耳穴按压对干眼症患者结膜杯状细胞的影响研究

Effect of Auricular-plaster Therapy on Conjucntival Goblet Cells in Xerophthalmia

目的:观察耳穴按压联合人工泪液对干眼症患者的症状评分、结膜杯状细胞密度以及常规泪液功能检查结果的影响,评估其对干眼患者的治疗价值。方法:35例干眼症患者均予以耳穴按压联合人工泪液滴眼液治疗,观察治疗前后患者干眼症状评分、泪液分泌量、泪膜破裂时间以及结膜杯状细胞密度的变化,并评估结膜杯状细胞密度与干眼症状评分和常规泪液检查结果的相关性。结果:耳穴按压联合人工泪液治疗前后干眼症患者泪液分泌量比较,差异无统计学意义(F=0.373,P=0.589),但干眼症状评分明显降低,泪膜破裂时间延长,结膜杯状细胞密度增加,治疗前后三者差异均有统计学(F=0.271,1.190,0.624;P=0.000,0.000,0.000)意义;另外治疗前后结膜杯状细胞密度与干眼症状评分呈明显负相关(r2=-0.680),与泪膜破裂时间有一定的正向相关性(r2=0.277),但结膜杯状细胞密度与泪液分泌实验相关性不明显(r2=0.097)。结论:耳穴按压联合人工泪液能增加干眼症患者结膜杯状细胞密度,对改善干眼症状,降低泪膜破裂时间有较好的效果。

Objective: To assess the efficacy of auricular-plaster therapy combined with lacrima on conjucntival goblet cells in xerophthalmia. Methods: 35 cases of xerophthalmia were treated with auricular-plaster therapy combined with artificial lacrima. Before and after treatment,dry eye symptom score,tear secretion volume( Schirmer's test),breakup time( BUT),mean goblet cells density were observed and compared. Then correlative analysis was performed between goblet cells density,dry eye questionnaire,tear film breakup time and Schirmer's test scores. Results: There was no significant difference in statistics in tear secretion volume between groups after treatment( F = 0. 373,P = 0. 589). While the significant statistical differences were presented in dry eye score symptom, mean goblet cells density, BUT, in comparison before and after treatment( F = 0. 271,1. 190,0. 624; P = 0. 000,0. 000,0. 000). In addition,there was a significant negative association of mean goblet cells density with dry eye symptom score( r2 =-0. 680),a positive association also was observed between mean goblet cells density and BUT( r2 = 0. 277),in contrast to Schirmer's scores( r2 = 0. 097). Conclusion: Auricular-plaster therapy combined with lacrima apparently can relieve the symptoms of xerophthalmia,elongate BUT,and increase the mean goblet cells density.