中药熏蒸联合耳穴贴压对2型糖尿病相关干眼患者的临床疗效及炎症反应的影响

doi:10.20047/j.issn1673-7210.2023.08.36

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摘要目的观察中药熏蒸联合耳穴贴压对2型糖尿病相关干眼患者的临床疗效及炎症反应的影响。方法选取2021年6月至12月于河北省眼科医院就诊的2型糖尿病相关干眼患者120例为研究对象，按照随机数字表法分为中药熏蒸组、耳穴贴压组、中药熏蒸联合耳穴贴压组，每组40例。比较各组治疗前后眼表疾病指数（OSDI）评分、泪液分泌试验（SIt）、荧光素染色泪膜破裂时间（FBUT）、角膜荧光素染色（CFS）评分、白细胞介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）、基质金属蛋白酶-9（MMP-9）。检测各组结膜上皮细胞核因子-κB（NF-κB）表达。结果治疗后三组OSDI评分均低于治疗前，且中药熏蒸联合耳穴贴压组OSDI评分低于中药熏蒸组、耳穴贴压组，差异有统计学意义（P＜0.05）。治疗后三组SIt大于治疗前，FBUT长于治疗前，CFS评分低于治疗前，且中药熏蒸联合耳穴贴压组SIt大于中药熏蒸组、耳穴贴压组，FBUT长于中药熏蒸组、耳穴贴压组，CFS评分低于中药熏蒸组、耳穴贴压组，差异有统计学意义（P＜0.05）。治疗后三组TNF-α、IL-1β、MMP-9水平均低于治疗前，且中药熏蒸联合耳穴贴压组TNF-α、IL-1β、MMP-9水平均低于中药熏蒸组、耳穴贴压组，差异有统计学意义（P＜0.05）。中药熏蒸联合耳穴贴压组结膜上皮细胞NF-κB表达均低于中药熏蒸组、耳穴贴压组，差异有统计学意义（P＜0.05）。结论中药熏蒸和耳穴贴压法联合应用可明显改善2型糖尿病相关干眼患者的眼部症状，提高泪液分泌量和泪膜稳定性，减轻眼部炎症反应，值得推荐应用。

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	李维娜1 缪辉1 王立芳1 董萍1 尹会苏1 李静2 王俏2

关键词 ： 2型糖尿病相关干眼, 中药熏蒸, 耳穴贴压, 炎症反应

Abstract：Objective To observe the effects of Chinese medicine fumigation combined with auricular point sticking on clinical efficacy and inflammatory reaction in patients with type 2 diabetic dry eyes. Methods One hundred and twenty patients with type 2 diabetic dry eyes treated in Hebei Eye Hospital from June to December 2021 were selected as the research objects. According to the random number table method, they were divided into Chinese medicine fumigation group, auricular point sticking group, and Chinese medicine fumigation combined with auricular point sticking group, with 40 cases in each group. The scores of ocular surface disease index (OSDI), schirmer I test (SIt), fluorescein break-up time (FBUT), corneal fluorescein staining (CFS) and the levels of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), matrix metalloproteinase-9 (MMP-9) in each group before and after treatment were compared. Conjunctival epithelial cell nuclear factor kappa B (NF-κB) expression in each group was detected. Results After treatment, OSDI scores of three groups were lower than those before treatment, and OSDI score of Chinese medicine fumigation combined with auricular point sticking group was lower than that of Chinese medicine fumigation group and auricular point sticking group, the differences were statistically significant (P＜0.05). After treatment, SIt of three groups were more than those before treatment, FBUT of three groups were longer than those before treatment, and CFS scores of three groups were lower than those before treatment, and SIt of Chinese medicine fumigation combined with auricular point sticking group was more than that of Chinese medicine fumigation group and auricular point sticking group, FBUT of Chinese medicine fumigation combined with auricular point sticking group was longer than that of Chinese medicine fumigation group and auricular point sticking group, CFS score of Chinese medicine fumigation combined with auricular point sticking group was lower than that of Chinese medicine fumigation group and auricular point sticking group, the differences were statistically significant (P＜0.05). After treatment, the levels of TNF-α, IL-1β, MMP-9 in three groups were lower than those before treatment, and Chinese medicine fumigation combined with auricular point sticking group was lower than that of Chinese medicine fumigation group and auricular point sticking group, the differences were statistically significant (P＜0.05). Conjunctival epithelial cell NF-κB expression of Chinese medicine fumigation combined with auricular point sticking group was lower than that of Chinese medicine fumigation group, auricular point sticking group, the differences were statistically significant (P＜0.05). Conclusion The combination of Chinese medicine fumigation and auricular point sticking can obviously improve the ocular symptoms of patients with type 2 diabetic dry eyes, increase the amount of tear secretion and the tear film stability, alleviate the local inflammatory reaction. It is worthy of recommendation.

Key words： Type 2 diabetic dry eyes Chinese medicine fumigation Auricular point sticking Inflammation

基金资助:河北省医学科学研究课题（20191053）；
中国中医科学院基本科研业务费自主选题项目（ZZ0808041）。

通讯作者: 李静（1969.10-），女，主任护师，硕士生导师；研究方向：眼科护理及管理。

作者简介: 李维娜（1964.6-），女，副主任护师；研究方向：眼科护理及管理。

引用本文:

李维娜1 缪辉1 王立芳1 董萍1 尹会苏1 李静2 王俏2. 中药熏蒸联合耳穴贴压对2型糖尿病相关干眼患者的临床疗效及炎症反应的影响[J]. 中国医药导报, 2023, 20(8): 158-162.
LI Weina1 MIAO Hui1 WANG Lifang1 DONG Ping1 YIN Huisu1 LI Jing2 WANG Qiao2. Effects of Chinese medicine fumigation combined with auricular point sticking on clinical efficacy and inflammatory reaction in patients with type 2 diabetic dry eyes. 中国医药导报, 2023, 20(8): 158-162.

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