本文關(guān)鍵詞：韋氏杞菊甘露方熏蒸治療女性圍絕經(jīng)期干眼病的研究　出處：《北京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

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【摘要】：目的:圍絕經(jīng)期女性是干眼的易患人群。圍絕經(jīng)期女性干眼的發(fā)病機制及其相關(guān)影響因素較為復(fù)雜,目前臨床以對癥治療緩解癥狀為主,缺乏有效的針對病因的治療。對于該特殊類型的干眼,中西醫(yī)結(jié)合療法是目前臨床較為推崇的治療方法。韋氏杞菊甘露方在臨床中治療此類干眼病已應(yīng)用多年,初步獲得了較好的療效,但由于既往臨床試驗多以小規(guī)模病例觀察為主,缺乏嚴(yán)格設(shè)計的前瞻性隨機對照試驗的支持,其證據(jù)強度偏弱,給后續(xù)推廣韋氏眼科治療干眼病的寶貴經(jīng)驗、并進(jìn)一步開展藥物的作用機制研究帶來了不便,亟需對本方的臨床療效進(jìn)行規(guī)范、嚴(yán)謹(jǐn)?shù)脑僭u價,故本研究擬采用前瞻性隨機對照試驗的方法評價杞菊甘露方治療女性圍絕經(jīng)期干眼的臨床療效;驗證水液缺乏型圍絕經(jīng)期女性干眼病肝腎不足、津液虧耗的中醫(yī)病機。方法:1、選取本院眼科門診就診的水液缺乏型肝腎不足證圍絕經(jīng)期女性干眼病患者60例,按患者就診的先后次序,采用計算機分配隨機數(shù)字,將患者隨機分為治療組及對照組(各30例)。2、治療組:30例患者(60眼)采用韋氏杞菊甘露方(枸杞子、菊花、北沙參、玉竹、麥冬、石斛、桑葉、薄荷)煎湯取汁后,用熏蒸儀器進(jìn)行中藥熏蒸治療,曰1次,每次20分鐘;聯(lián)合玻璃酸鈉滴眼液日四次點眼。對照組:30例患者(60眼)采用局部點玻璃酸鈉滴眼液治療,日四次。2組均連續(xù)治療14 d。3、于治療前及治療14d后,分別觀察患者淚膜破裂時間(BUT)、淚液分泌量(SIT)及角膜熒光素染色(FL),并對患者主觀癥狀評分進(jìn)行分析比較。結(jié)果:1、兩組患者治療前年齡、淚膜破裂時間(BUT)、角膜熒光染色(FL)、淚液分泌(SIT)及主觀不適癥狀評分均無顯著差異(P0.05);2、治療14d后,試驗組及對照組BUT優(yōu)于治療前(P0.05);試驗組BUT、FL、主觀癥狀評分的改善幅度好于對照組(P0.05),SIT改善幅度與對照組比較無統(tǒng)計學(xué)意義的差異(P0.05);3、觀察統(tǒng)計兩組總體治療有效率,差異有明顯統(tǒng)計學(xué)意義:試驗組:76.7%;對照組:36.7%;4、統(tǒng)計分析水液缺乏型圍絕經(jīng)期女性干眼納入患者的中醫(yī)不適癥狀及舌脈資料,大致符合肝腎不足、津液虧耗的中醫(yī)病機特點。且在中醫(yī)不適癥狀表現(xiàn)上以目干疲勞(88.3%)、咽干口燥(63.3%)、失眠多夢(53.3%)及心煩(18.3%)等為主,提示水液缺乏型肝腎不足證圍絕經(jīng)期女性干眼患者中醫(yī)不適癥狀表現(xiàn)的特殊性。結(jié)論:韋氏杞菊甘露方熏蒸聯(lián)合玻璃酸鈉滴眼液治療對水液缺乏型肝腎不足證圍絕經(jīng)期女性干眼患者的BUT及FL兩項客觀指標(biāo)及主觀不適癥狀均有改善作用,該療法在延長BUT、促進(jìn)角膜上皮修復(fù)及減輕主觀癥狀評分方面優(yōu)于玻璃酸鈉滴眼液組。為女性圍絕經(jīng)期干眼病患者的角結(jié)膜提供保護和營養(yǎng)作用,有助于組織損傷修復(fù),在臨床治療該特殊類型干眼上療效顯著并切實可行。
[Abstract]:Objective: perimenopausal women are vulnerable to dry eyes. The pathogenesis and related influencing factors of dry eye in perimenopausal women are rather complex. At present, symptomatic treatment is the main way to relieve symptoms, and there is no effective treatment for the cause of the disease. For this special type of dry eye, the combination of traditional Chinese and Western medicine is the most respected method of treatment at present. Webster's party Qiju Ganlu in the clinical treatment of such a dry eye has been applied for many years, we obtained good effect, but because of previous clinical trials with a small number of cases observed, the lack of prospective randomized controlled trials and strict design support, the strength of evidence is weak, valuable experience, to promote follow-up Webster's treatment of dry eye eye and further to study the mechanism of drug action inconvenience, the urgent need for re evaluation standard and strict clinical curative effect of the party, so this study using the method of prospective randomized controlled trials evaluating treatment of perimenopausal women Qiju Ganlu therapeutic effect of dry eye; lack of water verification TCM type of perimenopausal women dry eye, fluid depletion of liver and kidney deficiency. Methods: 1. 