泪膜导向性治疗的临床观察

Clinical Observation of Tear Film Oriented Therapy

摘要: 目的：观察泪膜导向性治疗在重度干眼合并眼睑刷上皮病变中的临床疗效。方法：观察60例120眼重度干眼合并眼睑刷上皮病变患者，分为治疗组30例60眼和对照组30例60眼。治疗组予以3%地夸磷索钠滴眼液联合1%醋酸泼尼松龙滴眼液点眼；对照组予以重组牛碱性成纤维细胞生长因子滴眼液联合0.1%普拉洛芬滴眼液点眼。两组均于治疗2 wks后复查。观察指标：分别于治疗前后进行眼表疾病评分指数(ocular surface disease index, OSDI)问卷调查；泪膜破裂时间(breakuptime, BUT)；荧光素钠角膜染色裂隙灯显微镜检查观察角膜病变情况；荧光素、丽丝胺绿混合染色试纸染色，观察眼睑刷区域的病变情况，按病变程度评分；眼压测量。比较两组治疗前后的差异。结果：治疗组治愈47眼(78.33%)，好转13眼(21.66%)，无效0眼，治愈率78.33%而对照组治愈25眼(41.66%)，好转27眼(45.00%)，无效8眼(13.33%)，治愈率41.66%，两组差异有统计学意义(P < 0.05)。结论：泪膜导向性治疗在重度干眼合并眼睑刷上皮病变治疗中疗效显著。

Abstract: Objective: To observe the clinical effect of tear film oriented therapy in the treatment of severe dry eyes complicating eyelid-wiper epitheliopathy. Methods: 60 cases were divided into two groups randomly. The treated group was treated with 3% diquafosol eye drops combined with 1% Prednisolone Acetate Ewiperye Drops and the control group was treated with bFGF and 0.1% topical pranoprofen. All patients were rechecked after 2 weeks of treatment. The observated items inclouded questionary survey of OSDI conducted before and after treatment, breakup time of tear film (BUT), fluorescein staining of the cornea and dual staining of eyelid wiper area with fluorescein and lisamine green. All patients were scored according to their lesion degree. The difference of the items was compared between the two groups before and after treatment. Result: The therapeutic effect of LWE in treated group was excellent in 47 eyes (78.33%), effective in 13 (21.66%), ineffective in 0 eye (0%), and the total cure rate was 78.33%. In control group it was excellent in 25 eyes (41.66%), effective in 27 (45.00%), ineffective in 8 eye (13.33%), and the total cure rate was 41.66%. There were statistically significant differences between the two groups (P < 0.05). Conclusion: Tear film oriented therapy had significant effect in treating severe dry eyes complicating eyelid-wiper epitheliopathy.