Results:There was a significant difference in overall response rate between the treatment group and the control group[98.67%(74/75)vs 90.67%(68/75),P<0.05].After treatment,both groups had significant changes in total TCM syndrome score,TCM syndrome score of each item,BUT,FLT,and SIT,and there were significant differences in these indices between the two groups after treatment(P<0.01).There was also a significant difference in the incidence rate of adverse reactions between the treatment group and the control group[2.66%(2/75)vs 12.00%(9/75),P<0.05].Conclusion:In the treatment of patients with dry eye disease caused by meibomian gland dysfunction,Jinzhi Qingmu prescription combined with tobramycin and dexamethasone ophthalmic ointment can alleviate eye discomforts and accompanying symptoms and improve ocular surface parameters and treatment outcome,and its combination with TCM can alleviate the adverse reactions of Western medicine.Therefore,it holds promise for clinical application.