60 cases of dry eye patients with fluid deficiency and liver and kidney deficiency were selected from our ophthalmology clinic. According to the order of patient visits, the patients were randomly assigned to treatment group and control group (30 cases). 2, the treatment group: 30 patients (60 eyes) with Webster's Party (Qiju Ganlu medlar, chrysanthemum, North Adenophora, polygonatum, ophiopogon root, Dendrobium, mulberry leaf, Bo He) Decoction juice, Chinese medicine fumigation treatment by fumigation instrument, 1 times a day, every 20 minutes four times a day at Sodium Hyaluronate Eye Drops. In the control group, 30 cases (60 eyes) were treated with local point Sodium Hyaluronate Eye Drops for four times. The 2 groups were treated with 14 d continuously. 3. Before and after 14d treatment, the tear film rupture time (BUT), tear secretion (SIT) and corneal fluorescein staining (FL) were observed respectively, and the subjective symptom scores were analyzed and compared. Results: 1, two groups of patients before treatment, age, break-up time (BUT), corneal fluorescein staining (FL), Schirmer (SIT) showed no significant difference and the subjective symptoms score (P0.05); 2, after 14d treatment, the experimental group and the control group BUT was better than before treatment (P0.05) test; group BUT, FL and subjective symptom scores improved significantly better than the control group (P0.05), the improvement of SIT and the control group the differences were not statistically significant (P0.05); 3, observation statistics of the two groups overall efficiency of treatment, there was significant difference in experimental group: 76.7%; control group: 4, 36.7%; statistical analysis of water deficiency in perimenopausal women into dry eye patients with TCM symptoms and tongue, pathogenesis is roughly in line with the liver and kidney deficiency, fluid depletion. In traditional Chinese medicine and discomfort symptoms with dry eye fatigue (88.3%), dry mouth and throat (63.3%), insomnia (53.3%) and upset (18.3%) etc, special tip water deficiency syndrome of liver and kidney deficiency perimenopausal women dry eye discomfort in patients with traditional Chinese medicine symptoms. Conclusion: Webster Qiju Ganlu Decoction fumigation and treatment of liquid water Sodium Hyaluronate Eye Drops deficiency deficiency of liver and kidney in perimenopausal women do two objective indexes of BUT and FL in patients with ocular and subjective symptoms were improved, the treatment in the extension of BUT and promote corneal epithelial repair and reduce subjective symptoms score better than the Sodium Hyaluronate Eye Drops group. It provides protection and nutrition for the conjunctiva of perimenopausal women with dry eye. It helps to repair tissue injury. It is effective and effective in the clinical treatment of this special dry eye.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R276.7

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