千里熏蒸方治疗睑脂异常型干眼合并阻塞型睑板腺功能障碍的效果  

Effect of Qianli Fumigation Decoction in the treatment of lipid deficiency dry eye combined with obstructive meibomian gland dysfunction

作　　者：李冬 伊琼[1] 韦企平[2] 朱成义[1] LI Dong;YI Qiong;WEI Qiping;ZHU Chengyi(Department of Ophthalmology,Beijing Hepingli Hospital,Beijing100013,China;Department of Ophthalmology,Dongfang Hospital of Beijing University of Chinese Medicine,Beijing100078,China)

机构地区：[1]北京市和平里医院眼科,北京100013 [2]北京中医药大学东方医院眼科,北京100078

出　　处：《中国医药导报》2021年第12期142-145,158,共5页China Medical Herald

基　　金：北京市东城区优秀人才(卫生)培养资助项目(2019WJGW-10-10);北京中医药科技发展资金项目(JJ2018-20);首都特色应用研究项目(Z181100001718085)。

摘　　要：目的评估千里熏蒸方治疗睑脂异常型干眼合并阻塞型睑板腺功能障碍(OMGD)的临床效果。方法选取2019年4月—11月北京市和平里医院诊断为轻中度睑脂异常型干眼合并轻中度OMGD的患者150例,采用随机数字表法将其分为对照组和治疗组,每组各75例。两组均给予普拉洛芬滴眼液、玻璃酸钠滴眼液及睑板腺按摩治疗。同时对照组采用蒸馏水熏蒸治疗,治疗组采用千里熏蒸方熏蒸治疗。两组均以治疗1周为1个疗程,共计4个疗程。4周后,观察并分析两组临床疗效及眼表疾病指数(OSDI)量表评分、非侵入性首次泪膜破裂时间(NIBUTf)、非侵入性平均泪膜破裂时间(NIBUTav)、泪河高度(TMH)、睑板腺评分、眼红分析及荧光素钠染色评分(FSS)的变化情况。结果研究期间两组均脱落2例,最终完成研究的患者为146例。治疗前,两组OSDI量表评分、NIBUTf、NIBUTav、TMH、睑板腺评分、眼红分析及FSS比较,差异无统计学意义(P>0.05)。治疗后,治疗组临床疗效优于对照组,差异有统计学意义(P<0.05)。治疗后,两组OSDI量表评分、睑板腺评分、眼红分析及FSS均较治疗前显著降低,且治疗组低于对照组,差异均有统计学意义(均P<0.05);两组NIBUTf、NIBUTav、TMH均较治疗前显著提高,且治疗组明显高于对照组,差异均有统计学意义(均P<0.05)。结论千里熏蒸方可有效缓解轻中度睑脂异常型干眼合并轻中度OMGD患者的干眼症状,恢复睑板腺的功能,改善眼表微环境,恢复泪膜稳态。Objective To evaluate the clinical effect of Qianli Fumigation Decoction in the treatment of lipid deficiency dry eye combined with obstructive meibomian gland dysfunction(OMGD).Methods A total of 150 patients diagnosed as mild to moderate lipid deficiency dry eye combined with mild to moderate OMGD in Beijing Hepingli Hospital from April to November 2019 were selected and they were divided into control group and treatment group by random number table method,with 75 cases in each group.Both groups were treated with Pralprofen Eye Drops,Sodium Hyaluronate Eye Drops and meibomian gland massage.At the same time,the control group was treated with distilled water fumigation,and the treatment group was treated with Qianli Fumigation Decoction fumigation.One treatment course was once a week in both groups,and there were four courses in total.After four weeks,the clinical efficacy and changes of ocular surface disease index(OSDI)scale score,non-invasive first breakup time of tear film(NIBUTf),non-invasive average breakup time of tear film(NIBUTav),tear meniscus hight(TMH),meibomian gland score,eye red analysis and fluorescein stain score(FSS)of the two groups were observed and analyzed.Results During the study period,two patients in both groups dropped out,146 patients were finally completed the study.Before treatment,there were no significant differences in OSDI scale score,NIBUTf,NIBUTav,TMH,meibomian gland score,eye red analysis and FSS between the two groups(P>0.05).After treatment,the clinical efficacy of the treatment group was better than that of the control group,the difference was statistically significant(P<0.05).After treatment,OSDI scale score,meibomian gland score,eye red analysis and FSS in both groups were significantly lower than those before treatment,and the treatment group was lower than the control group,the differences were statistically significant(all P<0.05).NIBUTf,NIBUTav and TMH in both groups were significantly increased compared with before treatment,and the treatment group was significantly h

关 键 词：千里熏蒸方 睑脂异常型干眼 阻塞型睑板腺功能障碍 睑板腺按摩 中药熏蒸 

分 类 号：R777[医药卫生—眼科]