Clinical Observation On The Combined Therapy Of Sticking Scraping And Scraping Around The Eyes In The Treatment Of Dry Eye

Objective:To observe the clinical effect of combined therapy of periocular application and scraping in the treatment of dry eye.Methods:This study was a prospective randomized controlled trial.According to the proposed inclusion and exclusion criteria,a total of 120 dry eye patients(240 eyes)admitted to the ophthalmology clinic of Beijing Erlong Road Hospital from July 2018 to January 2020 were divided into 2 groups by block random method,with 60 patients(120 eyes)in each group.The experimental group included 60 patients(120 eyes),including 16 males(32 eyes)and 44 females(88 eyes).The control group included 60 patients(120 eyes),19 males(38 eyes)and 41 females(82 eyes).The experimental group was treated with eye peripheral application combined with scraping therapy,3 times a week,each treatment time was 25min,and the course of treatment was 2 weeks.The control group was treated with sodium carboxymethyl cellulose eye drops,4 times a day,for 2 weeks.Ocular surface disease index score(OSDI),tear film rupture time(BUT),tear secretion test I(Schirmer I),and corneal fluoriferin staining score(FL)were observed 2 and 4 weeks after treatment.Patients' safety indexes and adverse reactions were also observed.Treatment methods of eye peri-ocular application combined with scraping:doctors wear masks,wash hands,and inform the subjects of the operation process;First,eye application therapy was performed.Patients lay flat and closed their eyes,and the sterile gauze soaked in Chinese medicine solution was pasted on the patients' eyes(to cover the acupoints such as Jingming,Cuanzhu,Yuyao,Sizhukong,Taiyang,Yangbai,Sibai,and Chengqi),and the applied gauze was removed 15 minutes later.Eye skin smear scraping essential oil(pay attention to avoid the flow of essential oil into the eyes),doctors hand eye scraping board and skin into a 45° Angle from the eyebrow along the eyebrow arch shape scraping to the side of the hair,from the inner canthus along the zygoma shape scraping to the side of the hair,from Yintang point up scraping to the top of the hair,the technique of flat filling and reducing,Need to stimulate to Jingming,Xiajingming,Cuanzhu,Yuyao,Sibai,Yangbai,Taiyang,Shenting,Touwei,Xuanlu points.Carboxymethyl cellulose sodium eye drops treatment:Carboxymethyl cellulose sodium eye drops,1 drop each time,after the drops closed the eyes for 1min.Results:A total of 120 patients(240 eyes)who met the criteria for dry eye were included in this study.There were 60 patients in experimental group(120 eyes)and 60 patients in control group(120 eyes).There were no significant differences in gender,age,ocular surface disease index scale score(OSDI),corneal fluorescin staining score(FL),tear film rupture time(BUT),tear secretion test I(Schirmer I)between the two groups(P>0.05),and the baseline data were comparable.1.Intra-group comparison:after 2 weeks compared with the baseline,dry eye symptoms were significantly improved,corneal fluorescein staining was reduced,tear film rupture time and tear secretion test I were longer than before,and the above were improved compared with the baseline,with statistical significance(P<0.05).After 4 weeks,dry eye symptoms were significantly improved compared with baseline,corneal fluorescence staining was reduced,tear film rupture time and tear secretion test I were prolonged compared with baseline,and the above were all improved compared with baseline,with statistical significance(P<0.05).2.Intra-group comparison of control group:after 2 weeks,dry eye symptoms were significantly improved,corneal fluorescein staining was reduced,tear film rupture time and tear secretion test Iwere prolonged compared with before,and the above were improved compared with the baseline,with statistical significance(P<0.05).After 4 weeks,dry eye symptoms were significantly improved compared with baseline,corneal fluorescence staining was reduced,tear film rupture time and tear secretion test I were prolonged compared with baseline,and the above were all improved compared with baseline,with statistical significance(P<0.05).3.Comparison between the experimental group and the control group:after treatment,the score of ocular surface disease index scale,tear film rupture time,tear secretion test I,the experimental group was better than the control group,the difference was statistically significant(P<0.05).Corneal fluorescein staining:after 2 weeks,there was statistically significant difference between the two groups(P<0.05),while after 4 weeks,there was no statistically significant difference between the two groups(P>0.05).4.Comparison between the experimental group and the control group:after treatment,the score of ocular surface disease index scale changed compared with the baseline,the tear film rupture time changed compared with the baseline,the tear secretion test I changed compared with the baseline,the experimental group was better than the control group,the difference was statistically significant(P<0.05).Changes in corneal fluorescein staining from baseline:after 2 weeks,there was statistically significant difference between the groups(P<0.05),while after 4 weeks,there was no statistically significant difference between the groups(P>0.05).5.No adverse reactions occurred in both the experimental group and the control group during the test,and no abnormal safety indexes were observed before and after treatment.Conclusion:1.The comprehensive treatment of periocular sticking and scraping can effectively improve the ocular symptoms of patients with dry eyes.2.The comprehensive treatment of periocular application and scraping can effectively improve the tear film stability of patients with dry eyes,prolong the tear film rupture time and increase the tear secretion of the eye base.3.The combined therapy of scraping around the eye can improve the corneal epithelial status of patients with dry eyes and reduce the number of corneal fluorescein staining.However,after 4 weeks,the comparison of corneal luciferin staining between the experimental group and the control group,and the comparison of corneal luciferin staining changes from baseline showed no statistical significance.Therefore,long-term observational studies are needed.4.No adverse reactions and adverse events occurred in the experimental study of the comprehensive therapy of eye peri-ocular application and scraping,which is safe and reliable and easy to popularize.