秦皮滴眼液联合睑板腺挤压器治疗睑板腺功能障碍性干眼的随机对照研究  

Clinical Study of Qinpi Eye Drops Combined with Meibomian Gland Squeezer for Treating Dry Eye Associated with Meibomian Gland Dysfunction: A Randomized Controlled Trial

作　　者：王大虎[1] 刘新泉[1] 张殷建[1] 阮雯洁[1] 朱华英[1] 苏晶[1] 江丹[1] 董志国[1] WANG Da-hu;LIU Xin-quan;ZHANG Yin-jian;RUAN Wen-jie;ZHU Hua-ying;SU Jing;JIANG Dan;DONG Z.hi-guo(Department of Ophthalmology,Longhua Hospital Shanghai University of Traditional Chinese Medicine,Shanghai 20003)

机构地区：[1]上海中医药大学附属龙华医院眼科,上海200032

出　　处：《中国中西医结合杂志》2018年第10期1190-1196,共7页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金资助项目(No.81574028);上海中医药大学预算内项目(No.2015YSN32)

摘　　要：目的观察秦皮滴眼液联合睑板腺挤压器治疗睑板腺功能障碍(MGD)性干眼的的临床疗效。方法采用随机对照的方法,将63例(126眼) MGD性干眼患者通过随机数字表法分成治疗组30例(60眼)和对照组33例(66眼)。两组基础治疗均为每日进行眼睑清洁、热敷,典必殊眼膏每天1次涂抹睑缘,0. 1%玻璃酸钠滴眼液每日4~6次治疗。治疗组采用秦皮滴眼液3次/天+睑板腺挤压器1次/周治疗,对照组采用睑板腺挤压器1次/周治疗。均连续治疗1个月。对患者治疗前、治疗2周后及治疗1个月后的主要临床症状积分、眼表面疾病指数(OSDI)、泪膜破裂时间(BUT)、角膜荧光染色(CFS)、泪液分泌试验(SIT)、睑板腺分泌能力及睑板腺分泌物质量等进行观察记录。结果治疗前,两组主要临床症状积分、OSDI、BUT、CFS、SIT、睑板腺分泌能力及睑板腺分泌物质量比较,差异均无统计学意义(P> 0. 05);治疗2周后,两组主要临床症状积分、OSDI较治疗前均降低(P <0. 05),且治疗组优于对照组(P <0. 01)。治疗1个月后,两组主要临床症状积分、OSDI、SIT、睑板腺分泌能力及睑板腺分泌物质量较治疗前降低(P <0. 01),BUT、CFS水平升高(P <0. 01),且治疗组的疗效明显优于对照组(P <0. 01)。睑板腺挤压器在操作过程中可引起结膜充血、流泪、轻度疼痛等不适,次日恢复如常,但无1例发生急性结膜炎、角膜炎等不良反应。结论秦皮滴眼液联合睑板腺挤压器较单纯睑板腺挤压器治疗可明显改善MGD性干眼的眼部不适,且无明显不良反应,是一种安全可行的治疗方法。Objective To observe the therapeutic effect of Qinpi eye drops combined with the meibomian gland squeezer for the treatment of dry eye associated with meibomian gland dysfunction（ MGD）. Methods A randomized controlled trial was performed,63 cases（ 126 eyes） of dry eye associated with MGD were randomly assigned to 2 groups.Thirty cases（ 60 eyes） who were chosen as the treatment group were treated on Qinpi eye drops 3 times a day combined with the meibomian gland squeezer once a week,for a period of one month. The other 33 cases（ 66 eyes） were sorted as the control group and only treated on the meibomian gland squeezer once a week,for a period of one month. Both groups received the routine treatment for a period of 1 month including daily lid hygiene and warm compresses,Tobradex eye ointment was used to daub eyelid margin once a day,and 0. 1% sodium hyaluronate eye drops 4-6 times a day. Before treatment,two weeks and one month after treatment,the personal information with the main symptom score,international ocular surface disease index（ OSDI）,fluorescein tear break-up time（ BUT）,corneal fluorescein staining test（ CFS）,Schirmer I test（ SIT）,the quality of expressed meibum and meibum expressibility were all observed. Results Before treatment,there was no significant difference between the two groups in the main symptom score,OSDI,BUT,CFS,SIT,the quality of expressed meibum and meibum expressibility（ P〈0. 05）. After 2 weeks of treatment,the main symptom score and OSDI of the two groups were decreased compared to baseline（ P〈0. 05）,and the treatment group was superior to the control group（ P〈0. 01）. After 1 month of treatment,the main symptom score,OSDI,SIT,the quality of expressed meibum and meibum expressibility of the two groups were lower than before treatment（ P〈0. 01）,while BUT and CFS were increased compared to baseline（ P〈0. 01）,and the treatment group was significantly better than the control group（ P〈0. 01）. In addition,the meibomian gland

关 键 词：睑板腺功能障碍 干眼 秦皮滴眼液 睑板腺挤压器 

分 类 号：R777.34[医药卫生—眼科]