Clinical Observation Of Jianpi Huatan Decoction In The Treatment Of MGD Dry Eye With Spleen Deficiency And Phlegm Coagulation

Objective: The purpose of this article is to explore the clinical efficacy of Jianpi Huatan Decoction in the treatment of dry eyes caused by meibomian gland dysfunction(MGD)due to spleen deficiency and phlegm coagulation,so as to provide new clinical diagnosis and treatment ideas and basis for the future diagnosis and treatment of MGD dry eyes.Research Method: We collected 60 patients with MGD dry eye of spleen deficiency and phlegm coagulation type who met the inclusion criteria from January 2021 to March 2023 in the ophthalmology department of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine.According to the principle of random distribution,60 patients(120 eyes)were divided into two groups.One group was used as the treatment group and 30 cases(60eyes)were included,this group was given self-prepared Jianpi Huatan Decoction(tutor’s experience prescription)plus or minus oral,twice a day,0.3% sodium hyaluronate eye drops,1 drop each time,4 times a day,apply Dianshu Eye Ointment three times a day,meibomian gland massage,once a week,twice a course of treatment,lasting for two courses.The other group,as the control group,included 30 cases and was treated with 0.3% sodium hyaluronate eye drops,one drop each time,four times a day,apply Dianshu Eye Ointment three times a day,meibomian gland massage,once a week,twice a course of treatment,lasting for two courses.Record the Schirmer I test(SIt),break-up time of tear film(BUT),corneal fluorescein staining(FL),eyelid ester trait score,dry eye questionnaire(OSDI)score,symptom and sign score of traditional chinese medicine,before treatment,two weeks after treatment and four weeks after treatment,the indexes of the two groups before and after treatment were compared and statistically processed to analyze and discuss the difference of curative effect.Result: In this study,a total of 60 patients with MGD dry eyes of spleen deficiency and phlegm coagulation type were included,including 30 patients in the treatment group and 30 patients in the control group.(1)After a course of treatment,the total treatment effect of patients in the treatment group reached 56.7%.While that of the control group was 26.7%.There was a statistical difference in the clinical treatment effect between the two groups(P=0.045<0.05).After two courses of treatment,the total treatment effect of patients in the treatment group reached 93.3% and 70% in the control group.There was a significant difference in the clinical treatment effect between the two groups(P=0.002<0.05).After two courses of treatment,the effective rate of the treatment group was better than that of the control group.(2)Comparison between groups: There was no significant difference in the scores of OSDI and TCM symptoms and signs between the two groups(P>0.05)after 2 weeks of treatment,but the scores of OSDI and TCM symptoms and signs in the two groups were lower than those before treatment.After 2 weeks of treatment,there were statistically significant differences in SIt,BUT,FL score and eyelid ester trait score between the treatment group and the control group(P<0.05).The values of SIt in the two groups were higher than those before treatment,and the tear film rupture time of the two groups was prolonged in different degrees compared with that before treatment,and the FL score and eyelid ester trait score of the two groups were lower than that before treatment.After 4 weeks of treatment,there were significant differences in tear secretion,ocular surface disease index,FL,TCM symptoms and signs,BUT and eyelid ester between the treatment group and the control group(P<0.01).SIt increased,tear film rupture time prolonged,corneal injury alleviated,OSDI score,TCM symptom and sign score and eyelid ester score decreased in the two groups.The observation indexes of the treatment group were significantly better than those of the control group,and the clinical curative effect of the treatment group was better than that of the control group.(3)Inter-group comparison: After two courses of treatment,the tear secretion,ocular surface disease index score,FL score,TCM symptom and sign score,BUT,and meibum trait score in the treatment group were statistically different at three time points(P<0.01).The tear secretion volume,BUT,FL score,OSDI score,TCM symptom and sign score and palpebral ester score of the control group were significantly different after two courses of treatment(P<0.01).After treatment,the tear secretion volume of the treatment group and the control group increased,the tear film rupture time increased,the corneal injury is less than before,the OSDI score decreased,the TCM symptom and sign score decreased,and the palpebral ester character was significantly improved.The improvement of the treatment group was better than that of the control group.Conclusion: Jianpi Huatan Decoction has a significant effect on MGD dry eye of spleen deficiency and phlegm coagulation type,it can significantly increase the stability of tear film,balance the microenvironment of eye su rface,increase the amount of tear secretion and tear film rupture time,repair corneal injury to a certain extent,and improve the symptoms of eye and body discomfort.