氢盐水超声雾化熏蒸对干眼症患者眼表炎症和症状的影响

Impact of Hydrogen Saline Ultrasonic Atomization Fumigation on Ocular Surface Inflammation and Symptoms in Dry Eye Disease Patients

摘要: 目的：本研究探讨了每日30分钟连续5天的氢盐水超声雾化熏蒸对干眼症患者眼表炎症和症状的影响。研究方法：在这项随机前瞻性单盲对照试验中，36名干眼症患者被随机分到实验组(氢盐水)和对照组(生理盐水)，每组18名患者。两组患者均接受连续5天，每日30分钟的超声雾化熏蒸治疗。在干预前后评估了以下指标：泪液基质金属蛋白酶-9 (MMP-9)水平、眼表疾病指数(OSDI)评分、眼红指数(ORI)、泪河高度(TMH)以及泪膜破裂时间(BUT)。统计分析方法包括Shapiro-Wilk检验、独立样本t检验、Mann-Whitney U检验、Wilcoxon符号秩检验和Fisher精确检验。结果：治疗后，对照组与实验组的组间比较各指标差异无统计学意义(P > 0.05)。组内比较中，实验组的泪液MMP-9水平有显著降低，由70.19 (31.32, 90.96) ng/ml降至32.67 (3.79, 185.63) ng/ml (P = 0.025)，OSDI评分由48.61 ± 16.91降至27.78 ± 12.98 (P < 0.001)，而实验组治疗前后的ORI、TMH和BUT差异无统计学意义(P > 0.05)。对照组的组内比较中，OSDI评分有所下降，由41.67 (34.38, 46.35)降至25.00 (20.83, 33.85) (P < 0.001)，而MMP-9水平、ORI、TMH或BUT差异无统计学意义(P > 0.05)。两组的疗效对比中，实验组的MMP-9与OSDI下降幅度比对照组大，且差异具有统计学意义(P = 0.016)，其余指标改变幅度差异无统计学意义(P > 0.05)。结论：与生理盐水相比，氢盐水超声雾化熏蒸更能降低干眼症患者的泪液MMP-9水平，并缓解了主观症状。

Abstract: AIM: This study investigated the effects of ultrasonic atomization fumigation with hydrogen saline (administered for 30 minutes daily over 5 consecutive days) on ocular surface inflammation and symptoms in patients with dry eye disease. METHODS: In this randomized prospective single-blind controlled trial, 36 patients with DED were randomly assigned to either the experimental group (hydrogen saline) or the control group (physiological saline), with 18 patients in each group. Patients in both groups received continuous ultrasonic atomization fumigation therapy for 30 minutes per day over 5 consecutive days. The following indicators were evaluated before and after the intervention: tear matrix metalloproteinase-9 (MMP-9) level, Ocular Surface Disease Index (OSDI) score, Ocular Redness Index (ORI), tear meniscus height (TMH), and tear break-up time (BUT). The statistical analysis methods included the Shapiro-Wilk test, independent samples t-test, Mann-Whitney U test, Wilcoxon signed-rank test, and Fisher’s exact test. RESULTS: After treatment, there was no statistically significant difference in all indicators between the control group and the experimental group (P > 0.05). In the intragroup comparison, the tear MMP-9 level in the experimental group decreased significantly, from 70.19 (31.32, 90.96) ng/ml to 32.67 (3.79, 185.63) ng/ml (P =0.025), and the OSDI score decreased from 48.61 ± 16.91 to 27.78 ± 12.98 (P < 0.001). However, there were no statistically significant differences in ORI, TMH, and BUT in the experimental group before and after treatment (P > 0.05). In the intragroup comparison of the control group, the OSDI score decreased, from 41.67 (34.38, 46.35) to 25.00 (20.83, 33.85) (P < 0.001), while there were no statistically significant differences in MMP-9 level, ORI, TMH, or BUT (P > 0.05). In the comparison of therapeutic effects between the two groups, the decrease amplitudes of MMP-9 and OSDI in the experimental group were larger than those in the control group, with statistically significant differences (P = 0.016), and there were no statistically significant differences in the change amplitudes of the other indicators (P > 0.05). Conclusion: Compared with physiological saline, ultrasonic atomization fumigation with hydrogen saline was more effective in reducing the tear MMP-9 level in patients with DED and alleviating their subjective symptoms, indicating that it has anti-inflammatory benefits and symptom-improving effects.