OBJECTIVE:To observe the clinical efficacy on improving the quality of meibum in patients suffer from dry eye disease (DED) due to meibomian gland dysfunction (MGD) with hyperactivity ofdue todeficiency pattern after being treated with Pinggan Yuyin Qingre formula (, PGYYQR).METHODS:Totally 120 patients who met the inclusion criteria were included and stratified into three levels according to the level of MGD (1-3), and patients in each level was randomly allocated into the treatment group and control group according to a 1∶1 ratio. Both groups were treated with sodium hyaluronate eye drops, and the treatment group was also given PGYYQR granules. Both groups were treated continuously for eight weeks. The score of the properties of meibomian gland (MG) secretion, the score of the palpebral margins, the average noninvasive tear breakup time (NITBUTav), lipid layer thickness (LLT), and Traditional Chinese Medicine (TCM) syndrome efficacy were compared between the two groups after treatment.RESULTS:A total of 116 cases were included in the statistical analysis. The differences were statistically significant in the score of the properties of MG secretion, the score of the palpebral margins, and NITBUTav between the two groups after treatment, the treatment group was superior to the control group; there was no evidence of a difference in LLT. In terms of TCM syndrome efficacy, the total effective rate was 84.7% in the treatment group and 50.9% in the control group, with the statistically significant difference. None of the included cases had adverse reactions.CONCLUSIONS:PGYYQR is effective in improving the quality of meibum, and the tear film stability which thereby relieving the ocular symptoms in MGD-related DED patients with hyperactivity ofdue todeficiency pattern.

原发性开角型青光眼是一种以视神经损伤和视野缺损为主要表现的不可逆致盲性眼病,其病因及发病机制复杂,目前西医的治疗无法完全阻断视神经损伤的进展.支楠教授是孔嗣伯的学术继承人,其将孔门"两纲六要"学说应用于眼科辨证,认为该病多以肝郁为先、湿热为障,致脾胃气机失调,治疗上以疏肝开郁和胃,清热利湿健脾为主调理脾胃气机升降.文章将结合典型病例,探讨支楠治疗原发性开角型青光眼学术思想.

目的:评价平肝育阴清热方治疗睑板腺功能障碍导致蒸发过强且中医证属阴虚阳亢型干眼症患者的临床疗效及安全性.方法:连续的120例符合准的门诊患者被纳入试验,按照睑板腺功能的分级(1～3级)分别纳入轻中重三层,每层按照1∶1的比例随机分配为试验组或对照组.两组均予玻璃酸钠滴眼液治疗,1滴/眼/次,每日3次,试验组同时加服平肝育阴清热方配方颗粒,每日2次,两组均连续治疗8周.总体及分层比较两组患者治疗前后非侵入性泪膜破裂时间(NITBUT),角膜病变程度、睑板腺排出脂质难易度、睑板腺结构、眼部症状积分、眼表疾病指数(OSDI)量表得分及中医兼证证候积分.结果:纳入120例患者中脱落1例,剔除3例,116例纳入统计.治疗前后两组患者NITBUT,角膜病变程度,眼部症状积分,OSDI量表得分均表现为试验组优于对照组,差异具有统计学意义;睑板腺排出脂质难易度得分差异无统计学意义,试验组仅有优于对照组的趋势;两组治疗后中医兼证证候得分与治疗前相比差异均有统计学意义.全部纳入病例均无不良反应发生,无心电图或肝肾功能异常改变.结论:平肝育阴清热方可有效改善睑板腺功能障碍导致的蒸发过强,中医证属阴虚阳亢型干眼症患者的泪膜稳定性,眼干涩、灼热、眼痒、异物感等眼部症状及阴虚阳亢的中医症状,且以中重度患者改善效果更为明显;具有改善睑板腺功能的趋势,安全性佳,患者依从性较好.

目的 观察自拟清火散结汤口服结合药液熏蒸双目治疗表层巩膜炎的效果.方法 选择2016年12月-2018年12月于作者所在医院就诊的表层巩膜炎患者43例(60只眼),采用随机数字表法将其分为中药组22例(30只眼)与对照组21例(30只眼).中药组给予清火散结汤口服结合药液熏蒸双目,对照组给予局部冰袋冷敷,每次10 ～ 15 min,每日3次、患眼局部点普南扑灵滴眼液,2组均治疗4周.比较2组有效率、复发率及主观症状、巩膜充血评分.结果 中药治疗组治愈8只眼(26.67％),好转17只眼(56.67％),无效5只眼(6.67％),总有效率83.3％.对照组治愈5只眼(16.67％),好转17只眼(56.67％),无效8只眼(16.67％),总有效率73.3％,前者的疗效好于后者,但是差异不显著(x2=0.884,P=0.347).对治愈患者分别3个月后随访,中药治疗组复发1只眼,复发率12.5％,对照组复发4只眼,复发率80.0％,2组有差异但无明显统计学意义(Fisher精确检验,P=0.532).单纯性巩膜炎患者治疗后2组主观症状、巩膜充血评分均较治疗前明显改善(P＜0.05);治疗组主观症状、巩膜充血评分优于对照组,但无显著统计学差异(P＞0.05);结节性表层巩膜炎患者中药治疗后主观症状、巩膜充血评分均较前明显改善(P＜0.05),对照组与治疗前比较差异无统计学意义(P＞0.05);治疗后中药组主观症状评分、巩膜充血评分均优于对照组,差异有显著统计学意义(P＜0.05).根据修改后的正文补充2组有效率、复发率及主观症状、巩膜充血评分统计分析结果.结论 自拟清火散结汤口服结合药液熏蒸双目治疗表层巩膜炎,对于结节性表层巩膜炎,治疗有明显优势,对于单纯性巩膜炎,中药或西药治疗均有改善,西医冷敷和非甾体类消炎药对症使用也有一定价值,中药组较对照组有治疗优势,但没有表现出显著统计学差异.

Objective To observe the therapeutic effect of Buzhong Yiqi Decoction on the treatment of normal tension glaucoma (NTG).Methods 102 eyes of 58 patients with NTG were selected and randomly divided into the treatment group and the control group.The control group was treated with rattan prostaglandins for eye dropping.The treatment group was treated with Buzhong Yiqi Decoction and rattan prostaglandins.Both groups were treated continually for 6 months.Visual field,visual acuity,intraocular pressure(IOP) and the improvement of TCM clinical syndrome scores were compared before and after the treatment.Results The therapeutic effect of treatment group was better than that of the control group,the difference was statistically significant (P ＜ 0.05).The difference of medium defects(MD) of visual field,visual acuity and IOP of two groups were statistically significant(P ＜ 0.05).Conclusion Buzhong Yiqi Decoction is effective for normal tension glaucoma and can improve the patients' life quality.