方法：收集2015-01/11间在我院眼科门诊进行治疗的干眼症患者102例204眼作为研究对象，随机分为3组：对照组、人工泪液组、环孢素滴眼液联合人工泪液组，各34例68眼，对照组不做特殊治疗，人工泪液组采用人工泪液滴眼，3次/d，环孢素滴眼液联合人工泪液组采用环孢素滴眼液联合人工泪液，3次/d，先滴人工泪液，再滴环孢素滴眼液，两种滴眼液间隔15min，所有患者连续治疗8wk后，观察比较各组之间泪液羊齿状试验(tear ferning test， TFT)、角膜上皮荧光素染色(corneal fluorescein staining ，FL)检查，泪液分泌试验(Schirmer Ⅰ test，SⅠt)、泪膜破裂时间(break-up time of tear film ，BUT)、结膜印迹细胞学检查(conjunctive impression cytology，CIC)等指标的变化。

结果：(1)治疗4wk环孢素滴眼液联合人工泪液组羊齿状结晶分级优于人工泪液组及对照组，差异具有统计学意义(χ²=16.345，P=0.003)，治疗8wk环孢素滴眼液联合人工泪液组羊齿状结晶分级均优于人工泪液组及对照组，差异有统计学意义(P<0.05)；(2)治疗8wk对照组染色评分与治疗前比较，染色加重(t=-4.500，P=0.003)； 人工泪液组、环孢素滴眼液联合人工泪液组角膜染色评分与治疗前比较，染色减轻，评分减少，差异具有统计学意义(P<0.05)。在治疗4、8wk，环孢素滴眼液联合人工泪液组的染色评分均比人工泪液组减少，差异具有统计学意义(t=3.553，P=0.006，t=4.523，P=0.001)；(3)环孢素滴眼液联合人工泪液组治疗4、8wk与对照组比较，BUT值延长，差异具有统计学意义(P<0.05)，环孢素滴眼液联合人工泪液组和人工泪液组之间BUT值比较差异无统计学意义(P>0.05)；(4)环孢素滴眼液联合人工泪液组在治疗8wk后结膜印迹细胞学检查，分级优于对照组及人工泪液组，差异有统计学意义(P<0.05)；(5)治疗4wk，环孢素滴眼液联合人工泪液组SⅠt值增加，与人工泪液组及对照组比较，差异有统计学意义(χ²=6.384，P =0.012)； 治疗8wk环孢素滴眼液联合人工泪液组SⅠt值均优于治疗前，环孢素滴眼液联合人工泪液组SⅠt值优于人工泪液组，差异均具有统计学意义(P<0.05)。

结论：环孢素滴眼液联合人工泪液治疗干眼症，可改善泪液环境，增加泪液分泌量，延长泪膜破裂时间，增强泪膜稳定性。

METHODS:One hundred and two patients(204 eyes)with dry eye as the research objects were collected from January 2015 to November 2015 and randomly divided into 3 groups:control group, subgroup A, subgroup B, 34 patients(68 eyes)in each group. The control group did not do special treatment. Subgroup A was treated with artificial tears eye drops 3 times per day and subgroup B with cyclosporine eye drop first, 15min later with artificial tears, 3 times per day. All patients were treated for 8wk. Tear ferning test(TFT), corneal fluorescein staining(FL), Schirmer I test(SIt), breakup time of tear film(BUT)and conjunctive impression cytology(CIC)in each group were observed and compared.

RESULTS:(1)At 4wk after treatment, fern fractional crystallization grade of subgroup B was better than those of subgroup A and control group(χ²=16.345,P=0.003); at 8wk after treatment, fern fractional crystallization grade of subgroup B was better than those of subgroup A and control group(P<0.05).(2)The FL of control group at 8wk was worse compared with before treatment(t=-4.500,P=0.003); the FL of subgroup A and subgroup B became lighter and the scores decreased compared with before treatment(P<0.05); at 4 and 8wk after treatment, the FL scores of subgroup B were lower than those of subgroup A(t=3.553, P=0.006; t=4.523, P=0.001).(3)Compared with control group, the BUT of subgroup B at 4 and 8wk prolonged(P<0.05); the BUT of subgroup B had no difference with subgroup A(P>0.05).(4)At 8wk after treatment, conjunctival impression cytology of subgroup B was better than those of the control group and subgroup A(P<0.05).(5)At 4wk after treatment, SIt of subgroup B increased, compared with subgroup A and the control group(χ²=6.384, P=0.012); at 8wk after treatment, SIt of subgroup A and B were better than those before the treatment, SIt of the B subgroup was better than that of subgroup A(all P<0.05).

CONCLUSION:Cyclosporin eye drops combined with artificial tears can improve micro environment of the tear, increase the amount of tear secretion, extend BUT and enhance the stability of the tear film.