Abstract:

Objective　To analyze the effect of Zigan Bushen Runmu Decoction combined with acupuncture and sodium hyaluronate eye drops in xerophthalmia. Methods　A total of 120 patients with xerophthalmia admitted to Shaanxi Provincial Hospital of Chinese Medicine were enrolled between May 2020 and May 2023. According to the random number table method, they were divided into a control group (60 cases) and a combination group (60 cases). In the control group, there were 32 males and 28 females, aged (42.58±3.15) years, and the course of disease was (4.21±1.13) months. In the combination group, there were 34 males and 26 females, aged (43.46±3.27) years, and the course of disease was (4.09±1.09) months. The control group was treated with sodium hyaluronate eye drops, and the combination group was treated with Zigan Bushen Runmu Decoction and acupuncture on the basis of the control group for 2 weeks. The clinical curative effect and incidence of adverse reactions during treatment were compared between the two groups. The ocular symptom score, TCM syndrome score, tear film breakup time (BUT), Schirmer's I Test (SIT), and corneal fluorescein staining (FL) score were compared before and after treatment. t test and χ² test were used. Results　The total clinical response rate of the combination group was higher than that of the control group [93.33% (56/60) vs. 80.00% (48/60)], with a statistically significant difference (χ²=4.615, P=0.032). After 2 weeks of treatment, the scores of ocular symptoms (eye drying, foreign body sensation, and fatigue) and TCM syndromes (dry mouth, dizziness and tinnitus, soreness and weakness of waist and knees, and insomnia and dreaminess) in the combination group were lower than those in the control group (t=15.123, 8.527, 10.752, 14.267, 6.734, 16.780, and 8.226, all P<0.001). After treatment, the BUT of the combination group was longer than that of the control group [(11.17±1.12) s vs. (7.74±0.73) s], the SIT was higher than that of the control group [(13.71±1.38) mm vs. (9.55±1.07) mm], and the FL score was lower than that of the control group [(4.07±0.42) points vs. (4.68±0.51) points], with statistically significant differences (t=19.873, 18.453, and 7.152, all P<0.001). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (χ²=1.878, P=0.171). Conclusion　The clinical effect of Zigan Bushen Runmu decoction combined with acupuncture and sodium hyaluronate eye drops is better than that of sodium hyaluronate eye drops, which can significantly improve the clinical eye symptoms, reduce the TCM syndrome scores, improve the tear film stability, and does not increase the incidence of clinical adverse reactions.

Key words:

Xerophthalmia, Zigan Bushen Runmu Decoction, Acupuncture, Sodium hyaluronate eye drops, Tear film stability

摘要：

目的　分析滋肝补肾润目汤联合针刺、玻璃酸钠滴眼液治疗干眼症的效果。方法　前瞻性选取陕西省中医医院2020年5月至2023年5月收治的120例干眼症患者。按照随机数字表法分为对照组和联合组，每组60例。对照组男32例，女28例，年龄（42.58±3.15）岁，病程（4.21±1.13）个月，采用玻璃酸钠滴眼液治疗；联合组男34例，女26例，年龄（43.46±3.27）岁，病程（4.09±1.09）个月，在对照组基础上联合滋肝补肾润目汤、针刺治疗；两组均持续治疗2周。比较两组患者临床疗效和治疗期间不良反应发生率，比较治疗前后眼部症状评分、中医证候评分、泪膜破裂时间（BUT）、泪液分泌实验（SIT）和角膜荧光素染色（FL）评分。采用t检验、χ²检验。结果　联合组治疗总有效率高于对照组［93.33%（56/60）比80.00%（48/60）］，差异有统计学意义（χ²=4.615，P=0.032）。治疗2周后，联合组的干涩感、异物感、疲劳感、口干少津、头晕耳鸣、腰膝酸软和夜寐多梦评分均低于对照组（t=15.123、8.527、10.752、14.267、6.734、16.780、8.226，均P<0.001）；BUT长于对照组［（11.17±1.12）s比（7.74±0.73）s］，SIT高于对照组［（13.71±1.38）mm比（9.55±1.07）mm］，FL评分低于对照组［（4.07±0.42）分比（4.68±0.51）分］，差异均有统计学意义（t=19.873、18.453、7.152，均P<0.001）。两组治疗期间总不良反应发生率比较差异无统计学意义（χ²=1.878，P=0.171）。结论　采用滋肝补肾润目汤联合针刺、玻璃酸钠滴眼液治疗干眼症临床疗效优于单纯玻璃酸钠滴眼液治疗，可明显改善患者的眼部症状，降低中医证候积分，提高泪膜稳定性，且不会增加不良反应发生率。

关键词:

干眼症, 滋肝补肾润目汤, 针刺, 玻璃酸钠滴眼液, 泪膜稳定性