摘要
目的观察疏肝解郁法治疗肝郁气滞型干眼合并焦虑抑郁情绪患者的临床疗效。方法收集2018年3月—2018年10月在江苏省中医院眼科诊断为肝郁气滞型干眼,同时合并焦虑抑郁情绪障碍的患者40例,取右眼纳入研究。随机分为中药组和对照组,每组20例(20只眼)。对照组予右旋糖苷羧甲基纤维素钠滴眼液点眼,中药组在对照组基础上予丹栀逍遥散加味治疗,均治疗2周。记录2组治疗前后的泪膜破裂时间(BUT)、泪液分泌试验(SIT)、角膜荧光染色(CFS)、症状积分及焦虑(SAS)和抑郁(SDS)量表评分,并进行统计学分析。结果(1)临床疗效:中药组总有效率为85.00%,对照组总有效率为55.00%,2组比较差异有统计学意义(χ^2=4.286,P=0.038)。(2)症状积分:治疗后组间比较,t=-2.523,P=0.016,差异有统计学意义;治疗前后比较,中药组(t=5.433,P=0.000)、对照组(t=3.833,P=0.001),差异均有统计学意义。(3)干眼指标:治疗后组间比较,中药组BUT(t=-2.216,P=0.033)、SIT(t=2.511,P=0.016)优于对照组,差异有统计学意义。治疗前后比较,中药组BUT(t=-5.762,P=0.000)、SIT(t=-5.747,P=0.000),对照组BUT(t=-2.392,P=0.027)升高,差异均有统计学意义。(4)情绪评分:治疗后,中药组评分低于对照组(t焦虑=-2.146,P=0.038;t抑郁=-2.340,P=0.025),差异有统计学意义。治疗前后比较,中药组的焦虑(t=4.180,P=0.000)、抑郁(t=3.369,P=0.003)评分下降,差异均有统计学意义;而对照组的焦虑、抑郁评分无显著变化(P>0.05)。结论疏肝解郁法对干眼患者合并的焦虑抑郁有抑制作用,联合人工泪液治疗肝郁气滞型干眼有较好的疗效。
OBJECTIVE To observe the clinical effects of the method of soothing liver stagnation and alleviating depression on dry eye with anxiety and depression in liver depression and qi stagnation syndrome.METHODS Forty patients with liver depression and qi stagnation type dry eye complicated with anxiety and(or)depression were selected from the ophthalmology clinic of Jiangsu Province Hospital of Chinese Medicine from March to October 2018,the right eyes were taken in to the study.And cases were divided into two groups:the Chinese medicine combined intervention group with 20 cases(20 eyes),and the control group with 20 cases(20 eyes).The control group was treated with artificial tears alone,while the Chinese medicine combined intervention group was supplemented with modified Danzhi Xiaoyao powder on the basis of artificial tears.Parameters including tear film break-up time(BUT),tear secretion(schirmer I test,SIT),corneal fluorescence staining(CFS),clinical symptom scores,and emotional scores anxiety(SAS)and depression(SDS)scale scores before and after treatment were observed.RESULTS(1)Clinical efficacy:the total effective rate of the Chinese medicine group was 85.00%,and that of the control group was 55.00%.The difference between the two groups was statistically significant(χ^2=4.286,P=0.038).(2)Symptom scores:comparison between groups after treatment showed that result of the Chinese medicine group was better than control group,the difference was statistically significant(t=-2.523,P=0.016);after treatment,the Chinese medicine group(t=5.433,P=0.000)and the control group(t=3.833,P=0.001)both experienced improvements,the differences were statistically significant.(3)Dry eye indexs:After treatment,BUT(t=-2.216,P=0.033)and SIT(t=2.511,P=0.016)of the Chinese medicine group were better than the control group,and the difference was statistically significant.After treatment,BUT(t=-5.762,P=0.000)and SIT(t=-5.747,P=0.000)in the Chinese medicine group improved obviously,while only BUT(t=-2.392,P=0.027)in the control group improved,the difference was statistically significant.(4)Mood scores:After treatment,the scores of the Chinese medicine group was lower than that of the control group(tanxiety=-2.146,P=0.038;tdepression=-2.340,P=0.025),the difference was statistically significant.After treatment,the scores of anxiety(t=4.180,P=0.000)and depression(t=3.369,P=0.003)in the Chinese medicine group decreased,and the difference was statistically significant,while that of the control group did not change significantly(P>0.05).CONCLUSIONS The intervention of Traditional Chinese Medicine in the treatment of dry eye had a regulatory effect on patients'anxiety and depression,and its combination with artificial tears had favorable clinical efficacy in the treatment of dry eye with liver depression and qi stagnation syndrome.
作者
杨颖
周思彤
高卫萍
王育良
YANG Ying;ZHOU Sitong;GAO Weiping(The AffiliatedHospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)
出处
《中国中医眼科杂志》
2020年第12期880-884,共5页
China Journal of Chinese Ophthalmology
基金
江苏省中医院创新发展基金(Y2017CX11)。
关键词
疏肝解郁法
肝郁气滞
干眼
焦虑
抑郁
soothing liver stagnation and alleviating depression methods
liver depression and qi stagnation
dry eye
anxiety
depression
