| Objective:Through the observation of tobradex eye drops combined with the fumigation of traditional Chinese medicine for soothing wind and clearing heat in the treatment of blepharitis-dry eye,this paper provides the basis and new method for clinical treatment of blepharitis-dry eye.Methods:198 eyes of 99 cases blepharitis-dry eye with wind-heat syndrome which met the inclusion criteria,were collected from January to November,2019,in the second People’s Hospital of Fujian University of Traditional Chinese Medicine.And they were randomly divided into traditional Chinese medicine fumigation group,tobradex eye drops group and combined medication group,33 cases 66 eyes each group.The traditional Chinese medicine fumigation group is fumigated by the soothing wind and clearing heat traditional Chinese medicine,2 times a week,2 weeks 1 course,2 consecutive courses;the tobradex eye drops group is provided with the tobramycin-dexamethasone eye drops qid 2 weeks,bid 1 week,qd 1week;the combination medicine group is used for treating the soothing wind and clearing heat traditional Chinese medicine to be fumigated with the tobramycin-dexamethasone eye drops.Before treatment,after 2 weeks of treatment,after 4 weeks of treatment,the patient’s primary symptoms score,the margin hyperemia score,the margin scale score,the plate gland secretion score,the corneal fluorescence intensity staining score,the tear film rupture time,the tear secretion amount,the lacrimal passage height,and safety indexes such as intraocular pressure and vision in the treatment process were recorded.Results:(1)Main sensory symptom score: after 2 weeks of treatment,the main sensory symptom scores of the combined drug group were lower than those of the Chinese medicine fumigation group and the tobradex eye drops group.The main sensory symptom scores of the Chinese medicine fumigation group,the tobradex eye drops group(except photophobia)and the combined medicine group were lower than those before treatment,the difference was statistically significant(P<0.05).After 4 weeks of treatment,the scores of redness,dryness and cauterization in the combined group were lower than those in the Chinese medicine fumigation group and the tobradex eye drops group;the scores of main sensory symptoms in the three groups were lower than those before treatment;the Chinese medicine fumigation group,the combined drug group(except itching and cauterizing)and the tobradex eye drops group(removing eye redness and cauterizing)all the sensory symptom scores were lower than those after 2 weeks of treatment(P<0.05).(2)Palpebral border signs and tarsal gland secretion: after 2 weeks of treatment,the scores of palpebral margin hyperemia,tarsal scale and tarsal gland secretion in the combined drug group were lower than those in the Chinese medicine fumigation group and tobradex eye drops group,and the scores of palpebral margin hyperemia,tarsal scale and tarsal gland secretion in the three groups were all lower than before treatment(P<0.05).After 4 weeks of treatment,the scores of tarsal gland secretion in the combined group were lower than those in the tobradex eye drops group;the scores of palpebral margin hyperemia,tarsal scale and tarsal glandsecretion in the three groups were lower than those before treatment;the scores of tarsal margin hyperemia,tarsal scale and tarsal gland secretion in the fumigation group of traditional Chinese medicine and the scores of palpebral gland secretion in the tobradex eye drops group margin congestion,palpebral margin scales score lower than 2 weeks after treatment,the difference was statistically significant(P<0.05).(3)Corneal fluorescein sodium staining score: after 2 weeks of treatment,the corneal fluorescein sodium staining score of the combined drug group was lower than that of the Chinese medicine fumigation group and the tobradex eye drops group;the scores of the three groups were gradually decreased;after 4 weeks of treatment,there was no significant difference in the scores of the three groups(P>0.05).(4)Tear film rupture time,tear secretion volume,tear river height: three groups after treatment,tear film rupture time gradually prolonged,the difference is statistically significant(P<0.05).The tear film rupture time(8.09±1.07 s)was higher than that of Chinese medicine fumigation group(7.55±1.03 s)and tobradex eye drops group(7.31±1.02)(P<0.05).The tear film rupture time(11.97±0.94 s)was higher than that of Chinese medicine fumigation group(10.57 ± 1.46)and tobradex eye drops group(10.31 ± 1.35s);treatment There was no significant difference in tear secretion between the three groups compared with the height of the lacrimal river(P>0.05).After 4 weeks of treatment,compared with those of before and 2weeks after treatment,in the three groups,the amount of tear secretion were increased and the height of the lacrimal river were higher(P<0.05).(5)Total curative effect evaluation: the cure rate of Chinese medicine fumigation group was 18%,the improvement rate was 82%,the cure rate was 41%,the improvement rate was59%,the cure rate was 15%,the improvement rate was 85%,the total curative effect of the combined medicine group was better than that of Chinese medicine fumigation group and tobradex eye drops group,the difference was statistically significant(P<0.05).Compared with traditional Chinese medicine fumigation group and Dianbishu eye drops group,there was no significant difference(P>0.05).Conclusion:Simple the soothing wind and clearing heat traditional Chinese medicine fumigation can improve the main symptoms of inflammatory dry eyes of eyelid margin,signs of eyelid margin,secretion of tarsal gland,reduce corneal fluorescein sodium staining,prolong tear film rupture time,increase tear secretion and tear river height.The soothing wind and clearing heat traditional Chinese medicine fumigation combined with tobradex eye drops can improve clinical efficacy.The effect of the soothing wind and clearing heat traditional Chinese medicine fumigation on intraocular pressure is small. |
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