中药熏蒸联合睑板腺按摩治疗睑板腺功能障碍的临床研究  

Clinical research on treatment of meibomian gland dysfunction by Traditional Chinese Medicine fumigation combined with meibomian gland massage

作　　者：白旭东 吴丹巍[1] 徐庆[1] 金茹娜[1] 杨静静 BAI Xudong;WU Danwei;XU Qing(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院眼科,上海200437

出　　处：《中国中医眼科杂志》2020年第6期407-411,426,共6页China Journal of Chinese Ophthalmology

基　　金：上海市中医薄弱领域专科建设项目(BRZK2016003)。

摘　　要：目的观察中药熏蒸联合睑板腺按摩治疗睑板腺功能障碍患者睑板腺功能的改善程度及对泪液质和量的影响。方法将符合纳入标准的睑板腺功能障碍患者55例(110只眼),随机分为2组,对照组27例(54只眼),治疗组28例(56只眼)。对照组采用蒸馏水熏蒸联合睑板腺按摩,治疗组采用中药熏蒸联合睑板腺按摩,以眼表疾病指数评分(OSDI)、睑板腺功能评分及干眼相关检查作为观察指标,评价治疗2次、4次、6次和8次后各时间点各项观察指标的改善情况和变化趋势。结果治疗组总有效率为91.1%,显著高于对照组的75.9%,差异有统计学意义(χ^2=4.608,P=0.032)。两组治疗后各时间点的OSDI评分、睑脂排出难易程度评分、睑脂性状评分和泪膜破裂时间(BUT)组内和组间比较,差异均有统计学意义(P<0.05);两组治疗后各时间点的OSDI评分(组内:F=176.190,P=0.000;组间:F=5.342,P=0.025)、睑脂排出难易程度评分(组内:Wald χ^2=108.457,P=0.000;组间:Wald χ^2=127.990,P=0.000)、睑脂性状评分(组内:F=508.798,P=0.000;组间:F=11.766,P=0.001)和泪膜破裂时间(BUT)(组内:F=1183.050,P=0.000;组间:F=5.820,P=0.018),组内和组间比较,差异均有统计学意义;两组治疗后各时间点的睑板腺缺失面积评分、泪液分泌试验(SⅠT)组内和组间比较,差异均无统计学意义(P>0.05)。结论中药熏蒸联合睑板腺按摩能有效改善患者眼表刺激症状、睑脂排出难易程度和睑脂性状,提高患者泪膜的稳定性。OBJECTIVE To observe the improvement of the function of meibomiangland and the influence of the quality and quantity of tear in the treatment of meibomian gland dysfunction by Chinese Medicine fumigation combined with meibomian gland massage.METHODS Fifty-five patients(110 eyes)with meibomian gland dysfunction met the inclusion criteria were randomly divided into control group of 27 cases(54 eyes)and treatment group of 28 cases(56 eyes).The control group was treated with distilled water fumigation combined with meibomian gland massage,and the treatment group was treated with Traditional Chinese Medicine fumigation combined with meibomian gland massage.The OSDI,meibomian gland function scores and dry eye related indicators were used as observation indexes to evaluate the improvement and change trend of each observation index at each time point after 2,4,6,8 times.RESULTS The total effective rate of the treatment group was 91.1%,which was significantly higher than that of the control group(75.9%).There was statistically significant differences in both groups(χ^2=4.608,P=0.032).OSDI scores at each time point after treatment in the two groups(within the group:F=176.190,P=0.000;between two groups:F=5.342,P=0.025),the difficulty discharge of meibomian scores(within the group:Wald χ^2=108.457,P=0.000;between two groups:Wald χ^2=127.990,P=0.000),the scores of meibum character(within the group:F=508.798,P=0.000;between two groups:F=11.766,P=0.001)and BUT(within the group:F=1183.050,P=0.000;between two groups:F=5.820,P=0.018)The differences between the groups are statistically significant.CONCLUSIONS Traditional Chinese Medicine fumigation combined with meibomian gland massage could effectively improve the symptoms of eye surface stimulation,the difficulty discharge of meibomian,meibum character and the stability of tear film.

关 键 词：睑板腺功能障碍 干眼 中药熏蒸 睑板腺按摩 

分 类 号：R777.13[医药卫生—眼科]