| Dry Eye Disease(DED),as a common ocular surface Disease,is mainly characterized by dryness,foreign body sensation,fatigue,photophobia,fluctuating vision and burning sensation,etc.DED has various etiologies,complex pathogenesis and various types,which are difficult to cure clinically and also occur repeatedly.DED belongs to the traditional Chinese medicine "white astringent disease" category,for the treatment of the disease from the whole body syndrome differentiation treatment,you all have a unique view of traditional Chinese medicine,Professor Kang Zefeng heritage classic,combined with years of clinical experience,prepared from the "nourishing blood run eye prescription" treatment of dry eye,clinical effect is significant,for the treatment of dry eye provides a new idea.The first partObjectivesPrescriptions of patients diagnosed as lipid-abnormal moderate dry eye in the outpatient department were collected,and data mining was conducted by TCM inheritance computing platform to explore prescription medication rules,summarize the medication experience of Professor Kang Zefeng,and pass on treatment ideas and methods.MethodsThe cases of moderate dry eye of lipid-abnormal type treated by Professor Kang Zefeng were collected,and the frequency,meridian return of sexual taste,efficacy and prescription rule,clustering of traditional Chinese medicine of a single Chinese medicine were analyzed by TCM inheritance computing platform software.ResultsA total of 132 Chinese herbs were recorded in this time,and the top ten Chinese herbs in use frequency were Angelica sinensis,Fructus vitae,Paeonia alba,Ligusticum chuanxiong,Gastrodia elata,Cornus officinalis,whole scorpion,rehmannia glutinosa,rhizoma glutinosa,and Rhizome.Four gas analysis:warm drugs accounted for 37.7%,cold drugs accounted for 35.24%;Five flavor analysis:sweet medicine accounted for 32.81%,spicy medicine accounted for 30.98%;Analysis of GUI Jing:GUI Gan Jing accounted for 32.98%;Efficacy analysis:32.4%for tonifying and deficiency;The support degree was>50%and the confidence degree was 0.8.The commonly used drug pairs were Angelica-Paeony,Angelica-Ligusticum chuanxiong,Angelica-ripe rehmannia glutinosa,Vine and Fructus corni,scorpion-grain essence grass,etc.Correlation analysis of drugs:Rhizoma glutinosa->Gastrodia elata,Gastrodia elata,Comus officinalis->Fructus tendrissima,Whole scorpion,Root->paeonia alba,etc.According to the number of cluster 3-5,two core combinations were analyzed:Angelica-Radix paeoniae officinalis-Rhizoma corni,Angelica-Ligusticum chuanxiong-Radix Paeoniae officinalis-Gastrodia elata;Three new prescriptions:nourishing qi and moistening eyes,nourishing blood and moistening eyes,immortal drink plus or minus.conclusionProfessor Kang Zefeng used the methods of nourishing blood and moistening eyes,invigorating qi and nourishing Yin in the treatment of lipid-abnormal dry eye.A small part of the use of heat,clear leader evil,syndrome differentiation treatment.The second partObjectivesTo evaluate the clinical efficacy and safety of Yangxue Runmu Prescription in the treatment of lipid-abnormal moderate dry eye,provide evidence support for further promotion and application,and provide reference basis for TCM treatment of dry eye.MethodsA prospective,randomized,controlled trial design was used in this study.A total of 60 patients with lipid-abnormal moderate dry eye that met the criteria of intake and discharge were collected,and the patients were assigned to the control group and the experimental group in a 1:1 ratio by random number table method.The treatment group was treated with yangxue Run Mu Fang granule orally and meibomian gland massage twice a day,one bag at a time,meibomian gland massage once a week for 4 weeks.The control group was treated with sodium hyaluronate eye drops and meibomian gland massage,1-2 drops of sodium hyaluronate eye drops,4 times a day,meibomian gland massage once a week for 4 weeks.General data of this study included gender and age,and efficacy indicators included changes in subjective symptom score from baseline at week 4,changes in corneal fluorescein sodium staining from baseline,changes in BUT,Tear Break Time from baseline,and Tear secretion Test(Schirmer I Test,SIT changes from baseline,iOP changes from baseline,and safety analysis.Results1.A total of 62 patients with moderate lipid abnormalities were included in this study,and 5 patients were detached.A total of 57 cases(114 eyes)were completed,including 28 cases(56 eyes)in the treatment group and 29 cases(58 eyes)in the control group.2.There was no statistical significance in age and gender between the two groups(P>0.05).3.There was no significant difference in BUT before treatment between 2 groups(P>0.05).The difference was statistically significant after 1 month of treatment(P<0.0001).4.There was no significant difference between the two groups before corneal fluorescein staining(P>0.05).The difference was statistically significant after 1 month of treatment(P<0.0001).5.The difference between the two groups before Schirmer I was statistically significant(P<0.0001).After adjusting for baseline by covariance analysis at 1 month of treatment,the difference between groups was statistically significant(P<0.0001).6.There was statistically significant difference between the two groups before dry eye instrument examination(P<0.0001).After adjusting for baseline by covariance analysis at 1 month of treatment,the difference between groups was statistically significant(P<0.0001).7.There was no significant difference in visual acuity between the 2 groups before treatment(P>0.05).After 1 month of treatment,the difference between groups was statistically significant(P<0.0001).8.There was no significant difference between the two groups before treatment of meibomian gland blockage(P>0.05).After 1 month of treatment,the difference between groups was statistically significant(P<0.0001).9.The scores of Chinese dry eye Questionnaire before treatment were statistically significant between the two groups(P<0.0001).After adjusting for baseline by covariance analysis at 1 month of treatment,the difference between groups was statistically significant(P<0.0001).10.Comparison of clinical efficacy:the total effective rate of the main efficacy indicators was 92.85%in the treatment group and 75.87%in the control group;The difference between groups was statistically significant,the therapeutic effect of the treatment group was better than the control group.The total effective rate was 92.85%in the treatment group and 31.03%in the control group.Conclusion1.Yangxue Runmu Decoction has significant effect on improving BUT,increasing tear secretion,promoting meibomian gland lipid secretion,and improving dry eye signs and subjective symptoms in patients with moderate abnormal lipids.2.Yangxue Runmu Decoction can improve the visual acuity of patients with dry eye,but there is no statistical difference compared with sodium hyaluronate eye drops.3.Yangxue Runmu Decoction has good compliance,effectiveness and safety,without any adverse reactions or adverse events. |
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