润目方熏蒸联合地夸磷索钠滴眼液治疗白内障术后干眼症临床研究

Clinical Study of Runmu Formula(润目方)Fumigation Combined withDiquafoxol Sodium Eye Drops in Treatment of Dry Eye Disease after Cataract Surgery

目的探讨白内障术后干眼症(DED)患者采用润目方熏蒸联合地夸磷索钠滴眼液治疗对其临床疗效、泪液分泌质量、中医症状、生命质量等的改善情况。方法将苏州中西医结合医院眼科2021年10月—2022年10月收治的白内障术后DED患者80例作为此次研究的研究对象,按照就诊先后顺序并以随机化原则分为对照组(37例)和观察组(43例)。两组于术后均给予妥布霉素地塞米松滴眼液,此基础上对照组常规给予地夸磷索钠滴眼液治疗,观察组在前述对照组用药基础上加用润目方熏蒸,均治疗2疗程。比较两组治疗2疗程后的临床疗效,治疗前及治疗1、2疗程后的泪液分泌质量,治疗前及治疗2疗程后的中医症状积分、美国国家眼科研究所视觉相关生命质量量表(NEI-VFQ-25)评分,治疗其间不良反应发生情况。结果对照组治疗2疗程的总有效率(62.16%)相比观察组(86.05%)更低(P<0.05)。治疗1、2疗程后相比于治疗前,两组泪膜破裂时间(BUT)逐渐延长,观察组均长于对照组,基础泪液分泌试验(SITI)长度逐渐增长,观察组均长于对照组,角膜荧光素染色(FL)评分逐渐降低,观察组均低于对照组(P<0.05)。治疗2疗程后相比于治疗前,两组中医症状积分各项分值均降低,观察组低于对照组,NEI-VFQ-25评分各项的分值均升高,观察组高于对照组(P<0.05)。治疗期间的总不良反应发生率两组相比差异无统计学意义(P>0.05)。结论润目方熏蒸联合地夸磷索钠滴眼液应用于白内障术后DED患者可改善泪液分泌质量,减轻临床症状,提升生命质量,具有较好的临床效果,且安全性良好,临床应用疗效确切。

Objective To investigate the improvement of clinical efficacy,quality of tear secretion,symptoms of traditional Chinese medicine and quality of life in patients with dry eyes disease(DED)after cataract surgery treated with Runmu Formula(润目方)fumigation combined with diquafoxol sodium eye drops.Methods Eighty patients with DED after cataract surgery admitted to the department of ophthalmology in Suzhou Hospital of Integrated Chinese and Western Medicine from October 2021 to October 2022 were selected as the research objects of this study,and were divided into the control group(37 cases)and the observation group(43 cases)according to the order of treatment and the principle of randomization.Both groups were treated with tobramycin and dexamethasone eye drops after surgery,on the basis of which the control group was routinely treated with diquafosone sodium eye drops,and the observation group was treated with Runmu Formula fumigation on the basis of the control group.Both groups were treated for 2 courses.The clinical efficacy after 2 courses of treatment,the quality of tear secretion before treatment and after 1 and 2 courses of treatment,the scores of symptoms of traditional Chinese medicine,national eye institute visual function questionnaire-25(NE-VFQ-25)before treatment and 2 courses after treatment,and the occurrence of adverse reactions during treatment were compared between the two groups.Results The total effective rate of the control group(62.16%)was lower than that of the observation group(86.05%)(P<0.05).Compared with those before treatment,the break up time(BUT)of the two groups gradually extended after 1 and 2 courses of treatment,and time of the control group was shorter than that of the observation group.The length of schirmer I test(SITI)gradually increased,and the length of the control group was shorter than that of the observation group.The score of fluorescent test(FL)decreased gradually,and the score of the observation group was lower than that of the control group(P<0.05).Compared with those before treatment,the scores of symptoms of traditional Chinese medicine decreased after 2 courses of treatment,and the score of the observation group was lower than that of the control group,the scores of NEI-VFQ-25 increased,and the score of the observation group was higher than that of the control group(P<0.05).There was no difference in the total incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusion The application of Runmu Formula fumigation combined with diquapoxol sodium eye drops in DED patients after cataract surgery could improve the quality of tear secretion,reduce clinical symptoms and improve the quality of life,with good clinical effect,good safety and accurate clinical application efficacy.