| 引用本文: |
武鼎慧, 郭跃先, 徐小强.清热润目汤雾化熏蒸联合玻璃酸钠滴眼液治疗阴虚湿热证老年性白内障术后干眼的临床疗效[J].湖南中医药大学学报,2025,45(4):687-692[点击复制] |
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| 清热润目汤雾化熏蒸联合玻璃酸钠滴眼液治疗阴虚湿热证老年性白内障术后干眼的临床疗效 |
| 武鼎慧,郭跃先,徐小强 |
| (长治市中医医院眼科, 山西 长治 046000;长治市第二人民医院眼科, 山西 长治 047500;北大医疗潞安医院眼科, 山西 长治 046200) |
| 摘要: |
| 目的 探讨清热润目汤雾化熏蒸联合玻璃酸钠滴眼液治疗阴虚湿热证老年性白内障术后干眼的临床疗效及其对泪液分泌质量和睑板腺功能的影响。方法 将2022年7月至2024年7月长治市中医医院收治的104例阴虚湿热证老年性白内障术后干眼患者，采用随机数字表法分为观察组和对照组，每组52例。对照组予玻璃酸钠滴眼液治疗，每眼滴入1~2滴，每日4次；观察组在对照组基础上予清热润目汤雾化熏蒸治疗，雾化熏蒸持续时间20 min，每日1次。两组均治疗2周。观察两组临床疗效、中医证候积分、泪液分泌质量、睑板腺功能、泪液炎症因子水平及治疗安全性。结果 观察组治疗总有效率（92.31%）高于对照组（76.92%）（P＜0.05）。与治疗前比较，观察组治疗后中医证候各项积分及总分、白细胞介素-6、肿瘤坏死因子-α、C反应蛋白、角结膜荧光素染色评分及睑板腺分泌物评分均降低（P＜0.05），且观察组低于对照组（P＜0.05）；观察组治疗后泪膜破裂时间、泪液分泌试验、睑板油脂厚度、睑板腺开口数量均升高（P＜0.05），且观察组高于对照组（P＜0.05）。两组不良反应发生率比较差异无统计学意义（P>0.05）。结论 清热润目汤雾化熏蒸联合玻璃酸钠滴眼液治疗阴虚湿热证老年性白内障术后干眼患者临床疗效良好，可缓解患者的干眼症状，提高泪液分泌质量，改善患者的睑板腺功能，降低泪液炎症因子水平，且治疗安全性良好。 |
| 关键词: 白内障 干眼 清热润目汤 阴虚湿热证 雾化熏蒸治疗 泪液分泌质量 睑板腺功能 |
| DOI：10.3969/j.issn.1674-070X.2025.04.015 |
| 投稿时间：2024-11-16 |
| 基金项目:山西省中医药管理局科研课题（2023ZYYB072）。 |
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| linical efficacy of nebulization and fumigation with Qingre Runmu Decoction combined with Sodium Hyaluronate Eye Drops in treating dry eye after cataract surgery in elderly patients with yin-deficiency and damp-heat pattern |
| WU Dinghui, GUO Yuexian, XU Xiaoqiang |
| (Ophthalmology Department, Changzhi Hospital of Chinese Medicine, Changzhi, Shanxi 046000, China;Ophthalmology Department, The Second People's Hospital of Changzhi, Changzhi, Shanxi 047500, China;Ophthalmology Department, PKU Care Lu'an Hospital, Changzhi, Shanxi 046200, China) |
| Abstract: |
| Objective To explore the clinical efficacy of nebulization and fumigation with Qingre Runmu Decoction (QRRMD) combined with Sodium Hyaluronate Eye Drops in treating dry eye after cataract surgery in elderly patients with yin-deficiency and damp-heat pattern and its effects on tear secretion quality and meibomian gland function. Methods A total of 104 elderly patients with dry eye after cataract surgery due to yin-deficiency and damp-heat pattern, admitted to Changzhi Hospital of Chinese Medicine from July 2022 to July 2024, were randomly divided into an observation group and a control group using random number table method, with 52 cases in each group. The control group was treated with Sodium Hyaluronate Eye Drops, with 1-2 drops in each eye, four times a day; while the observation group was treated additionally with nebulization and fumigation with QRRMD on the basis of the control group, with a nebulization and fumigation duration of 20 min, once a day. Both groups were treated for two weeks. The clinical efficacy, Chinese medicine pattern scores, tear secretion quality, meibomian gland function, tear inflammatory factor levels, and treatment safety were observed in the two groups. Results The total effective rate in the observation group (92.31%) was higher than that in the control group (76.92%) (P＜0.05). Compared with those before treatment, the scores of each item and the total score of TCM pattern, interleukin-6, tumor necrosis factor-α, C-reactive protein, corneal and conjunctival fluorescein staining score, and meibomian gland secretion score in the observation group reduced after treatment (P＜0.05), and those in the observation group were lower than those in the control group (P＜0.05); the tear film break-up time, Schirmer test results, meibomian gland lipid thickness, and meibomian gland orifice count in the observation group increased after treatment (P＜0.05), and those in the observation group were higher than those in the control group (P＜0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Nebulization and fumigation with QRRMD combined with sodium hyaluronate eye drops has good clinical efficacy in the treating dry eye after cataract surgery in elderly patients with yin-deficiency and damp-heat pattern. It can relieve dry eye symptoms, improve tear secretion quality, enhance meibomian gland function, reduce tear inflammatory factor levels, and ensure good treatment safety. |
| Key words: cataract dry eye Qingre Runmu Decoction yin-deficiency and damp-heat pattern nebulization and fumigation therapy tear secretion quality meibomian gland function |
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