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地夸磷索钠联合氟米龙治疗干眼症的临床效果观察
李 月1,2,蒋 莉2,李锦芬2,3,黄 慧2,蓝倩倩2,覃远君2,熊家伟2,3,廖 涛2,3,徐 帆2
1.桂林医学院,桂林 541199;2.广西壮族自治区人民医院(广西医学科学院)眼科,眼科疾病医学研究所,南宁 530021;3.广西医科大学,南宁 530021
摘要:
[摘要] 目的 观察地夸磷索钠联合氟米龙治疗干眼症的临床效果。方法 招募2023年广西壮族自治区人民医院眼科收治的干眼症患者76例,按就诊顺序随机分为对照组和观察组,每组38例。观察组接受地夸磷索钠联合氟米龙治疗,对照组接受玻璃酸钠联合氟米龙治疗,均选择患者右眼进行观察、分析。比较两组治疗前后眼表疾病指数(OSDI)评分、泪液分泌相关指标[基础泪液分泌试验(SⅠt)结果、泪河高度(TMH)]、泪膜稳定性指标[泪膜破裂时间(FBUT)、首次非接触性泪膜破裂时间(F-NIBUT)、平均非接触性泪膜破裂时间(A-NIBUT)]、角膜荧光素染色(CFS)评分、睑板腺检查指标(睑板腺开口状态评分、睑板腺分级评分、睑板腺分泌物性状评分)、眼压及药物不良反应发生情况。结果 两组治疗后OSDI评分均较治疗前显著下降(P<0.05),且观察组评分比对照组更低,差异有统计学意义(P<0.05)。观察组治疗后SⅠt结果显著高于对照组(P<0.05),两组治疗后TMH比较差异无统计学意义(P>0.05)。两组治疗后FBUT、F-NIBUT及A-NIBUT均较治疗前显著延长(P<0.05),且观察组指标水平较对照组更长,差异有统计学意义(P<0.05)。两组治疗后CFS评分均较治疗前显著下降(P<0.05),但组间比较差异无统计学意义(P>0.05)。与治疗前相比,两组治疗后睑板腺开口状态评分和睑板腺分泌物性状评分均显著下降(P<0.05),睑板腺分级评分变化不显著(P>0.05)。在治疗前后,两组间睑板腺分级评分、睑板腺开口状态评分及睑板腺分泌物性状评分比较差异均无统计学意义(P>0.05)。在治疗期间两组未观察到不良反应事件发生。两组眼压在治疗前后无显著改变(P>0.05)。结论 地夸磷索钠联合氟米龙可有效改善干眼症患者的临床症状及体征,且效果优于玻璃酸钠联合氟米龙治疗,值得临床应用与推广。
关键词:  地夸磷索钠  氟米龙  玻璃酸钠  干眼症  临床疗效
DOI:10.3969/j.issn.1674-3806.2025.02.13
分类号:R 779.6
基金项目:广西卫生健康委员会自筹经费科研课题(编号:Z-A20230133)
Observation on the clinical efficacy of diquafosol sodium combined with fluorometholone in treatment of dry eye syndrome
LI Yue1,2, JIANG Li2, LI Jinfen2,3, HUANG Hui2, LAN Qianqian2, QIN Yuanjun2, XIONG Jiawei2,3, LIAO Tao2,3, XU Fan2
1.Guilin Medical University, Guilin 541199, China; 2.Department of Ophthalmology, Institute of Ophthalmic Diseases, the People′s Hospital of Guangxi Zhuang Autonomous Region(Guangxi Academy of Medical Sciences), Nanning 530021, China; 3.Guangxi Medical University, Nanning 530021, China
Abstract:
[Abstract] Objective To observe the clinical efficacy of diquafosol sodium(DQS) combined with fluorometholone in treatment of dry eye syndrome. Methods A total of 76 dry eye syndrome patients admitted to Department of Ophthalmology, the People′s Hospital of Guangxi Zhuang Autonomous Region in 2023 were recruited and were randomly divided into control group and observation group according to the patient′s visit sequence, with 38 cases in each group. The observation group was treated with DQS combined with fluorometholone, and the control group was treated with sodium hyaluronate combined with fluorometholone. The patients′ right eyes were selected to be observed and analyzed. The ocular surface disease index(OSDI) scores, relevant indicators of tear secretion[results of Schirmer Ⅰ test(SⅠt), tear meniscus height(TMH)], tear film stability indicators[fluorescein breakup time(FBUT), first noninvasive breakup time(F-NIBUT), and average noninvasive breakup time(A-NIBUT)], corneal fluorescein staining(CFS) scores, meibomian gland examination indicators(meibomian gland opening status scores, meibomian gland grading scores, meibomian gland secretion trait scores), intraocular pressure, and the occurrence of adverse drug reactions were compared between the two groups before and after treatment. Results The OSDI scores in both groups after treatment were significantly decreased compared with those before treatment(P<0.05), and the posttherapeutic OSDI scores in the observation group were lower than those in the control group, and the differences were statistically significant(P<0.05). After treatment, the results of SⅠt in the observation group were significantly higher than those in the control group(P<0.05), and there was no significant difference in TMH between the two groups(P>0.05). After treatment, FBUT, F-NIBUT and A-NIBUT in both groups were significantly prolonged compared those before treatment(P<0.05), and the levels of the indicators in the observation group were longer than those in the control group, and the differences were statistically significant(P<0.05). The CFS scores in both groups after treatment were significantly decreased compared with those before treatment(P<0.05), but there were no significant differences in the CFS scores between the two groups(P>0.05). Compared with those before treatment, the meibomian gland opening status scores and meibomian gland secretion trait scores were significantly decreased in both groups after treatment(P<0.05), but the changes in the meibomian gland grading scores were not significant(P>0.05). Before and after treatment, there were no significant differences in the meibomian gland grading scores, meibomian gland opening status scores and meibomian gland secretion trait scores between the two groups(P>0.05). During the treatment period, no adverse events were observed in both groups. There were no significant changes in intraocular pressure between the two groups before and after treatment(P>0.05). Conclusion Diquafosol sodium combined with fluorometholone can effectively improve the clinical symptoms and signs of the dry eye syndrome patients, and the effects of diquafosol sodium combined with fluorometholone are better than those of sodium hyaluronate combined with fluorometholone, and diquafosol sodium combined with fluorometholone is worthy of clinical application and promotion.
Key words:  Diquafosol sodium  Fluorometholone  Sodium hyaluronate  Dry eye syndrome  Clinical efficacy