世界中医药

目的：探讨中西医综合疗法对白内障术后干眼的干预作用。方法：将行白内障超声乳化联合人工晶体植入术的60例老年性白内障患者，随机分为对照组(n＝18)、人工泪液组（n＝21）和综合观察组（n＝21），3组患者均局部应用白内障术后常规药物左氧氟沙星眼液、双氯芬酸钠眼液、氟米龙眼液，人工泪液组加用玻璃酸钠眼液，综合观察组加用玻璃酸钠眼液及自拟干眼方(珠子参15 g、枸杞子9 g、菊花9 g、玄参9 g、生地黄9 g、熟地黄9 g、山药9 g)，观察分析治疗前、治疗后1周、治疗后1个月、治疗后3个月的主观干燥异物感、角结膜荧光素试验、基础泪液分泌试验、泪膜破裂时间变化，3组对照综合分析评价。结果：综合观察组和人工泪液组在缓解白内障超声乳化术后干眼方面均具有良好的疗效，治疗前后比较差异有统计学意义(P<0.05)；综合观察组在缓解患者干眼临床症状方面有效率为85.7％，较人工泪液组(71.4％)有优势，2组比较差异有统计学意义(P<0.05)；人工泪液组在治疗后1周时即显示效果，至治疗后3个月时仍显示效果，与人工泪液组比较差异有统计学意义(P<0.05)。综合观察组和人工泪液组在改善白内障超声乳化术后干眼的泪膜稳定性、泪液分泌量及荧光素染色等方面，与治疗前比较，差异有统计学意义(P<0.05)；综合观察组比人工泪液组效果明显，差异有统计学意义(P<0.05)。治疗期间3组均未出现过敏、皮疹、刺激及胃肠道等不良反应。结论：中西医综合疗法可有效改善白内障术后干眼患者的临床症状、增加泪液分泌量、增强泪膜稳定性，是一种安全有效的干预方法。

English Summary:

To investigate the effects of integrated traditional Chinese and Western Medicine on dry eye after cataract surgery.Methods:A total of 60 patients with senile cataract were treated with phacoemulsification combined with intraocular lens implantation in our hospital were randomly divided into control group (n＝18), artificial tear group (n＝21) and comprehensive treatment group (n＝21).Patients of 3 groups were treated with conventional drugs of levofloxacin eye drops, diclofenac sodium eye drops and fluorometholone eye drops after cataract surgery.Artificial tear group was treated with sodium hyaluronate eye drops.Comprehensive treatment group was treated with sodium hyaluronate eye drops and self-made dry eye formula (Rhizoma Panacis Majoris 15 g, Fructus Lycii 9 g, Flos Chrysanthemi 9 g, Radix Scrophulariae 9 g, Radix Rehmanniae Recens 9 g, Radix Rehmanniae Preparata 9 g, Rhizoma Dioscoreae 9 g).Subjective dry foreign body, conjunctival fluorescein test, Schirmer test, tear film break-up time before treatment, and 1 week, 1 month, 3 months after treatment were observed.The three groups were compared and analyzed.Results:The comprehensive treatment group and artificial tear group in relieving dry eye after phacoemulsification had good curative effects with significant difference between before and after treatment (P<0.05); The effective rate of the comprehensive treatment group in relieving dry eye symptoms was 85.7% and had advantages compared with artificial tear group (71.4%).The difference was statistically significant (P<0.05); Effects were shown 1 week after treatment in artificial tear group, and last till 3 months after treatment.There was significant difference compared with the control group (P<0.05).The differences in improving tear film stability, eye secretion and fluorescein staining of comprehensive treatment group and artificial tear group were statistically significant compared with before treatment (P<0.05); The comprehensive treatment group had better effects than artificial tear group, and there was significant difference (P<0.05).There were no adverse reactions such as allergy, skin rash and gastrointestinal tract diseases in 3 groups.Conclusion:Combined therapy of traditional Chinese medicine and Western medicine can effectively improve clinical symptoms of dry eye patients after cataract surgery, increase the tear secretion and strengthen tear film stability, which is a safe and effective intervention method.

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