干眼的中医辩证及治疗的研究进展
Progress in Traditional Chinese Medicine Dialectics and Treatment of Dry Eyes
DOI: 10.12677/acm.2025.1582355, PDF,   
作者: 高 杰：山东省第二医科大学临床医学院，山东 潍坊；刘同同：济南市明水眼科医院眼科，山东 济南；张维洁*：临沂市中心医院护理部，山东 临沂
关键词: 干眼；中医；干眼治疗；Dry Eye； Traditional Chinese Medicine； Dry Eye Treatment
摘要: 目前干眼症是眼科临床最常见的眼表疾病之一。中医认为干眼症属于“白涩症”的范畴，是由于津液分布不均或者分泌不足所致。干眼发病机理复杂与性别、年龄、激素水平、睡眠质量及心理因素等密切相关。中医通过中药方剂、中药熏蒸、超声雾化、穴位敷贴、中药滴眼剂以及针灸等方法来调节患者整体的阴阳失衡，改善眼内气血津液的分布，从根本上治疗干眼。本综述将对干眼的中医诊疗进行基本概括，重点阐述其在中医辩证、中医治疗方式的进展，以期为干眼的预防和治疗及临床综合管理提供一种思路和研究方向。
Abstract: Currently, dry eye syndrome is one of the most common ocular surface diseases in clinical ophthalmology. Traditional Chinese medicine believes that dry eye syndrome belongs to the category of “white astringency syndrome”, which is caused by uneven distribution or insufficient secretion of body fluids. The complex pathogenesis of dry eye is closely related to gender, age, hormone levels, sleep quality, and psychological factors. Traditional Chinese medicine regulates the overall imbalance of yin and yang, improves the distribution of qi, blood and body fluid in the eyes, and fundamentally treats dry eyes through Chinese medicine prescriptions, Chinese medicine fumigation, ultrasonic atomization, acupoint application, Chinese medicine eye drops, acupuncture and moxibustion and other methods. This review will provide a basic overview of the traditional Chinese medicine diagnosis and treatment of dry eye, with a focus on the progress of TCM dialectics and TCM treatment methods, in order to provide a train of thought and research direction for the prevention, treatment, and comprehensive clinical management of dry eye.
文章引用：高杰, 刘同同, 张维洁. 干眼的中医辩证及治疗的研究进展[J]. 临床医学进展, 2025, 15(8): 1215-1221. https://doi.org/10.12677/acm.2025.1582355

参考文献

[1] 余穑婕, 陈子林. 干眼的定义与分类的研究现状[J]. 中国临床新医学, 2019, 12(7): 801-804.
[2] 桂炎香, 李青松, 赵黎, 等. 干眼的中医治疗进展[J]. 现代中西医结合杂志, 2020, 29(9): 1018-1021.
[3] 刘景祥, 李燕伟, 张冰洁. 干眼症患者泪液乳铁蛋白检测的意义[J]. 中国实验诊断学, 2006(6): 663-665.
[4] 韦振宇, 刘含若, 梁庆丰. 我国干眼流行病学的研究进展[J]. 中华眼科医学杂志(电子版), 2020, 10(1): 46-50.
[5] 李丽萍, 赵洪超, 陈艳芳, 等. 不同频率强脉冲光治疗对睑板腺功能障碍患者泪膜稳定性及睑板腺功能的影响[J]. 昆明医科大学学报, 2022, 43(7): 62-67.
[6] 张宝冬, 石薇, 张贵森, 等. 强脉冲光治疗睑板腺功能障碍性干眼的临床研究[J]. 山西医药杂志, 2018, 47(9): 1048-1050.
[7] 姜祎, 庞雨莲, 张旭. 干眼检查方法的研究进展[J]. 国际眼科杂志, 2023, 23(4): 573-577.
