地夸磷索钠联合强脉冲光治疗在糖尿病相关干眼症中的应用

Application of diquafosol sodium combined with intense pulsed light therapy in the treatment of diabetes-related dry eye disease

摘要:

目的 探讨地夸磷索钠联合强脉冲光治疗对糖尿病相关干眼症患者的治疗效果。方法 选取2021年1月—2023年1月邯郸市第一医院收治的糖尿病相关干眼症患者86例。通过随机数字表法将患者分为两组，各43例。对照组患者给予地夸磷索钠滴眼液治疗，观察组在对照组基础上联合强脉冲光治疗。比较两组患者的治疗有效率，检测治疗前后泪液中炎症因子［肿瘤坏死因子（TNF-α）、白细胞介素-6（IL-6）、白细胞介素-17（IL-17）］水平，分别在治疗前后进行泪液分泌试验（SIT），并测定泪膜破裂时间（BUT）和泪河高度，比较两组患者治疗前后的前睑板腺分泌状态评分、睑板腺缺失评分、泪膜脂质层厚度、眼表疾病指数量表（OSDI）评分、干眼症状（SPEED）评分、角膜荧光素染色（FLS）评分。结果 观察组治疗总有效率高于对照组（P <0.05）。治疗后两组TNF-α、IL-6、IL-17均降低（P <0.05）；观察组治疗前后TNF-α、IL-6、IL-17的差值均大于对照组（P <0.05）。治疗后两组SIT、BUT及泪河高度均升高（P <0.05）；观察组治疗前后SIT、BUT及泪河高度的差值均大于对照组（P <0.05）。治疗后两组睑板腺分泌状态评分、睑板腺缺失评分均降低（P <0.05），泪膜脂质层厚度升高（P <0.05）；观察组治疗前后睑板腺分泌状态评分、睑板腺缺失评分、泪膜脂质层厚度的差值均大于对照组（P <0.05）。治疗后两组OSDI评分、SPEED评分、FLS评分均降低（P <0.05）；观察组治疗前后OSDI评分、SPEED评分、FLS评分的差值均大于对照组（P <0.05）。结论 地夸磷索钠联合强脉冲光治疗有助于提高糖尿病相关干眼症的疗效，改善眼部症状。

Abstract:

Objective To explore the therapeutic effects of diquafosol sodium combined with intense pulsed light therapy in patients with diabetes-related dry eye disease.Methods A total of 86 patients with diabetes-related dry eye admitted to Handan First Hospital from January 2021 to January 2023 were selected. They were divided into two groups by the random number table method, with 43 cases in each group. Patients in the control group were treated with diquafosol sodium eye drops, while the observation group was additionally treated with intense pulsed light. The treatment effective rate was compared between the two groups. The levels of inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-17 (IL-17) ] in tears were detected before and after treatment. The Schirmer I test (SIT) was performed before and after treatment, and the tear film break-up time (BUT) and tear meniscus height were measured. The meibomian gland secretion score, meibomian gland dropout score, tear film lipid layer thickness, Ocular Surface Disease Index (OSDI) score, Standard Patient Evaluation of Eye Dryness (SPEED) score, and corneal Fluorescein Staining (FLS) score were compared between the two groups before and after treatment.Results The overall treatment effective rate of the observation group was higher than that of the control group (P < 0.05). After treatment, the levels of TNF-α, IL-6, and IL-17 were all decreased in both groups (P < 0.05), and the differences of them before and after treatment were higher in the observation group than in the control group (P < 0.05). After treatment, both groups showed increases in SIT, BUT, and tear meniscus height (P < 0.05), and the changes in these parameters from pre- to post-treatment were greater in the observation group than in the control group (P < 0.05). Both groups exhibited decreased meibomian gland secretion and dropout scores (P < 0.05) and increased tear film lipid layer thickness after treatment (P < 0.05), while the pre- to post-treatment differences in these meibomian gland parameters were greater in the observation group compared to the control group (P < 0.05). Additionally, OSDI, SPEED, and corneal FLS scores decreased in both groups after treatment (P < 0.05), with the observation group showing greater improvements than the control group (P < 0.05).Conclusion The combination of diquafosol sodium and intense pulsed light is effective in improving the therapeutic outcomes and ocular symptoms of patients with diabetes-related dry eye disease.