目的 探討杞菊潤目顆粒聯(lián)合玻璃酸鈉滴眼液治療干眼癥的臨床療效。方法 選取2021年1月—2022年12月黑龍江中醫(yī)藥大學(xué)附屬第一醫(yī)院收治的136例（272眼）干眼癥患者，按隨機(jī)數(shù)字表法將所有患者分為對照組和治療組，每組各68例。對照組給予玻璃酸鈉滴眼液，每眼1滴/次，3次/d。治療組在對照組基礎(chǔ)上口服杞菊潤目顆粒，1袋/次，3次/d，開水沖服。兩組療程均為4周。觀察兩組臨床療效，比較治療前后兩組角膜熒光素染色（FL）評分、無表面麻醉的SchirmerⅠ試驗（SⅠt）結(jié)果等眼表功能指標(biāo)，眼表疾病指數(shù)（OSDI）量表、標(biāo)準(zhǔn)干眼狀評估（SPEED）問卷評分，視覺質(zhì)量參數(shù)值及淚液中胸腺基質(zhì)淋巴細(xì)胞生成素（TSLP）、白細(xì)胞介素（IL）-2、核苷酸結(jié)合寡聚化結(jié)構(gòu)域樣受體1（Nod-1）、轉(zhuǎn)化生長因子-β2（TGF-β2）水平。結(jié)果 治療后，治療組總有效率是94.12%，顯著高于對照組的82.35%（P＜0.05）。治療后，兩組FL評分均顯著降低，無表面麻醉的SⅠt和熒光素染色淚膜破裂時間（FBUT）均顯著增加（P＜0.05）；治療后，治療組FL評分低于對照組，而無表面麻醉的SⅠt和FBUT高于對照組（P＜0.05）。治療后，兩組OSDI量表評分、SPEED問卷評分均顯著下降（P＜0.05）；且治療后，治療組OSDI量表評分、SPEED問卷評分顯著低于對照組（P＜0.05）。治療后，兩組淚膜動態(tài)客觀散射指數(shù)（TF-OSI）均顯著降低，而調(diào)制傳遞函數(shù)截止頻率（MTF cutoff）均顯著增加（P＜0.05）；視覺質(zhì)量參數(shù)均以治療組改善更顯著（P＜0.05）。治療后，兩組淚液中TSLP、IL-2、Nod-1水平均顯著下降，淚液中TGF-β2水平均顯著上升（P＜0.05）；均以治療組改善更顯著（P＜0.05）。結(jié)論 杞菊潤目顆粒聯(lián)合玻璃酸鈉滴眼液治療干眼癥可獲得良好療效，能有效改善患者眼表功能，緩解干眼癥狀，提高視覺質(zhì)量，促進(jìn)眼部炎癥及病情緩解，安全性較好，值得臨床推廣應(yīng)用。

Objective To explore the clinical efficacy of Qiju Runmu Granules combined with Sodium Hyaluronate Eye Drops in treatment of dry eyes. Methods A total of 136 patients (272 eyes) with dry eye admitted to the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from January 2021 to December 2022 were selected and divided into control group and treatment group according to random number table, with 68 cases in each group. Patients in the control group were given Sodium Hyaluronate Eye Drops, 1 drop per eye, 3 times daily. Patients in the treatment group were po administered with Qiju Runmu Granules with boiling water on the basis of the control group, 1 bag/time, 3 times daily. The treatment course of both groups was 4 weeks. The clinical efficacy of the two groups was observed. The corneal fluorescein staining (FL) score, SchirmerⅠ test (SⅠt) results without surface anesthesia and other ocular surface function indexes, ocular surface disease index (OSDI) scale and standard dry eye appearance Assessment (SPEED) questionnaire scores, visual quality parameters and levels of thymus stromal lymphoietin (TSLP), interleukin (IL)-2, nucleotide-bound oligomeric domain-like receptor 1 (Nod-1) and transforming growth factor-β2 (TGF-β2) in tears in two groups were compared before and after treatment. Results After treatment, the total effective rate of the treatment group was 94.12%, significantly higher than that of the control group (82.35%) (P < 0.05). After treatment, FL score in two groups was significantly decreased, SⅠt and FBUT without topical anesthesia were significantly increased (P < 0.05). After treatment, FL scores in the treatment group were lower than those in the control group, but SⅠt and FBUT without topical anesthesia were higher than those in the control group (P < 0.05). After treatment, OSDI scale scores and SPEED questionnaire scores were significantly decreased in both groups (P < 0.05). The OSDI scale score and SPEED questionnaire score of the treatment group were significantly lower than those of the control group (P < 0.05). After treatment, TF-OSI was significantly decreased and MTF cutoff was significantly increased in two groups (P < 0.05). Visual quality parameters were significantly improved in the treatment group (P < 0.05). After treatment, the levels of TSLP, IL-2, and Nod-1 in tears of two groups were significantly decreased, while the levels of TGF-β2 in tears of two groups were significantly increased (P < 0.05). The improvement was more significant in treatment group (P < 0.05). Conclusion Qiju Runmu Granules combined with Sodium Hyaluronate Eye Drops has achieve good therapeutic effect in treatment of dry eyes, and can effectively improve the patients' ocular surface function, and can effectively improve the ocular surface function of patients, relieve dry eye symptoms, improve visual quality, promote ocular inflammation and disease remission with good safety, which is worthy of clinical application.

R988.1

國家自然科學(xué)基金面上項目（81973908）；黑龍江省中醫(yī)藥科研項目（ZYW2022-051）；黑龍江中醫(yī)藥大學(xué)科研基金項目（201708）