玻璃酸钠滴眼液联合中药外熏治疗干眼症疗效及安全性Meta分析

目的:系统评价玻璃酸钠滴眼液联合中药外熏治疗干眼症(Dry eye disease,DED)的临床疗效及安全性,为临床用药提供循证医学支持。方法:计算机检索英文数据库(4个):PubMed、Embase、Cochrane Library、Web of Science; 中文数据库(4个):中国知网(CNKI)、万方数字化期刊(Wanfang Data)、维普中文科技期刊(VIP)、中国生物医学文献(CBM)数据库,时间截止至2021 年2月18日,搜索玻璃酸钠滴眼液联合中药外熏与单独玻璃酸钠滴眼液治疗比较的临床随机对照试验(Randomized controlled trial,RCT)。根据Cochrane标准筛选纳入研究,提取数据并运用RevMan 5.4软件进行统计学分析。结果:20篇文献符合纳入标准,共2018例患者,Meta分析显示:与单独应用玻璃酸钠滴眼液相比,在其基础上联合使用中药外熏可明显改善干眼症患者临床总有效率OR=3.45,95%CI(2.63,4.54), P<0.00001]、泪膜破裂时间(Tear break up time,BUT)MD=1.72,95%CI(1.45,1.99), P<0.00001]、泪液分泌量(SchirmerⅠ test,SIT)MD=3.37,95%CI(2.67,4.07), P<0.00001],干眼症状评分MD=-2.30,95%CI(-3.24,-1.37), P<0.00001]、角膜荧光素钠染色(Corneal fluorescein staining,CFS)评分MD=-0.71,95%CI(-0.98,-0.44), P<0.00001],差异具有统计学意义,两组均未见明显不良反应 。结论:玻璃酸钠滴眼液治联合中药外熏在改善干眼症患者临床总有效率、泪膜破裂时间、泪液分泌量、干眼症状评分、角膜荧光素钠染色评分等方面具有一定的优势,且未见显著不良反应。

A Meta-analysis of the efficacy and safety of sodium hyaluronate eye drops combined with herbal fumigation in the treatment of dry eye disease

Objective:To evaluate the efficacy and safety of sodium hyaluronate eye drops combined with herbal fumigation in the treatment of dry eye disease(DED),providing evidence-based medicine support for clinical medication.Methods:Eight databases(PubMed、Web of Science、Embase、Cochrane Library、CNKI、VIP、Wanfang and CBM )were searched up to February 18,2021.Search for a clinical randomized controlled trial(RCT)comparing the treatment of sodium hyaluronate eye drops combined with external fumigation of traditional Chinese medicine and sodium hyaluronate eye drops alone.Data analysis was carried out using RevMan software(V.5.4).Results:Twenty clinical trials were included with 2018 influenza patients.The results of Meta-analysis showed that compared with the sodium hyaluronate eye drops alone,combined with herbal fumigation can significantly improve the total clinical effective rate in patients with dry eye OR=3.45,95% CI(2.63,4.54),P<0.00001],Tear break time(BUT)MD=1.72,95%CI(1.45,1.99),P<0.00001],Schirmer Ⅰ Test(SIT)MD=3.37,95%CI(2.67,4.07),P<0.00001],dry eye symptom score MD=-2.30,95%CI(-3.24,-1.37),P<0.00001],Corneal fluorescein staining(CFS)Score MD=-0.71,95%CI(-0.98,-0.44),P<0.00001],the difference was statistically significant,and there were no obvious adverse reactions in the two groups.Conclusion:Sodium hyaluronate eye drops combined with herbal fumigation has certain advantages in improving the total clinical effective rate,BUT,SIT,dry eye symptom score,CFS score in patients with dry eye,and no significant adverse reactions.