摘要
目的观察杞精明目汤离子导入治疗结膜松弛症(CCh)肝肾阴虚证的疗效。方法纳入2022年6月—2023年2月在上海市普陀区中心医院诊治的CCh患者108例(108只眼),随机分为对照组(A组)、0.9%氯化钠注射液离子导入组(B组)和杞精明目汤离子导入组(C组),各36例(36只眼)。最终纳入A组34例(34只眼),B组33例(33只眼),C组33例(33只眼)。A组予0.1%玻璃酸钠滴眼液治疗,B组予0.9%氯化钠注射液离子导入治疗,C组予杞精明目汤离子导入组治疗。3组均治疗8周。检测受试者治疗前、后的泪膜破裂时间(BUT)、泪液分泌试验(SⅠT)、眼表疾病指数(OSDI)评分、中医症候积分(TCMSS)并做统计分析。结果(1)BUT:3组时间效应、组别效应、时间和组别交互效应差异均有统计学意义(均P<0.05)。3组治疗前后比较,A组治疗后各时间点的BUT与治疗前比较,差异均无统计学意义(P>0.05),B、C组治疗后各时间点的BUT均较治疗前延长,差异均有统计学意义(均P<0.05)。3组治疗后4周B组BUT与A组比较,差异无统计学意义(P>0.05);C组BUT长于A组和B组,差异均有统计学意义(均P<0.05)。3组治疗后8周B组、C组BUT均长于A组,差异均有统计学意义(均P<0.05);C组BUT长于B组,差异有统计学意义(P<0.05)。(2)SⅠT:3组时间效应、组别效应、时间和组别交互效应差异均无统计学意义(P>0.05)。3组治疗前后比较及治疗后组间各时间点SⅠT比较,差异均无统计学意义(P>0.05)。(3)OSDI评分:时间效应、组别效应、时间和组别交互效应差异均有统计学意义(均P<0.05)。3组治疗前后OSDI比较,A组治疗后各时间点的OSDI评分与治疗前比较,差异均无统计学意义(P>0.05),B、C组治疗后各时间点的OSDI评分均较治疗前降低,差异均有统计学意义(均P<0.05)。3组治疗后4周B组、C组OSDI评分均低于A组,差异均有统计学意义(均P<0.05);C组OSDI评分与B组比较,差异无统计学意义(P>0.05)。3组治疗后8周B组、C组OSDI评分均低于A组,差异均有统计学意义(均P<0.05);C组OSDI评分低于B组,差异有统计学意义(P<0.05)。(4)TCMSS:组别效应、时间效应、时间和组别交互效应差异均有统计学意义(均P<0.05)。3组治疗前后TCMSS比较,A组治疗后各时间点的TCMSS与治疗前比较,差异均无统计学意义(P>0.05),B、C组治疗后各时间点的TCMSS均较治疗前降低,差异均有统计学意义(均P<0.05)。3组治疗后4周A组、C组TCMSS与B组比较,差异均无统计学意义(P>0.05);C组TCMSS低于A组,差异有统计学意义(P<0.05)。3组治疗后8周B组、C组TCMSS均低于A组,差异均有统计学意义(均P<0.05);C组TCMSS低于B组,差异有统计学意义(P<0.05)。(5)临床疗效:3组总有效率比较,差异有统计学意义(P<0.05)。B、C组总有效率均高于A组,差异均有统计学意义(均P<0.05)。C组总有效率高于B组,差异有统计学意义(P<0.05)。(6)不良反应:3组不良反应发生率比较,差异无统计学意义(P>0.05)。结论杞精明目汤离子导入能较明显改善肝肾阴虚证CCh患者的眼表症状,提高泪膜的稳定性,治疗时间越长,临床结局改善越明显。
OBJECTIVE To observe the efficacy of ionic introduction of Qijing Mingmu Decoction in the treatment of conjunctivochalasis(CCh)with liver-kidney Yin deficiency syndrome.METHODS A total of 108 patients(108 eyes)with CCh diagnosed and treated in Shanghai Putuo District Central Hospital from June 2022 to February 2023 were included and randomly divided into the control group(Group A),the 0.9%sodium chloride injection ionic introduction group(Group B),and the Qijing Mingmu Decoction ionic introduction group(Group C),with 36 cases(36 eyes)in each group.Finally,34 cases(34 eyes)were included in Group A,33 cases(33 eyes)in Group B,and 33 cases(33 eyes)in Group C.Group A was treated with 0.1%sodium hyaluronate eye drops,Group B was treated with ionic introduction of 0.9%sodium chloride injection,and Group C was treated with ionic introduction of Qijing Mingmu Decoction.All three groups were treated for eight weeks.The tear film break-up time(BUT),Schirmer I test(SⅠT),Ocular Surface Disease Index(OSDI)scores,and Traditional Chinese Medicine Symptom Scores(TCMSS)of the subjects before and after treatment were detected and statistically analyzed.RESULTS(1)BUT:There were statistically significant differences in the time effect,group effect,and interaction effect between time and group among the three groups(all P<0.05).When comparing before and after treatment in the three groups,there were no statistically significant differences in the BUT at each time point after treatment compared with that before treatment in Group A(P>0.05).The BUT at each time point after treatment in Groups B and C was longer than that before treatment,and the differences were statistically significant(all P<0.05).When comparing four weeks after treatment,there was no statistically significant difference in the BUT between Group B and Group A(P>0.05).The BUT in Group C was longer than that in Group A and Group B,and the differences were statistically significant(both P<0.05).When comparing eight weeks after treatment,the BUT in Group B and Group C was longer than that in Group A,and the differences were statistically significant(both P<0.05).The BUT in Group C was longer than that in Group B,and the difference was statistically significant(P<0.05).