[8] Pearce, E.I. and Tomlinson, A. (2000) Spatial Location Studies on the Chemical Composition of Human Tear Ferns. Ophthalmic and Physiological Optics, 20, 306-313. [Google Scholar] [CrossRef] [PubMed]
[9] Zhang, Y., Yan, P., Tang, H. and Zhang, J. (2023) Rapid Detection of Tear Lactoferrin for Diagnosis of Dry Eyes by Using Fluorescence Polarization-Based Aptasensor. Scientific Reports, 13, Article No. 15179. [Google Scholar] [CrossRef] [PubMed]
[10] Regueiro, U., López-López, M., Varela-Fernández, R., Otero-Espinar, F.J. and Lema, I. (2023) Biomedical Applications of Lactoferrin on the Ocular Surface. Pharmaceutics, 15, Article 865. [Google Scholar] [CrossRef] [PubMed]
[11] 李玉红, 马凌葵. 干眼症患者泪液中溶菌酶及转化生长因子β_2的检验分析[J]. 临床眼科杂志, 2019, 27(4): 319-321.
[12] 杨涛, 郑玥, 陈爱菊. 杞菊地黄丸联合中药熏蒸治疗白内障术后干眼症临床研究[J]. 新中医, 2023, 55(3): 50-53.
[13] Farris, R.L., Stuchell, R.N. and Mandel, I.D. (1981) Basal and Reflex Human Tear Analysis. I. Physical Measurements: Osmolarity, Basal Volumes, and Reflex Flowrate. Ophthalmology, 88, 852-857. [Google Scholar] [CrossRef] [PubMed]
[14] 程验, 刘焱焱, 魏苗, 等. 泪液渗透压在干眼发病机制中的作用及诊疗进展[J]. 国际眼科杂志, 2023, 23(1): 84-89.
[15] Willcox, M.D.P., Argüeso, P., Georgiev, G.A., Holopainen, J.M., Laurie, G.W., Millar, T.J., et al. (2017) TFOS DEWS II Tear Film Report. The Ocular Surface, 15, 366-403. [Google Scholar] [CrossRef] [PubMed]
[16] Mathews, P.M., Karakus, S., Agrawal, D., Hindman, H.B., Ramulu, P.Y. and Akpek, E.K. (2017) Tear Osmolarity and Correlation with Ocular Surface Parameters in Patients with Dry Eye. Cornea, 36, 1352-1357. [Google Scholar] [CrossRef] [PubMed]
[17] Sullivan, B. (2014) Challenges in Using Signs and Symptoms to Evaluate New Biomarkers of Dry Eye Disease. The Ocular Surface, 12, 2-9. [Google Scholar] [CrossRef] [PubMed]
[18] Willshire, C., Buckley, R.J. and Bron, A.J. (2018) Estimating Basal Tear Osmolarity in Normal and Dry Eye Subjects. Contact Lens and Anterior Eye, 41, 34-46. [Google Scholar] [CrossRef] [PubMed]
[19] Lanza, N.L., Valenzuela, F., Perez, V.L. and Galor, A. (2016) The Matrix Metalloproteinase 9 Point-of-Care Test in Dry Eye. The Ocular Surface, 14, 189-195. [Google Scholar] [CrossRef] [PubMed]
[20] Jamerson, E.C., Elhusseiny, A.M., ElSheikh, R.H., Eleiwa, T.K. and El Sayed, Y.M. (2020) Role of Matrix Metalloproteinase 9 in Ocular Surface Disorders. Eye & Contact Lens: Science & Clinical Practice, 46, S57-S63. [Google Scholar] [CrossRef] [PubMed]
[21] Roda, M., Corazza, I., Bacchi Reggiani, M.L., Pellegrini, M., Taroni, L., Giannaccare, G., et al. (2020) Dry Eye Disease and Tear Cytokine Levels—A Meta-Analysis. International Journal of Molecular Sciences, 21, Article 3111. [Google Scholar] [CrossRef] [PubMed]
[22] 杨振山. 不同药物治疗白内障术后干眼症的效果[J]. 中国医药指南, 2024, 22(11): 98-100.
[23] 袁慧艳, 刘健, 张明明, 等. 干眼发病机制及致病因素的研究进展[J]. 中国中医眼科杂志, 2023, 33(7): 675-678+683.
[24] Dogru, M., Kojima, T., Simsek, C. and Tsubota, K. (2018) Potential Role of Oxidative Stress in Ocular Surface Inflammation and Dry Eye Disease. Investigative Opthalmology & Visual Science, 59, DES163-DES168. [Google Scholar] [CrossRef] [PubMed]
[25] 李娟, 金龙山, 沈贞女, 等. 细胞凋亡在干眼症发病中的作用及相关机制的研究进展[J]. 中国社区医师, 2017, 33(28): 12-13+19.
