探讨疏肝健脾法治疗活动期甲状腺相关眼病（TAO）并发干眼症的疗效，为临床治疗提供参考依据。【方法】将 108例活动期TAO并发干眼症肝郁气滞证患者随机分为观察组和对照组，每组各54例。2组患者均给予维持Graves病的常规 治疗，在此基础上，对照组给予激素冲击疗法（注射用甲泼尼龙琥珀酸钠静脉滴注）治疗，观察组在对照组的基础上联合中 药疏肝健脾方治疗，疗程为12周并复诊随访至6个月。观察2组患者治疗前后临床活动性分级评分（CAS）、突眼度、眼表疾 病指数（OSDI）评分、角膜荧光素染色（FL）评分、泪液分泌试验（SIT）和泪膜破裂时间（BUT）的变化情况，并评估2组患者的 临床疗效。【结果】（1）疗效方面，治疗6个月后，观察组的总有效率为94.44%（51/54），对照组为74.07%（40/54），组间比较 （χ2检验），观察组的疗效明显优于对照组（P＜0.05）。（2）活动性、突眼度和OSDI方面，治疗后，2组患者的CAS评分、OSDI 评分和突眼度均较治疗前降低（P＜0.01），且观察组的降低幅度均明显优于对照组（P＜0.1）。（3）泪液分泌功能方面，治疗 后，2组患者的SIT、FL评分、BUT均较治疗前改善（P＜0.01），且观察组的改善幅度均明显优于对照组，差异均有统计学意 义（P＜0.01）。【结论】疏肝健脾法治疗活动期TAO并发干眼症肝郁气滞证患者具有较好的临床疗效，可有效减轻突眼度，延 长泪膜破裂时间，增加泪液分泌，促进角膜上皮修复，改善视功能，提高生活质量。

To investigate the efficacy of the therapy of soothing liver and strengthening spleen （shortened as Shugan Jianpi therapy） in the treatment of active thyroid- associated ophthalmopathy （TAO） complicated with dry eye，and to provide a reference basis for clinical treatment. Methods A total of 108 patients with active TAO complicated with dry eye of liver depression and qi stagnation type were randomly divided into observation group and control group，54 patients in each group. Both groups were given conventional treatment for intervention of Graves’disease， and additionally the control group was given hormone shock therapy by intravenous injection of Methylprednisolone Sodium Succinate，and the observation group was treated with Chinese medicine prescription for soothing liver and strengthening spleen orally and intravenous injection of Methylprednisolone Sodium Succinate. The treatment period lasted for 12 weeks， and then the patients were followed up till to the 6th month. The changes of clinical activity score（CAS），proptosis，ocular surface disease index（OSDI），corneal fluorescein staining（FL），Schirmer I test（SIT）and tear film break-up time（BUT）in the two groups were observed before and after the treatment. After treatment，the clinical efficacy of the two groups was evaluated. Results（1）After 6 months of treatment， the total effective rate in the observation group was 94.44%（51/54）and that in the control group was 74.07%（40/54），and the intergroup comparison（tested by chisquare test）showed that the efficacy of the observation group was significantly superior to that of the control group （P＜0.05）.（2）After treatment，the CAS，OSDI score and proptosis of the patients in the two groups were all lower than those before treatment（P＜0.01），and the reduction in the observation group was significantly superior to that in the control group（P＜0.01）.（3）After treatment，the indicators of tear secretion function such as SIT， FL score and BUT of patients in the two groups were improved compared with those before treatment（P＜0.01）， and the improvement in the observation group was significantly superior to that in the control group，the differences being all statistically significant（P＜0.01）. Conclusion Shugan Jianpi therapy exerts certain clinical efficacy in treating patients with active TAO complicated with dry eye of liver depression and qi stagnation type，which can effectively relieve the proptosis，prolong the tear film break-up time，promote the secretion of tears and the repair of corneal epithelium，improve the visual function，and enhance the quality of life of the patients.

R276.7

中山市社会公益与基础研究项目（编号：2021B1073）