(2)SⅠT:There were no statistically significant differences in the time effect,group effect,and interaction effect between time and group among the three groups(P>0.05).There were no statistically significant differences in the SⅠT when comparing before and after treatment in the three groups and at each time point between groups after treatment(P>0.05).(3)OSDI scores:There were statistically significant differences in the time effect,group effect,and interaction effect between time and group(all P<0.05).When comparing the OSDI before and after treatment in the three groups,there were no statistically significant differences in OSDI scores at each time point after treatment compared with those before treatment in Group A(P>0.05).The OSDI scores at each time point after treatment in Groups B and C were lower than those before treatment,and the differences were statistically significant(all P<0.05).When comparing four weeks after treatment,the OSDI scores in Group B and Group C were lower than those in Group A,and the differences were statistically significant(both P<0.05).There were no statistically significant differences in the OSDI scores between Group C and Group B(P>0.05).When comparing eight weeks after treatment,the OSDI scores in Group B and Group C were lower than those in Group A,and the differences were statistically significant(all P<0.05).The OSDI scores in Group C were lower than those in Group B,and the difference were statistically significant(P<0.05).(4)TCMSS:There were statistically significant differences in the group effect,time effect,and interaction effect between time and group(all P<0.05).When comparing the TCMSS before and after treatment in the three groups,there were no statistically significant differences in the TCMSS at each time point after treatment compared with that before treatment in Group A(P>0.05).The TCMSS at each time point after treatment in Groups B and C were lower than those before treatment,and the differences were statistically significant(all P<0.05).When comparing four weeks after treatment,there were statistically significant differences(P<0.05).There were no statistically significant differences in the TCMSS between Group A,Group C and Group B(P>0.05).The TCMSS in Group C were lower than those in Group A,and the difference were statistically significant(P<0.05).When comparing eight weeks after treatment,the TCMSS in Group B and Group C were lower than those in Group A,and the differences were statistically significant(both P<0.05).The TCMSS in Group C were lower than those in Group B,and the differences were statistically significant(P<0.05).(5)Clinical efficacy:There was a statistically significant difference in the total effective rate among the three groups(P<0.05).The total effective rates in Groups B and C were higher than that in Group A,and the differences were statistically significant(both P<0.05).The total effective rate in Group C was higher than that in Group B,and the difference was statistically significant(P<0.05).(6)Adverse reactions:There was no statistically significant difference in the incidence of adverse reactions among the three groups(P>0.05).CONCLUSIONS Ionic introduction of Qijing Mingmu Decoction can significantly improve the ocular surface symptoms of patients with CCh of liver-kidney Yin deficiency syndrome and enhance the stability of the tear film.The longer the treatment time,the more obvious the improvement of the clinical outcome.
作者
杨倩
杨俊倚
李青松
YANG Qian;YANG Junyi;LI Qingsong(Putuo Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200062,China;Dental and Oph-thalmic Clinic of Putuo District,Shanghai 200060,China)
出处
《中国中医眼科杂志》
2025年第9期827-833,共7页
China Journal of Chinese Ophthalmology
基金
上海市卫生健康委员会临床研究专项(202040148)。
关键词
杞精明目汤
离子导入
结膜松弛症
Qijing Mingmu Decoction
ionic introduction
conjunctivochalasis
