本文關鍵詞：杞菊地黃湯加減聯(lián)合人工淚液治療肝腎陰虛型干眼的臨床觀察　出處：《長春中醫(yī)藥大學》2016年碩士論文　論文類型：學位論文

  更多相關文章： 杞菊地黃湯 人工淚液 肝腎陰虛 干眼

【摘要】：目的:探討杞菊地黃湯加減聯(lián)合玻璃酸鈉治療肝腎陰虛型干眼的臨床效果。方法:本研究將2015.1~2015.12期間在吉林省中醫(yī)院眼科門診被診斷為肝腎陰虛型干眼的患者96例作為研究對象,按照隨機分組法定為對照組和試驗組,試驗組以杞菊地黃湯為主方,辯證加減湯劑內服,聯(lián)合玻璃酸鈉點眼,對照組則只懫用玻璃酸鈉點眼。本臨床研究共3個療程,每個療程10天。詳細記錄治療前、治療結束時SIT、BUT、FL各個檢查項目和OSDI分值的變化,進行統(tǒng)計學分析。在治療結束后的第2個月、第4個月通過電話隨訪,采用問卷的形式,獲得OSDI積分情況,將積分相互比較來觀察近期鞏固療效。結果:1、試驗組和對照組在治療之前和結束時的SIT、BUT、FL相比,試驗組的各檢測項目均優(yōu)于對照組,且差異有統(tǒng)計學意義(P0.01)。試驗組和對照組在治療后SIT、BUT、FL分別與治療前進行對比,發(fā)現(xiàn)其在改善患者ST、BUT方面優(yōu)于對照組(P0.05),而FL(P=0.63)無明顯差異。2、在不同時間點記錄兩組研究對象的的OSDI分值,比較兩組研究對象在治療前和治療結束時OSDI積分,均有顯著性差異(P0.01)。將兩組研究對象治療前和治療結束后2個月、治療結束后4個月OSDI積分分別進行對比,發(fā)現(xiàn)差異具有顯著性(P0.01),說明兩種方法都可以在短期內鞏固療效。對照組在治療結束后第2和第4個月比較,差值均數(shù)為-5.38,p為0.03,差異具有統(tǒng)計學意義,說明治療結束后2個月的療效比治療結束4個月的療效好,在結束后4個月療效有所降低。試驗組在治療結束后第2個月和第4個月后相互比較,p值為0.58,差異沒有統(tǒng)計學意,說明治療結束后2個月的跟治療結束4個月的療效差不多。3、試驗組總有效率為89.58%,對照組總有效率為70.83%,經(jīng)x2檢驗,Pearsonx2=5.32,v=1,P=0.021,差異有統(tǒng)計學意義。結論:1、本臨床研究提示杞菊地黃湯加減聯(lián)合玻璃酸鈉點眼和單獨應用玻璃酸鈉點眼都可以有效治療肝腎陰虛型干眼,都可以不同程度的增加SIT、延長BUT、改善FL,緩解患者眼表癥狀和全身相關癥狀,且試驗組在SIT、BUT、OSDI上優(yōu)于對照組。2、通過比較兩組患者在不同時間點的OSDI積分情況,提示杞菊地黃湯加減聯(lián)合玻璃酸鈉治療干眼的近期鞏固療效較持久。3、試驗組治療干眼的總有效率優(yōu)于對照組,表明杞菊地黃湯加減聯(lián)合玻璃酸鈉治療肝腎陰虛型干眼具有臨床推廣價值。
[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.
【學位授予單位】：長春中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R777.34

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