清肝泻火除湿方联合凉泻针法治疗肝经郁热型干眼症的效果分析

Effect of Qinggan Xiehuo Chushi Recipe(清肝泻火除湿方)Combined with Cooling and Purging Acupuncture on Dry Eye of Heat Stagnation in Liver Meridian Type

目的探讨清肝泻火除湿方联合凉泻针法治疗肝经郁热型干眼症的效果。方法95例肝经郁热型干眼症患者依据治疗方法的不同分为对照组(玻璃酸钠滴眼液治疗,47例)、研究组(清肝泻火除湿方+凉泻针法+玻璃酸钠滴眼液治疗,48例)。比较两组治疗前、治疗4周中医证候积分、角膜荧光色素染色(corneal fluorescent pigment staining,FLS)评分、泪膜破裂时间(tear film rupture time,BUT)、基础泪液分泌量(basic tear secretion volume,SIt)及泪液中炎性因子水平。统计两组治疗期间不良反应发生率,对比两组中医证候疗效。结果治疗后研究组中医证候各项评分及总分均低于对照组(P<0.05)。治疗4周后研究组FLS评分[(2.16±0.73)分vs(4.37±0.92)分]低于对照组(t=12.984,P<0.05),BUT[(10.47±1.92)s vs(7.84±1.63)s]、SIt[(8.14±2.06)mm vs(6.53±1.94)mm]则高于对照组(t=7.190、3.920,均P<0.05)。治疗4周后研究组IL-6[(1.02±0.13)pg/L vs(1.36±0.15)pg/L]、IL-1β[(0.67±0.12)pg/L vs(1.14±0.19)pg/L]及TNF-α[(0.16±0.04)pg/L vs(0.27±0.09)pg/L]水平均低于对照组(t=11.814、14.447、7.725,均P<0.05)。两组不良反应发生率相近(χ^(2)=0.667,P=0.414)。研究组中医证候总有效率[95.83%(46/48)]高于对照组[78.72%(37/47)](χ^(2)=6.299,P=0.012)。结论清肝泻火除湿方联合凉泻针法治疗肝经郁热型干眼症可改善患者临床症状,提高眼表功能,降低泪液中炎性因子水平,提高中医证候疗效,且安全可靠。

Objective To investigate the effect of Qinggan Xiehuo Chushi Recipe(清肝泻火除湿方)combined with cooling and purging acupuncture in treating dry eye of heat stagnation in liver meridian type.Methods Ninety-five cases of dry eye of heat stagnation in liver meridian type were divided into control group(47 cases treated with sodium hyaluronate eye drops)and study group(48 cases treated with Qinggan Xiehuo Chushi Formula+cooling and purging acupuncture+sodium hyaluronate eye drops)according to different treatment methods.The TCM syndrome scores,corneal fluorescent pigment staining(FLS)score,tear film rupture time(BUT),basic tear secretion volume(SIt)and the levels of inflammatory factors in tears were compared between the two groups.The incidence of adverse reactions in the treatment period of the two groups was counted,and the curative effect of TCM syndrome of the two groups was compared.Results After treatment,the scores and total scores of TCM syndromes in the study group were lower(P<0.05).After 4 weeks of treatment,FLS score in the study group was lower than that in the control group[(2.16±0.73)points vs(4.37±0.92)points](t=12.984,P<0.05).The values of BUT[(10.47±1.92)s vs(7.84±1.63)s]and SIt[(8.14±2.06)mm vs(6.53±1.94)mm]in the control group were higher than those in the control group(t=7.190,3.920,P<0.05).After 4 weeks of treatment,the levels of IL-6[(1.02±0.13)pg/L],IL-1β[(0.67±0.12)pg/L]and TNF-α[(0.16±0.04)pg/L]in the study group were lower than those[(1.36±0.15)pg/L,(1.14±0.19)pg/L,(0.27±0.09)pg/L]in the control group(t=11.814,14.447,7.725,P<0.05).The incidence of adverse reactions in the two groups was similar during treatment(χ^(2)=0.667,P=0.414).The total effective rate of TCM syndrome in the treatment group[95.83%(46/48)]was higher than that in the control group[78.72%(37/47)](χ^(2)=6.299,P=0.012).Conclusion Qinggan Xiehuo Chushi Recipe combined with cooling and purging acupuncture can improve the clinical symptoms and the ocular surface function,reduce the levels of inflammatory factors in tears,and improve the efficacy of TCM syndromes,which is safe and reliable.