基于睑板腺按摩及雾化熏蒸干预治疗对睑板腺功能障碍相关性干眼疗效的Meta分析  

A Meta-analysis of therapeutic effects of meibomian gland massage plus aerosol fumigation on meibomian gland dysfunction-related dry eye

作　　者：郭炼玟 贾洪亮[2] 熊剑旭[3] 张文新 王莉[1] 薛静静[2] GUO Lianwen

机构地区：[1]江西中医药大学,江西南昌330000 [2]江西中医药大学附属医院,江西南昌330000 [3]丰城市中医院,江西宜春331100

出　　处：《中医临床研究》2024年第28期126-134,共9页Clinical Journal Of Chinese Medicine

基　　金：江西省中医药管理局科技计划项目(2023B0900):针刺联合睑板腺按摩及超声雾化治疗睑板腺功能障碍性干眼症临床疗效评价。

摘　　要：目的:系统评价睑板腺按摩联合雾化熏蒸干预治疗睑板腺功能障碍相关性干眼的疗效。方法:通过计算机检索中国知网期刊全文数据库、万方数据库、维普期刊数据库、PubMed、Embase、Web of Science共6个数据库,纳入2018年1月-2023年9月发表的治疗睑板腺功能障碍相关性干眼的临床随机对照试验文献。其中,对照组采用常规西医治疗睑板腺功能障碍相关性干眼,试验组在对照组的治疗基础上采用睑板腺按摩联合雾化熏蒸治疗。剔除重复文献,进行层层筛选,提取相关数据,进行风险偏倚评估,采用Review Manager 5.4和Stata 16软件对眼表疾病指数(Ocular Surface Disease Index,OSDI)评分、泪膜破裂时间(Break-up Time,BUT)、泪液分泌试验(Schirmer I Test,SIT)、角膜荧光染色(Corneal Fluorescein Staining,CFS)评分、睑板腺分泌物性状评分(Meibomian Gland Yielding Secretion Scale,MGYSS)、临床疗效6个结局指标进行Meta分析。结果:最终纳入25篇随机对照试验研究,涉及睑板腺功能障碍相关性干眼患者2732例。Meta分析结果表明,与对照组相比,试验组治疗做到了更好地提高临床疗效(OR=5.84,95%CI:4.24~8.04,Z=10.82,P<0.00001)、BUT(SMD=1.27,95%CI:0.84~1.71,Z=5.70,P<0.00001)、SIT(SMD=1.20,95%CI:0.35~2.04,Z=2.78,P=0.006),降低OSDI评分(SMD=-1.43,95%CI:-2.19~-0.67,Z=3.68,P=0.0002)、CFS评分(SMD=-0.96,95%CI:-1.51~-0.42,Z=3.46,P=0.0005)、MGYSS(SMD=-1.99,95%CI:-3.05~-0.93,Z=3.68,P=0.0002)。结论:与单纯西医常规治疗相比,睑板腺按摩联合雾化熏蒸干预治疗睑板腺功能障碍相关性干眼临床疗效更佳,能更好地改善患者的自觉症状和体征。Objective:To systematically evaluate the therapeutic effect of meibomian gland massage plus aerosol fumigation on meibomian gland dysfunction-related dry eye.Methods:Six databases including CNKI,Wanfang,VIP,PubMed,Embase and Web of Science were searched by computer to retrieve the literature published from January 2018 to September 2023 on clinical randomized controlled trials of treating meibomian gland dysfunction-related dry eye.Among them,the control group was treated in conventional Western medicine,and the trial group was treated by meibomian gland massage plus aerosol fumigation on the basis of the treatment in the control group.Duplicate literature was eliminated,and layers of screening was conducted to extract relevant data and assess risk bias.Review Manager 5.4 and Stata 16 were used to conduct a Meta-analysis on 6 outcome indicators,including ocular surface disease index(OSDI)score,tear film break-up time(BUT),tear Schirmer I test(SIT),corneal fluorescein staining(CFS)score,meibomial gland yielding secretion scale(MGYSS)score,and clinical efficacy.Results:A total of 25 randomized controlled trial studies were included,with 2732 meibomian gland dysfunction-related dry eye patients.According to results of the Meta-analysis,compared with the control group,clinical efficacy(OR=5.84,95%CI:4.24-8.04,Z=10.82,P<0.00001),BUT(SMD=1.27,95%CI:0.84-1.71,Z=5.70,P<0.00001),SIT(SMD=1.20,95%CI:0.35~2.04,Z=2.78,P=0.006)in the trial group were improved obviously,and OSDI score(SMD=-1.43,95%CI:-2.19--0.67,Z=3.68,P=0.0002),CFS score(SMD=-0.96,95%CI:-1.51--0.42,Z=3.46,P=0.0005),and MGYSS score(SMD=-1.99,95%CI:-3.05--0.93,Z=3.68,P=0.0002)were decreased.Conclusion:Compared with conventional Western medicine treatment alone,the intervention of meibomian gland massage plus aerosol fumigation shows a better clinical effect on meibomian gland dysfunction-related dry eye,and can better ameliorate patients’self-conscious symptoms and signs.

关 键 词：睑板腺按摩 雾化熏蒸 睑板腺功能障碍相关性干眼 META分析 

分 类 号：R276[医药卫生—中医五官科学]