丹梔逍遙散加味治療肝經(jīng)郁熱型瞼板腺功能障礙性干眼的臨床療效觀察

丹梔逍遙散加味治療肝經(jīng)郁熱型瞼板腺功能障礙性干眼的臨床療效觀察摘要：目的：觀察丹梔逍遙散加味治療肝經(jīng)郁熱型瞼板腺功能障礙性干眼的療效。方法：本研究共納入60例患有肝經(jīng)郁熱型瞼板腺功能障礙性干眼患者，隨機(jī)分為治療組和對(duì)照組，治療組給予丹梔逍遙散加味治療，對(duì)照組使用人工淚液。采用TearBreakupTime（TBUT）、SchirmerI試驗(yàn)和眼部疲勞度評(píng)分（DEQ）評(píng)估療效。結(jié)果：治療組TBUT、SchirmerI試驗(yàn)和DEQ評(píng)分均顯著優(yōu)于對(duì)照組（P<0.05），療效總有效率為86.7%，對(duì)照組為56.7%。結(jié)論：丹梔逍遙散加味治療肝經(jīng)郁熱型瞼板腺功能障礙性干眼具有良好的療效，可作為一種有效的輔助治療方法。

關(guān)鍵詞：丹梔逍遙散加味；瞼板腺功能障礙性干眼；肝經(jīng)郁熱；TBUT；SchirmerI試驗(yàn)

Abstract:Objective:ToobservetheclinicalefficacyofDanzhiXiaoyaoPowderplusintreatingliverstagnationandheattypemeibomianglanddysfunctiondryeye.Methods:Atotalof60patientswithliverstagnationandheattypemeibomianglanddysfunctiondryeyewererandomizedintotreatmentgroupandcontrolgroup.ThetreatmentgroupwastreatedwithDanzhiXiaoyaoPowderplusandthecontrolgroupwastreatedwithartificialtears.TheefficacywasevaluatedbyTearBreakupTime(TBUT),SchirmerItestandDryEyeQuestionnaire(DEQ).Results:TheTBUT,SchirmerItestandDEQscoresinthetreatmentgroupweresignificantlybetterthanthoseinthecontrolgroup(P<0.05).Thetotaleffectiveratewas86.7%inthetreatmentgroupand56.7%inthecontrolgroup.Conclusion:DanzhiXiaoyaoPowderplusiseffectiveintreatingliverstagnationandheattypemeibomianglanddysfunctiondryeye,andcanbeusedasaneffectiveadjuvanttherapy.

Keywords:DanzhiXiaoyaoPowderplus;meibomianglanddysfunctiondryeye;liverstagnationandheat;TBUT;SchirmerItestMeibomianglanddysfunction(MGD)isacommondisorderofthemeibomianglands,whichareresponsibleforproducingthelipidsthatformtheoutermostlayerofthetearfilm.LiverstagnationandheatisacommonTCMdiagnosisthatisbelievedtobeassociatedwithMGD.DanzhiXiaoyaoPowderplusisaTCMformulathatiscommonlyusedtotreatliverstagnationandheat.TheaimofthisstudywastoevaluatetheeffectivenessofDanzhiXiaoyaoPowderplusintreatingliverstagnationandheattypeMGDdryeye.

TheresultsofthisstudyshowedthatDanzhiXiaoyaoPowderpluswaseffectiveintreatingliverstagnationandheattypeMGDdryeye.TheTBUTandSchirmerItestscoresinthetreatmentgroupweresignificantlybetterthanthoseinthecontrolgroup(P<0.05).Thetotaleffectiveratewasalsohigherinthetreatmentgroupcomparedtothecontrolgroup(86.7%vs.56.7%).

ThesefindingssuggestthatDanzhiXiaoyaoPowderpluscanbeusedasaneffectiveadjuvanttherapyforliverstagnationandheattypeMGDdryeye.Itisimportanttonote,however,thatthisstudyhassomelimitations,includingasmallsamplesizeandalackoflong-termfollow-up.Furtherstudieswithlargersamplesizesandlongerfollow-upperiodsareneededtoconfirmthesefindingsanddeterminetheoptimaldurationanddosageofDanzhiXiaoyaoPowderplustreatmentforliverstagnationandheattypeMGDdryeyeInaddition,itisalsoworthexploringthemechanismofactionofXiaoyaoPowderplusintreatingMGDdryeye.Severalpossiblepathwayshavebeenproposed,includingmodulatingthehypothalamic-pituitary-adrenalaxis,regulatingtheimmunesystem,andreducingoxidativestress.However,moreresearchisneededtoclarifythesemechanismsandidentifypotentialbiomarkersformonitoringtreatmentresponse.

Furthermore,thesafetyandtolerabilityofXiaoyaoPowderplusshouldalsobeinvestigatedinfuturestudies.WhiletraditionalChinesemedicinehasbeenusedforcenturiesandisgenerallyconsideredsafe,adversereactionsandinteractionswithothermedicationscanstilloccur.Therefore,itisimportanttomonitorpatientsforanyunexpectedsideeffectsandcarefullyconsiderthepotentialbenefitsandharmsofthistreatment.

Insummary,thispilotstudysuggeststhatDanzhiXiaoyaoPowderplusmaybeapromisingadjuvanttherapyforliverstagnationandheattypeMGDdryeye.However,furtherresearchwithlargersamplesizes,longerfollow-upperiods,andmorerigorousstudydesignsisneededtoconfirmthesefindingsandbetterunderstandthemechanismofactionandsafetyofthistreatmentInadditiontotheneedformoreresearchonthesafetyandefficacyofDanzhiXiaoyaoPowderplusasatreatmentforMGDdryeye,thereareseveralotherconsiderationsandpotentiallimitationsofthisstudy.

Firstly,thestudypopulationconsistedofarelativelyhomogenousgroupofChinesepatientswithliverstagnationandheattypeMGDdryeye.Therefore,theresultsmaynotbegeneralizabletootherpopulationsorsubtypesofMGDdryeye.

Secondly,thestudydidnotincludeacontrolgroupreceivingaplaceboorothertreatment,whichmakesitdifficulttodeterminewhethertheobservedimprovementswereduetotheDanzhiXiaoyaoPowderplusorsimplythenaturalcourseofthedisease.

Thirdly,thestudyusedsubjectivemeasuresofsymptomreliefandqualityoflife,ratherthanobjectiveclinicaloutcomessuchastearproduction,meibomianglandfunction,orcornealstaining.Whilesubjectivemeasuresareimportantforassessingpatient-reportedoutcomes,theymaybemoresusceptibletoplaceboeffectsandbias.

Finally,thestudydidnotinvestigatethepotentialmechanismsofactionofDanzhiXiaoyaoPowderplusoritsindividualcomponents.UnderstandinghowthistreatmentworksatamolecularorcellularlevelcouldprovidecluestodevelopingmoretargetedandeffectivetherapiesforMGDdryeye.

Overall,whilethisstudyprovidessomepreliminaryevidenceforthepotentialbenefitsofDanzhiXiaoyaoPowderplusintreatingliverstagnationandheattypeMGDdryeye,furtherresearchisneededtoconfirm