杞菊地黄汤加减联合人工泪液治疗肝肾阴虚型干眼的临床观察

发布时间：2017-12-27 10:12

本文关键词：杞菊地黄汤加减联合人工泪液治疗肝肾阴虚型干眼的临床观察　出处：《长春中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:探讨杞菊地黄汤加减联合玻璃酸钠治疗肝肾阴虚型干眼的临床效果。方法:本研究将2015.1~2015.12期间在吉林省中医院眼科门诊被诊断为肝肾阴虚型干眼的患者96例作为研究对象,按照随机分组法定为对照组和试验组,试验组以杞菊地黄汤为主方,辩证加减汤剂内服,联合玻璃酸钠点眼,对照组则只懫用玻璃酸钠点眼。本临床研究共3个疗程,每个疗程10天。详细记录治疗前、治疗结束时SIT、BUT、FL各个检查项目和OSDI分值的变化,进行统计学分析。在治疗结束后的第2个月、第4个月通过电话随访,采用问卷的形式,获得OSDI积分情况,将积分相互比较来观察近期巩固疗效。结果:1、试验组和对照组在治疗之前和结束时的SIT、BUT、FL相比,试验组的各检测项目均优于对照组,且差异有统计学意义(P0.01)。试验组和对照组在治疗后SIT、BUT、FL分别与治疗前进行对比,发现其在改善患者ST、BUT方面优于对照组(P0.05),而FL(P=0.63)无明显差异。2、在不同时间点记录两组研究对象的的OSDI分值,比较两组研究对象在治疗前和治疗结束时OSDI积分,均有显著性差异(P0.01)。将两组研究对象治疗前和治疗结束后2个月、治疗结束后4个月OSDI积分分别进行对比,发现差异具有显著性(P0.01),说明两种方法都可以在短期内巩固疗效。对照组在治疗结束后第2和第4个月比较,差值均数为-5.38,p为0.03,差异具有统计学意义,说明治疗结束后2个月的疗效比治疗结束4个月的疗效好,在结束后4个月疗效有所降低。试验组在治疗结束后第2个月和第4个月后相互比较,p值为0.58,差异没有统计学意,说明治疗结束后2个月的跟治疗结束4个月的疗效差不多。3、试验组总有效率为89.58%,对照组总有效率为70.83%,经x2检验,Pearsonx2=5.32,v=1,P=0.021,差异有统计学意义。结论:1、本临床研究提示杞菊地黄汤加减联合玻璃酸钠点眼和单独应用玻璃酸钠点眼都可以有效治疗肝肾阴虚型干眼,都可以不同程度的增加SIT、延长BUT、改善FL,缓解患者眼表症状和全身相关症状,且试验组在SIT、BUT、OSDI上优于对照组。2、通过比较两组患者在不同时间点的OSDI积分情况,提示杞菊地黄汤加减联合玻璃酸钠治疗干眼的近期巩固疗效较持久。3、试验组治疗干眼的总有效率优于对照组,表明杞菊地黄汤加减联合玻璃酸钠治疗肝肾阴虚型干眼具有临床推广价值。
[Abstract]:Objective: To investigate the effect of Qiju Dihuang Decoction Combined with sodium hyaluronate in the treatment of dry eye clinical effect of yin deficiency of liver and kidney. Methods: in this study, during the period of 2015.1~2015.12 in ophthalmology clinic of TCM Hospital of Jilin province were diagnosed with liver and kidney yin deficiency of dry eye in 96 patients as the research object, in accordance with the statutory randomization into control group and experimental group, experimental group with Qijudihuang decoction, decoction taken orally dialectical addition and subtraction, combined with sodium hyaluronate eyedrops, control the group then only Zhi with sodium hyaluronate eye drops. The clinical study consisted of 3 courses of 10 days per course. The changes of the SIT, BUT, FL examination items and the OSDI score were recorded before and after the treatment, and the statistical analysis was carried out. After second months and fourth months after the treatment, the OSDI score was obtained by telephone follow-up. Results: 1. Compared with the SIT, BUT and FL at the end of the treatment, the test items in the experimental group and the control group were better than those in the control group, and the difference was statistically significant (P0.01). After treatment, SIT, BUT and FL in the experimental group and the control group were compared with those before treatment. It was found that they were better than those in the control group (P0.05) in improving ST and BUT, while FL (P=0.63) had no significant difference. 2, we recorded the OSDI scores of two groups at different time points, and compared the scores of OSDI in two groups before and at the end of treatment, there was a significant difference (P0.01). The OSDI scores of the two groups were compared before treatment, 2 months after treatment and 4 months after treatment. The difference was significant (P0.01), indicating that two methods can consolidate the curative effect in a short time. In the control group at second and fourth months after treatment, the difference was -5.38, P was 0.03, the difference was statistically significant. It showed that the effect of 2 months after treatment was better than the end of treatment 4 months, and the curative effect decreased at the end of 4 months. The experimental group was compared with each other after second months and fourth months after the treatment. The p value was 0.58. The difference was not statistically significant, indicating that the effect of 2 months after the end of treatment was almost the same as the 4 months after the end of treatment. 3, the total effective rate of the test group was 89.58%, the total effective rate of the control group was 70.83%, and the difference was statistically significant after x2 test, Pearsonx2=5.32, v=1 and P=0.021. Conclusion: 1. This study showed that the Qiju Dihuang Decoction Combined with sodium hyaluronate eyedrops and application of sodium hyaluronate eyedrops alone can be effective for treatment of liver kidney yin deficiency of dry eye, can be increased to different degrees of SIT, the extension of BUT, improve the FL, alleviate the patients with ocular symptoms and systemic symptoms, and the test group was better than in SIT, BUT, OSDI control group. 2, by comparing the two groups of patients at different time points OSDI points, suggesting that Qiju Dihuang Decoction Combined with sodium hyaluronate in the treatment of dry eye recently consolidate curative effect more lasting. 3, the test group for the treatment of dry eye in the total efficiency is better than the control group, showed that the treatment of liver and kidney yin deficiency of dry eye has clinical value of Qijudihuang decoction combined with sodium hyaluronate.
【学位授予单位】：长春中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R777.34

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