目的 探讨杞菊润目颗粒联合玻璃酸钠滴眼液治疗干眼症的临床疗效。方法 选取2021年1月—2022年12月黑龙江中医药大学附属第一医院收治的136例（272眼）干眼症患者，按随机数字表法将所有患者分为对照组和治疗组，每组各68例。对照组给予玻璃酸钠滴眼液，每眼1滴/次，3次/d。治疗组在对照组基础上口服杞菊润目颗粒，1袋/次，3次/d，开水冲服。两组疗程均为4周。观察两组临床疗效，比较治疗前后两组角膜荧光素染色（FL）评分、无表面麻醉的SchirmerⅠ试验（SⅠt）结果等眼表功能指标，眼表疾病指数（OSDI）量表、标准干眼状评估（SPEED）问卷评分，视觉质量参数值及泪液中胸腺基质淋巴细胞生成素（TSLP）、白细胞介素（IL）-2、核苷酸结合寡聚化结构域样受体1（Nod-1）、转化生长因子-β2（TGF-β2）水平。结果 治疗后，治疗组总有效率是94.12%，显著高于对照组的82.35%（P＜0.05）。治疗后，两组FL评分均显著降低，无表面麻醉的SⅠt和荧光素染色泪膜破裂时间（FBUT）均显著增加（P＜0.05）；治疗后，治疗组FL评分低于对照组，而无表面麻醉的SⅠt和FBUT高于对照组（P＜0.05）。治疗后，两组OSDI量表评分、SPEED问卷评分均显著下降（P＜0.05）；且治疗后，治疗组OSDI量表评分、SPEED问卷评分显著低于对照组（P＜0.05）。治疗后，两组泪膜动态客观散射指数（TF-OSI）均显著降低，而调制传递函数截止频率（MTF cutoff）均显著增加（P＜0.05）；视觉质量参数均以治疗组改善更显著（P＜0.05）。治疗后，两组泪液中TSLP、IL-2、Nod-1水平均显著下降，泪液中TGF-β2水平均显著上升（P＜0.05）；均以治疗组改善更显著（P＜0.05）。结论 杞菊润目颗粒联合玻璃酸钠滴眼液治疗干眼症可获得良好疗效，能有效改善患者眼表功能，缓解干眼症状，提高视觉质量，促进眼部炎症及病情缓解，安全性较好，值得临床推广应用。

Objective To explore the clinical efficacy of Qiju Runmu Granules combined with Sodium Hyaluronate Eye Drops in treatment of dry eyes. Methods A total of 136 patients (272 eyes) with dry eye admitted to the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from January 2021 to December 2022 were selected and divided into control group and treatment group according to random number table, with 68 cases in each group. Patients in the control group were given Sodium Hyaluronate Eye Drops, 1 drop per eye, 3 times daily. Patients in the treatment group were po administered with Qiju Runmu Granules with boiling water on the basis of the control group, 1 bag/time, 3 times daily. The treatment course of both groups was 4 weeks. The clinical efficacy of the two groups was observed. The corneal fluorescein staining (FL) score, SchirmerⅠ test (SⅠt) results without surface anesthesia and other ocular surface function indexes, ocular surface disease index (OSDI) scale and standard dry eye appearance Assessment (SPEED) questionnaire scores, visual quality parameters and levels of thymus stromal lymphoietin (TSLP), interleukin (IL)-2, nucleotide-bound oligomeric domain-like receptor 1 (Nod-1) and transforming growth factor-β2 (TGF-β2) in tears in two groups were compared before and after treatment. Results After treatment, the total effective rate of the treatment group was 94.12%, significantly higher than that of the control group (82.35%) (P < 0.05). After treatment, FL score in two groups was significantly decreased, SⅠt and FBUT without topical anesthesia were significantly increased (P < 0.05). After treatment, FL scores in the treatment group were lower than those in the control group, but SⅠt and FBUT without topical anesthesia were higher than those in the control group (P < 0.05). After treatment, OSDI scale scores and SPEED questionnaire scores were significantly decreased in both groups (P < 0.05). The OSDI scale score and SPEED questionnaire score of the treatment group were significantly lower than those of the control group (P < 0.05). After treatment, TF-OSI was significantly decreased and MTF cutoff was significantly increased in two groups (P < 0.05). Visual quality parameters were significantly improved in the treatment group (P < 0.05). After treatment, the levels of TSLP, IL-2, and Nod-1 in tears of two groups were significantly decreased, while the levels of TGF-β2 in tears of two groups were significantly increased (P < 0.05). The improvement was more significant in treatment group (P < 0.05). Conclusion Qiju Runmu Granules combined with Sodium Hyaluronate Eye Drops has achieve good therapeutic effect in treatment of dry eyes, and can effectively improve the patients' ocular surface function, and can effectively improve the ocular surface function of patients, relieve dry eye symptoms, improve visual quality, promote ocular inflammation and disease remission with good safety, which is worthy of clinical application.

R988.1

国家自然科学基金面上项目（81973908）；黑龙江省中医药科研项目（ZYW2022-051）；黑龙江中医药大学科研基金项目（201708）