目的 探讨明目蒺藜丸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7月—2023年1月在中国人民解放军中部战区总医院诊治的78例干眼症患者，根据用药方案的不同将所有患者分为对照组和治疗组，每组各39例。对照组给予玻璃酸钠滴眼液，1滴/次，3次/d；治疗组在对照组治疗基础上口服明目蒺藜丸，9 g/次，2次/d。两组均治疗8周。观察两组的临床疗效和临床症状改善时间，比较两组治疗前后视功能相关生命质量量表（NEI-VFQ-25）评分、视功能损害眼病患者生存质量量表（SQOL DVI）评分、眼表疾病量表（OSDI）评分、眼表功能指标、泪液细胞因子的变化情况。结果 治疗后，治疗组的总有效率是97.44%，显著高于对照组的79.49%（P＜0.05）。治疗后，治疗组眼睛干涩感、异物感、疲劳感、畏光、灼烧感改善时间上均显著短于对照组（P＜0.05）。治疗后，两组NEI-VFQ-25评分、SQOL DVI评分均显著升高，而中国干眼问卷量表评分、OSDI量表评分均显著降低（P＜0.05）；治疗后，治疗组患者相关量表评分改善均优于对照组（P＜0.05）。治疗后，两组患者泪膜破裂时间（FBUT）、SⅠt均较治疗前显著升高，而角膜荧光素染色（FL）评分显著降低（P＜0.05）；治疗后，治疗组眼表功能指标改善均优于对照组（P＜0.05）。治疗后，两组泪液中白细胞介素-1β（IL-1β）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）均显著降低，而溶菌酶、表皮生长因子（EGF）、乳铁蛋白（LF）均显著显著升高（P＜0.05）；治疗后，治疗组泪液细胞因子改善均优于对照组（P＜0.05）。结论 明目蒺藜丸联合玻璃酸钠滴眼液治疗干眼症可有效改善临床症状，改善眼表功能及泪液分泌，下调泪液细胞因子水平，提高生活质量，有着良好的临床应用价值。

Objective To explore the clinical efficacy of Mingmu Jili Pills combined with Sodium Hyaluronate Eye Drops in treatment of dry eye. Methods A total of 78 patients with dry eye diagnosed and treated in Chinese People’s Liberation Army Central Theater Command General Hospital from July 2021 to January 2023 were selected, and all patients were divided into control group and treatment group according to different medication regiments, with 39 cases in each group. Patients in the control group were given Sodium Hyaluronate Eye Drops, 1 drop/time, 3 times daily. Patients in the treatment group were po administered with Mingmu Jili Pills on the basis of the control group, 9 g/time, twice daily. Both groups were treated for 8 weeks. The clinical efficacy and improvement time of clinical symptoms of the two groups were observed, and the changes of NEI-VFQ-25 scores, SQOL DVI scores, OSDI scores, ocular surface function indexes and cytokines in tears before and after treatment were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 97.44%, which was significantly higher than that of the control group (79.49%, P< 0.05). After treatment, the improvement time of dry eyes, foreign body sensation, fatigue, photophobia and burning sensation in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, NEI-VFQ-25 scores and SQOL DVI scores of both groups were significantly increased, but scores of China Dry Eye Questionnaire scale and OSDI scale were significantly decreased (P < 0.05). After treatment, the improvement of relevant scale scores in the treatment group was better than that in the control group (P < 0.05). After treatment, tear film rupture time (FBUT) and SⅠt were significantly increased in both groups compared with before treatment, but corneal fluorescein staining (FL) score was significantly decreased (P < 0.05). After treatment, the improvement of ocular surface function index in treatment group was better than that in control group (P < 0.05). After treatment, the levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in tears of both groups were significantly decreased, but lysozyme, epidermal growth factor (EGF) and lactoferrin (LF) were significantly increased (P< 0.05). After treatment, the improvement of tear cytokines in the treatment group was better than that in the control group (P < 0.05). Conclusion Mingmu Jili Pills combined with Sodium Hyaluronate Eye Drops can effectively improve clinical symptoms in treatment of dry eye, and can improve eye surface function and tear secretion, downregulate the expression of tear cytokines, and improve life quality with good clinical application value.

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