叩齿治疗睑板腺功能障碍相关性干眼疗效观察  

Clicking teeth for meibomian gland dysfunction related dry eye:a randomized controlled trial

作　　者：杨琳[1] 牟晓琛 高颖[2] YANG Lin;MOU Xiaochen;GAO Ying(Beijing University of Chinese Medicine,Beijing 100029,China;Dongfang Hospital of Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院,北京100078

出　　处：《现代中西医结合杂志》2024年第17期2384-2389,2418,共7页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：北京市青年英才计划项目(YETP0825)。

摘　　要：目的评估叩齿治疗睑板腺功能障碍(MGD)相关性干眼的安全性和有效性。方法纳入2023年8月—2024年3月于北京中医药大学东方医院眼科门诊就诊的MGD相关性干眼患者51例,根据随机数字表分为2组,最终叩齿组20例(36眼)、对照组16例(28眼)完成研究。对照组给予干眼健康宣传教育、睑板腺按摩、玻璃酸钠滴眼液和双氯芬酸钠滴眼液点眼治疗,叩齿组在对照组治疗基础上给予叩齿锻炼,2组疗程均为4周。观察2组患者治疗前后的泪河高度、首次非接触式泪膜破裂时间(fNIBUT)、平均非接触式泪膜破裂时间(aNIBUT)、眼表疾病指数(OSDI)量表评分,评估治疗安全性。结果治疗后2组患者泪河高度均较治疗前明显增加(P均<0.05),且叩齿组明显高于对照组(P<0.05);叩齿组患者的fNIBUT、aNIBUT和对照组患者的aNIBUT均较治疗前明显延长(P均<0.05),且叩齿组患者的fNIBUT明显长于对照组(P<0.05);2组患者的OSDI量表评分均较治疗前明显降低(P均<0.05),但2组间比较差异无统计学意义(P>0.05)。研究过程中,2组患者均未报道不适症状。结论叩齿可以改善MGD相关性干眼患者的泪液分泌量和泪膜稳定性。Objective It is to evaluate the safety and efficacy of clicking teeth in the treatment of meibomian gland dysfunction(MGD)-related dry eye.Methods Fifty-one participants with MGD-related dry eye treated in the ophthalmology clinic of Dongfang Hospital of Beijing University of Chinese Medicine from August 2023 to March 2024 were selected and divided into clicking teeth group and control group according to the method of random number table.Finally 20 cases(36 eyes)in the clicking teeth group and 16 cases(28 eyes)in the control group completed the study.The control group was given health education on dry eye disease,and was treated with meibomian gland massage,sodium hyaluronate eye drops and diclofenac sodium eye drops,the clicking teeth group was treated with click teeth exercise on the treatment of the control group,both groups were treated for 4 weeks.The tear meniscus height(TMH),the first non-invasive tear break up time(fNIBUT),the average non-invasive tear break up time(aNIBUT)and ocular surface disease index(OSDI)scores of the patients in the two groups were observed before the treatment and after 4 weeks of treatment,and the safety of treatment was evaluated.Results The TMH of patients in both groups were increased significantly after treatment compared with that before treatment(both P<0.05),and the TMH of the clicking teeth group was significantly higher than that of the control group(P<0.05);the fNIBUT,aNIBUT of patients in the clicking teeth group and aNIBUT in the control group were all significantly longer than those before treatment(all P<0.05),and the fNIBUT of patients in the clicking teeth group was significantly longer than that of the control group(P<0.05);the OSDI scale scores of patients in the two groups were all significantly lower than those before treatment(both P<0.05),but the difference between the two groups was not statistically significant(P>0.05).No uncomfortable symptoms were reported by patients in the two groups during the study.Conclusion Clicking teeth can improve tear secretion

关 键 词：干眼 睑板腺功能障碍 叩齿 

分 类 号：R777.13[医药卫生—眼科]