目的 探讨明目二十五味丸联合羟糖甘滴眼液治疗干眼症的临床疗效。方法 选择2024年6月—2025年12月山西医科大学第一医院收治的干眼症患者128例，采用简单随机化方法将患者分为对照组（64例）和治疗组（64例）。对照组患者采用羟糖甘滴眼液，轻度患者1滴/次，1次/d；中度患者1滴/次，2次/d。治疗组患者在对照组基础上，口服明目二十五味丸，轻度患者9丸/次，中度患者10丸/次，2次/d。两组患者连续治疗8周。观察两组患者的总有效率，比较临床症状改善时间、治疗前后眼表功能指标泪膜破裂时间（BUT）、泪液分泌试验（SIT）和角膜荧光素染色（FL）、干眼相关生活质量评分问卷（DEQS）评分。结果 治疗后，治疗组总有效率显著高于对照组（95.31% vs 81.25%，P＜0.05）。相较于对照组，治疗组患者干涩感、异物感、视疲劳、畏光及烧灼感改善时间均显著更短（P＜0.05）。两组治疗后SIT、BUT均较治疗前明显上升，FL评分明显下降（P＜0.05），且治疗组眼表功能指标改善效果显著优于对照组（P＜0.05）。两组治疗后眼部症状困扰、日常生活影响评分及DEQS总分均较治疗前显著降低（P＜0.05），治疗组治疗后DEQS各分项评分及总分均显著低于对照组（P＜0.05）。结论 明目二十五味丸联合羟糖甘滴眼液治疗干眼症的临床疗效显著，能够缩短临床症状改善时间，改善眼表功能，提高生活质量，安全性高。

Objective To evaluate the clinical efficacy of Mingmu Ershiwuwei Pills combined with Hypromellose 2910, Dextran 70 and Glycerol Eye Drops in treatment of dry eye syndrome.Methods A total of 128 patients diagnosed with dry eye disease admitted to the First Hospital of Shanxi Medical University from June 2024 to December 2025 were enrolled and randomly divided into a control group and a treatment group, with 64 cases in each group. The control group received topical Hypromellose 2910, Dextran 70 and Glycerol Eye Drops: one drop once daily for mild dry eye and one drop twice daily for moderate dry eye. On the basis of the topical treatment, the treatment group received additional oral administration of Mingmu Ershiwuwei Pills, administered twice daily at doses of 9 pills per time for mild cases and 10 pills per time for moderate cases. Both groups received continuous treatment for 8 weeks. The overall clinical efficacy, symptom resolution time, ocular surface function indicators including tear break-up time (BUT), Schirmer I test (SIT) results, and corneal fluorescein staining (FL) scores, as well as Dry Eye-Related Quality of Life Score (DEQS) were compared before and after treatment. Results After treatment, the treatment group yielded a significantly higher overall clinical effective rate than the control group (95.31% vs 81.25%, P < 0.05). The treatment group presented markedly shorter resolution time for typical symptoms including ocular dryness, foreign body sensation, visual fatigue, photophobia, and burning sensation (P < 0.05). After intervention, both groups exhibited significant increases in SIT and BUT values and decreased FL scores (P < 0.05), with superior ocular surface improvements observed in the treatment group (P < 0.05). Additionally, all subitem scores and the total DEQS score, which reflect ocular symptom distress and daily life impairment, were significantly reduced in both groups post-treatment, and the treatment group showed more prominent improvements than the control group (P < 0.05). Conclusion The combination of Mingmu Ershiwuwei Pills and Hypromellose 2910, Dextran 70 and Glycerol Eye Drops achieves favorable clinical outcomes in dry eye disease treatment. This combined regimen effectively accelerates symptomatic relief, improves ocular surface function, and enhances patients’ quality of life with satisfactory safety profiles, demonstrating promising clinical application value.

R988.1

山西省卫生健康委科研课题（2024113）