中药熏蒸联合强脉冲光治疗MGD相关性干眼的临床观察

Clinical Observation of Chinese Herbal Fumigation Combined with Intense Pulsed Light in the Treatment of MGD-Related Dry Eye

摘要: 目的：观察中药熏蒸联合强脉冲光治疗睑板腺功能障碍(meibomian gland dysfunction, MGD)性干眼的临床作用。方法：收集风热证MGD性干眼患者72例144眼，随机分为观察组和对照组。对照组予强脉冲光治疗，观察组在对照组的基础上联合中药熏蒸治疗。评估治疗前后患者的眼部主观症状评分、睑缘改变评分、睑板腺分泌物排出能力评分、睑板腺分泌物性状评分、角膜荧光素钠染色评分及非接触式泪膜破裂时间(noninvasive breakup time, NIBUT)情况。结果：治疗后两组患者眼部各项评分较治疗前均降低，观察组评分低于对照组，差异均有统计学意义(P < 0.05)。治疗后两组患者NIBUT较治疗前均延长，观察组的NIBUT长于对照组，差异有统计学意义(P < 0.05)。结论：中药熏蒸联合强脉冲光能提高MGD性干眼患者的NIBUT，改善眼部症状、睑缘以及睑板腺分泌物性状，促进睑脂排出，减少角膜荧光素钠染色。

Abstract: Objective: To observe the clinical effect of Chinese herbal fumigation combined with intense pulsed light in the treatment of dry eye caused by meibomian gland dysfunction (MGD). Methods: A total of 72 patients with MGD-related dry eye with wind-heat syndrome (144 eyes) were collected and randomly divided into an observation group and a control group. The control group was treated with intense pulsed light, and the observation group was treated with Chinese herbal fumigation combined with the control group. The subjective ocular symptom scores, eyelid margin change scores, meibomian gland secretion discharge ability scores, meibomian gland secretion characteristics scores, corneal fluorescein sodium staining scores and noninvasive breakup time (NIBUT) of the patients were evaluated before and after treatment. Results: After treatment, the ocular scores of the two groups of patients were lower than those before treatment, and the scores of the observation group were lower than those of the control group, with significant differences (P < 0.05). After treatment, the NIBUT of the two groups of patients was prolonged compared with that before treatment, and the NIBUT of the observation group was longer than that of the control group, with significant differences (P < 0.05). Conclusion: Chinese medicine fumigation combined with intense pulsed light can improve the NIBUT of patients with MGD dry eye, improve ocular symptoms, eyelid margin and meibomian gland secretion characteristics, promote meibum discharge, and reduce corneal fluorescein sodium staining.