李玲榮 吳雙慶

[摘要] 目的 探討中藥熏蒸治療糖尿病相關性干眼癥的效果。 方法 選擇2017年1月～2018年1月在我院診斷治療的糖尿病相關性干眼癥患者60例為研究對象，隨機分為研究組與對照組，各30例。對照組采用人工淚液治療治療，研究組在此基礎上加用中藥熏蒸治療。比較兩組治療后主觀癥狀評分、角膜染色、淚膜破裂時間、淚液分泌量評分及兩組臨床療效。 結果 兩組治療后角膜染色評分顯著低于治療前，膜破裂時間、淚液分泌量評分顯著高于治療前，差異有統(tǒng)計學意義（P<0.05）;治療后，治療組角膜染色評分顯著低于對照組，膜破裂時間、淚液分泌量評分顯著高于對照組，差異有統(tǒng)計學意義（P<0.05）。兩組治療后主觀癥狀得分均顯著低于治療前，差異有統(tǒng)計學意義（P<0.05）;治療后研究組主觀癥狀得分顯著低于對照組，差異有統(tǒng)計學意義（P<0.05）。研究組總有效率顯著優(yōu)于對照組，差異有統(tǒng)計學意義（P<0.05）。 結論 中藥熏蒸治療糖尿病相關性干眼癥能夠顯著改善患者癥狀，提高臨床療效。

[關鍵詞] 中藥熏蒸;糖尿病;干眼癥;角膜染色;淚膜破裂時間;淚液分泌量

[中圖分類號] R276.7? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2019）19-0091-04

[Abstract] Objective To discuss the effect of traditional Chinese medicine fumigation on diabetic associated xerophthalmia. Methods Sixty patients with diabetes-related xerophthalmia who were diagnosed and treated in our hospital from January 2017 to January 2018 were selected as the subjects and were randomly divided into study group and control group with 30 cases in each group. The control group was treated with artificial tears， while the study group was treated with traditional Chinese medicine fumigation. The scores of subjective symptoms， corneal staining， tear film rupture time and tear secretion were compared between the two groups. Results After treatment， corneal staining score was significantly lower than that before treatment， membrane rupture time， tear secretion score were significantly higher than those before treatment， the difference was statistically significant（P<0.05）. After treatment， the corneal staining score of the treatment group was significantly lower than that of the control group， and the membrane rupture time and tear secretion score were significantly higher than those of the control group（P<0.05）. The scores of subjective symptoms in the two groups after treatment were significantly lower than those before treatment（P<0.05）， and the scores of subjective symptoms in the study group after treatment were significantly lower than those in the control group（P<0.05）. The total effective rate of the study group was significantly better than that of the control group（P<0.05）. Conclusion Traditional Chinese medicine fumigation treatment of diabetes related dry eye can significantly improve symptoms of the patients and improve clinical efficacy.

[Key words] Traditional Chinese medicine fumigation; Diabetes mellitus; Xerophthalmia; corneal staining; Tear film rupture time; Tear secretion

干眼癥是淚液質(zhì)、量的異常，或者動力學異常，淚膜穩(wěn)定性下降，眼部不適，導致眼表病變。我國糖尿病的發(fā)病率呈逐率上升的趨勢，目前我國糖尿病患病人數(shù)居全球第二，僅次于印度[1]。高血糖水平可導致多種眼部并發(fā)癥，例如白內(nèi)障、視網(wǎng)膜病變、瞼緣炎等[2]。糖尿病患者干眼癥的發(fā)病率大大高于正常人群，與淚液生成不足有關，淚腺功能下降，黏蛋白缺乏，脂質(zhì)缺乏，角膜知覺減退等[3]。研究顯示干眼癥嚴重程度與視網(wǎng)膜病變密切相關[4]。中藥熏蒸治療是以中醫(yī)理論為指導，利用藥物煎煮后產(chǎn)生的蒸汽，通過熏蒸機體達到治療目的的一種中醫(yī)外治方法[5]。本研究對糖尿病相關干眼癥患者實施中藥熏蒸治療，取得了較好的效果，現(xiàn)報道如下。