[26] 罗丽辉, 刘祖国, 林建贤, 等. 干眼患者结膜上皮细胞的凋亡与炎症[J]. 中国眼耳鼻喉科杂志, 2004(2): 75-77+137.
[27] 张梦婷. 养阴清中汤治疗阴虚湿热型干眼症的临床疗效评价[D]: [硕士学位论文]. 南京: 南京中医药大学, 2022.
[28] 于静, 接英, 王辉, 等. 气机升降理论在干眼治疗中的运用[J]. 中国中医眼科杂志, 2022, 32(8): 630-634.
[29] 彭艳春. 杞菊地黄汤加味配合羟糖甘滴眼液治疗肝肾阴虚型干眼临床研究[J]. 中国社区医师, 2017, 33(1): 87-88.
[30] 陶荣三, 陈梦平, 荆文涛. 中药联合人工泪液治疗水液缺乏性干眼临床观察[J]. 中国现代医生, 2016, 54(20): 58-61.
[31] 矫红, 武燕, 杨亚丽, 等. 养阴清热、健脾化痰法治疗睑板腺功能障碍及其相关干眼的临床观察[J]. 现代中医临床, 2016, 23(1): 38-43.
[32] 张风梅, 王军敬, 张巧玲. 甘露饮治疗湿热伤阴型干眼临床观察[J]. 中国中医眼科杂志, 2015, 25(5): 337-340.
[33] 吴玉玲. 中药熏蒸治疗干眼的临床观察及对视觉相关生存质量的影响[D]: [硕士学位论文]. 北京: 北京中医药大学, 2014.
[34] 彭炳新, 林华庆, 帅方舟, 等. 物理技术促进药物经皮吸收的研究进展[J]. 中国药房, 2017, 28(31): 4456-4461.
[35] 孙超, 冯俊奇, 孙军强, 等. 中药离子导入治疗膝骨关节炎75例[J]. 人民军医, 2009, 52(6): 378.
[36] 张欣悦, 高明利. 中药离子导入法治疗膝骨关节炎研究进展[J]. 河北中医, 2017, 39(1): 152-155+160.
[37] 张皜妍, 左韬. 中药超声雾化治疗2型糖尿病合并干眼临床观察[J]. 中医药临床杂志, 2020, 324): 743-747.
[38] 朱莉萍. 眼部中药雾化配合穴位贴敷治疗护理干眼症[J]. 湖北中医杂志, 2013, 35(9): 73.
[39] 黎琴, 吕婵, 廖美英, 等. 中药热奄包联合睑板腺按摩治疗脂质缺乏型干眼症的疗效观察[J]. 护士进修杂志, 2019, 34(19): 1769-1772.
[40] 任贻军, 林飞刚, 杨远荣, 等. 中药滴眼剂的研究概况[J]. 中华中医药学刊, 2010, 28(1): 173-175.
[41] 陈伟, 郑景华, 王立威, 等. 鱼腥草滴眼液联合玻璃酸钠滴眼液在干眼患者白内障术后中的应用效果[J]. 中国医学创新, 2019, 16(21): 120-123.
[42] Na, J.H., Jung, J.H., Park, J.G., et al. (2021) Therapeutic Effects of Acupuncture in Typical Dry Eye: A Systematic Review and Meta‐Analysis. Acta Ophthalmologica, 99, 489-498. [Google Scholar] [CrossRef] [PubMed]
[43] Liu, X., Gao, W.P., Zhao, N., et al. (2023) Acupuncture for Aqueous Deficiency Dry Eye: A Randomized Controlled Trial. Chinese Acupuncture & Moxibustion, 43, 1235-1238.
[44] Gong, L. and Sun, X. (2007) Treatment of Intractable Dry Eyes: Tear Secretion Increase and Morphological Changes of the Lacrimal Gland of Rabbit after Acupuncture. Acupuncture & Electro-Therapeutics Research, 32, 223-233. [Google Scholar] [CrossRef] [PubMed]
[45] Nishinaka, A., Nitta, K., Seki, T., Hara, H. and Shimazawa, M. (2020) The Changes in Blood Flow Seen in the Eye after Foot Acupuncture Treatment in Mice. Evidence-Based Complementary and Alternative Medicine, 2020, Article 6405471. [Google Scholar] [CrossRef] [PubMed]

为你推荐