睑板腺按摩联合妥布霉素地塞米松眼膏在东北地区治疗睑板腺功能障碍性干眼的疗效观察  

Effective observation on xerophthalmia of meibomian glands dysfunction treated with meibomian glands massage and tobramycin dexamethasone in the northeast area

作　　者：牛晓霞[1] 李云峰[1] 战露阳 高桂兰[1] 

机构地区：[1]哈尔滨爱尔眼科医院角膜眼表科,150076

出　　处：《中国医师进修杂志》2014年第30期14-17,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 探讨应用睑板腺按摩联合妥布霉素地塞米松眼膏治疗东北地区睑板腺功能障碍性干眼的临床疗效.方法 回顾性分析2013年1-11月东北地区诊治的睑板腺功能障碍性干眼患者403例（767眼）的临床资料,其中治疗组1采用“按摩＋妥布霉素地塞米松眼膏＋人工泪液（卡波姆眼用凝胶）”治疗,治疗组2采用“妥布霉素地塞米松眼膏＋人工泪液”治疗,对照组只用人工泪液治疗,观察记录治疗前及治疗后1,3个月泪膜破裂时间（BUT）、泪液分泌试验（SchirmerⅡ）、角膜染色评分以及干眼症状改善程度.结果 三组治疗前主观症状、BUT、SchirmerⅡ、角膜染色评分比较差异无统计学意义（P＞ 0.05）.治疗后1个月,治疗组1、治疗组2患者主观症状、BUT、SchirmerⅡ、角膜染色评分较治疗前明显好转（P＜0.01）,但对照组与治疗前比较差异无统计学意义（P＞0.05）.治疗后3个月,治疗组1、治疗组2有效率分别为87.1％（122/140）,60.8％（79/130）,显著高于对照组的48.9％（65/133）,差异有统计学意义（P＜0.05）.治疗组1、治疗组2有效率比较差异也有统计学意义（P＜0.05）.结论 睑板腺功能障碍性干眼的治疗应从病因着手进行热敷＋按摩＋抗炎综合治疗,有利于泪膜脂质层的稳定性和均匀性重建,恢复泪膜的完整性,使干眼及眼表炎性反应消除.但睑板腺功能障碍性干眼仍需门诊持久的观察治疗以及日常生活饮食的指导.患者良好的治疗依从性是临床疗效的关键.Objective To observe the clinical effect of xerophthalmia of meibomian glands dysfunction treated with meibomian glands massage and tobramycin dexamethasone in the northeast area.Methods The clinical data of 403 patients （767 eyes） with xerophthalmia of meibomian glands dysfunction in the northeast area in January to November 2013 were analyzed retrospectively.The patients were divided into 3 groups.Patients of treatment goup 1 were combined modality therapy by meibomian glands massage and tobramycin dexamethasone and artificial tears （carbomer eye ophthalmic gel）.Patients of treatment goup 2 were treated with tobramycin dexamethasone and artificial tears.Patients of control group were only used by artificial tears.Tear film break-uptime （BUT）,tear secretion test （Schirmer Ⅱ）,corneal staining score and symptom score were measured before treatment and after treatment for 1,3 months.Results There was no significant difference in the subjective symptoms,BUT,Schirmer Ⅱ,corneal staining score before treatment among three groups （P 〉 0.05）.Compared with that before treatment,the subjective symptoms,BUT,Schirmer Ⅱ,corneal staining score after treatment for 1 month was improved in treatment group 1 and treatment group 2 （P 〈 0.01）,but there was no significant difference in control group （P 〉 0.05）.After treatment for 3 months,the effective power in treatment group 1 [87.1%（122/140）] and treatment group 2 [60.8%（79/130）] was higher than that in control group [48.9%（65/133）],and there was significant difference （P 〈 0.05）.And there was significant difference between treatment group 1 and treatment group 2 （P 〈 0.05）.Conclusions Xerophthalmia of meibomian glands dysfunction in the northeast area due to speciality in the geographical environment and food habits.Combined modality therapy （applied heating,meibomian glands massage and tobradex） can provide a new direction of xerophthalmia of meibomian glands dysfunction,retrieve in the lipids component of the t

关 键 词：睑板腺 干眼病 妥布霉素地塞米松眼膏 

分 类 号：R777.13[医药卫生—眼科]