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目的观察围手术期口服滋阴活血方对超声乳化术后泪膜及眼表变化的影响。方法将55例(60只眼)行白内障超声乳化摘除联合人工晶体植入术的患者随机分为治疗组27例(30只眼)和对照组28例(30只眼),两组均行上方角巩缘3.2mm隧道切口超声乳化白内障摘除联合人工晶体(折叠式)植入术,手术前后均予西医常规处理措施;治疗组在常规治疗基础上,于术前3天至术后21天口服自拟滋阴活血方。观察两组术前及术后第1、7、21、30天干眼相关症状、泪膜破裂时间(BUT)、基础泪液分泌试验(SIT)及角膜荧光染色变化情况。结果①干眼相关症状评分:治疗组术后1天、7天明显高于术前(P<0.05),对照组术后1天、7天、21天、30天均明显高于术前(P<0.05,P<0.01);组间术后比较,第7天、21天、30天差异有统计学意义(P<0.05,P<0.01)。②基础泪液分泌试验:治疗组术前与术后1天差异有统计学意义(P<0.05),对照组术前与术后1天、7天、21天、30天差异均无统计学意义(P>0.05);组间术后比较,第1天差异有统计学意义(P<0.05)。③泪膜破裂时间:治疗组术前、术后差异无统计学意义(P>0.05),对照组术后7天较术前缩短(P<0.05);组间术后比较,第7天、30天差异有统计学意义(P<0.05)。④角膜荧光染色评分:治疗组术前与术后1天差异有统计学意义(P<0.01),对照组术后各观察期角膜荧光染色评分始终高于术前(P<0.05,P<0.01);组间术后比较,第术后7天、21天、30天差异有统计学意义(P<0.05)。结论超声乳化术可短期内影响患者的泪膜及眼表,围手术期口服滋阴活血方可缓解术后泪膜及眼表的改变。
Objective To observe the effects of perioperative oral Ziyinhuoxue prescription on changes of tear film and ocular surface after phacoemulsification. Methods 55 patients (60 eyes) undergoing cataract phacoemulsification combined with intraocular lens implantation were randomly divided into treatment group (n = 27) (30 eyes) and control group (n = 28) Pharyngeal Gongyuan 3.2mm tunnel incision phacoemulsification cataract extraction combined with intraocular lens (foldable) implantation, both before and after surgery to Western routine treatment; the treatment group on the basis of conventional treatment, preoperative 3 days to 21 days after oral administration Since the Ziyin Huoxue side. Dry eye-related symptoms, tear-break time (BUT), basal tear secretion test (SIT) and corneal fluorescence staining were observed before operation and on the 1st, 7th, 21st, Results ① The scores of dry eye-related symptoms in the treatment group were significantly higher than those before operation (P <0.05) on the 1st day and the 7th day after operation, while those in the control group were significantly higher than those on the 1st day, 7th day, 21th day and 30th day P <0.05, P <0.01). There was significant difference between the two groups in postoperative day 7, day 21 and day 30 (P <0.05, P <0.01). ② basal tear secretion test: The difference between the preoperative and postoperative one day in the treatment group was statistically significant (P <0.05), but there was no significant difference in the control group between preoperative and postoperative 1 day, 7 days, 21 days and 30 days (P> 0.05). There was significant difference on the first day between the two groups (P <0.05). (3) The time of tear film rupture: There was no significant difference between the two groups before and after treatment (P> 0.05), while the control group shortened 7 days after operation (P <0.05) 30 days difference was statistically significant (P <0.05). ④ Corneal fluorescence staining score: the difference between the preoperative and postoperative one day in the treatment group was statistically significant (P <0.01), and the corneal fluorescence staining score in the control group was always higher than that before operation (P <0.05, P <0.01) ). There was significant difference between the groups in postoperative 7 days, 21 days and 30 days (P <0.05). Conclusion Phacoemulsification can affect the tear film and ocular surface in patients in short term. Perioperative oral nourishing Yin and promoting blood circulation can alleviate the postoperative tear film and ocular surface changes.