标题：杞菊地黄丸联合中药熏蒸对干眼症患者OSDI评分、溶菌酶水平及视功能评分的影响

      作者：赵蒙蒙，金兰，宋艳敏，马晓婕，惠春艳    西安市中医医院眼科，陕西 西安 710021

      卷次： 2019年30卷22期

      【摘要】 目的 研究杞菊地黄丸联合中药熏蒸对干眼症患者眼表疾病指数(OSDI)评分、溶菌酶水平及视功能评分的影响。方法 选取2015年3月至2016年8月在西安市中医医院眼科接受治疗的104例干眼症患者为研究对象，采用随机数表法将其分为观察组和对照组各52例。两组患者均进行人工泪液治疗，对照组在上述常规治疗基础上进行中药熏蒸治疗，观察组在对照组治疗的基础上口服杞菊地黄丸，连续治疗30 d。比较两组患者的临床疗效、泪膜破裂时间(BUT)、泪液分泌量(Sit)、角膜荧光素染色(FL)情况和视功能评分，应用国际常用经典OSDI量表计算干眼症积分，检测并比较两组患者泪液中溶菌酶、表皮生长因子(EGF)及乳铁蛋白(LF)含量，肿瘤坏死因子-α(TNF-α)、白细胞介素-6 (IL-6)及超敏C反应蛋白(hs-CRP)水平。结果 观察组患者的治疗总有效率为94.23%，明显高于对照组的80.77%，差异有统计学意义(P<0.05)；治疗前，两组患者的BUT、Sit、FL评分、OSDI评分、溶菌酶水平、EGF、LF水平及视功能评分比较差异均无统计学意义(P>0.05)；治疗后，两组患者的 BUT、Sit、溶菌酶、EGF、LF水平及视功能评分均升高，且观察组明显高于对照组，FL评分、OSDI评分均降低，且观察组明显低于对照组，差异均有统计学意义(P<0.05)；治疗前，两组患者的血清炎症因子TNF-α、IL-6、hs-CRP水平比较，差异均无统计学意义(P>0.05)；治疗后，两组患者的TNF-α、IL-6、hs-CRP水平均降低，且观察组明显低于对照组，差异均有统计学意义(P<0.05)。结论 杞菊地黄丸联合中药熏蒸可有效降低干眼症患者OSDI评分，提高患者溶菌酶水平及视功能水平，减少炎症反应，值得临床推广使用。
      【关键词】 杞菊地黄丸；中药熏蒸；干眼症；OSDI评分；溶菌酶水平；视功能评分
      【中图分类号】 R777.34 【文献标识码】 A 【文章编号】 1003—6350（2019）22—2947—04

Effects of Qiju Dihuang Pill combined with Chinese medicine fumigation on OSDI score, lysozyme level, andvisual function score in patients with dry eye.
ZHAO Meng-meng, JIN Lan, SONG Yan-min, MA Xiao-jie, HUIChun-yan. Department of Ophthalmology, Xi'an Traditional Chinese Medicine Hospital, Xi'an 710021, Shaanxi, CHINA
【Abstract】 Objective To study the effects of Qiju Dihuang Pill combined with Chinese medicine fumiga-tion on Ocular Surface Disease Index (OSDI) score, lysozyme level, and visual function score in patients with dry eye.Methods A total of 104 patients of dry eye treated in Department of Ophthalmology, Xi'an Traditional Chinese Medi-cine Hospital from March 2015 to August 2016 were selected as subjects of study. The patients were divided into an ob-servation group and a control group according to random number table method, with 52 patients in each group. Patientsin the control group were fumigated with traditional Chinese medicine based on artificial tear, while the patients in theobservation group were given Qiju Dihuang Pill orally on the basis of the treatment in the control group, both for 30 con-secutive days. The clinical efficacy, the tear film break-up time (BUT), the Schirmer I test (Sit), the corneal fluoresceinstaining (FL), and visual function scores were compared between the two groups. The dry eye score was calculated by clas-sical OSDI scale, and the levels of lysozyme, epidermal growth factor (EGF), lactoferrin (LF) in tear, tumor necrosis fac-tor-α (TNF-α), interleukin-6 (IL-6), hypersensitive C-reactive protein (hs-CRP), and visual function score were measured.Results The total effective rate of the observation group was 94.23%, which was significantly higher than 80.77% ofthe control group (P<0.05). Before treatment, there were no significant differences in BUT, Sit, FL score, OSDI score, lyso-zyme, EGF, LF, and visual function scores between the two groups (P>0.05); after treatment, BUT, Sit, lysozyme, EGF,LF levels, and visual function scores in the two groups were all increased, and the levels in the observation group were sig-nificantly higher than those in the control group; after treatment, the FL score and OSDI score in the observation groupwere all decreased, and the levels in the observation group were significantly lower than those in the control group (P<0.05). Before treatment, there was no significant difference in levels of serum inflammatory factors (TNF-α, IL-6 andhs-CRP) between the two groups (P>0.05); after treatment, the levels of TNF-α, IL-6 and hs-CRP were all decreased, andthe levels in the observation group were significantly lower than those in the control group (P<0.05). Conclusion QijuDihuang Pill combined with Chinese medicine fumigation can effectively reduce OSDI score of patients with dry eye, im-prove lysozyme level and visual function level, and reduce inflammation, which is worthy of clinical application.
      【Key words】 Qiju Dihuang Pill; Chinese medicine fumigation; Dry eye; OSDI score; Lysozyme level; Visualfunction score