聚乙二醇滴眼液联合妥布霉素地塞米松眼膏治疗睑板腺功能障碍性干眼的初步观察

Clinical efficacy of polyethylene glycol eye drops combined with tobramycin dexamethasone ointment for dry eye with meibomian gland dysfunction

目的探讨聚乙二醇滴眼液联合妥布霉素地塞米松眼膏治疗睑板腺功能障碍性干眼的疗效。设计回顾性比较性病例系列。研究对象238例(476眼)睑板腺功能障碍性干眼患者。方法患者分成两组:组1,聚乙二醇滴眼液联合妥布霉素地塞米松眼膏治疗120例(240眼);组2,聚乙二醇滴眼液联合夫西地酸眼凝胶治疗118例(236眼)。裂隙灯观察记录用药前及用药后2、4周泪膜破裂时间(BUT)、泪液分泌试验(Schimer-I)、角膜荧光素染色(FL)以及干眼症状的改善程度。主要指标BUT、Schimer-I、FL评分以及干眼症状。结果治疗前,组1与组2 Schirmer-I、BUT、FL评分差异无统计学意义(P均>0.05);用药后2周,组1和组2的Schirmer-I、BUT和FL评分分别为(13.6±4.2)mm和(12.5±3.8)mm(P=0.45),(12.4±3.2)和(5.6±2.8)s(P=0.00),(1.3±0.7)和(4.7±1.1)(P=0.00)。用药后4周,组1和组2的Schirmer-I、BUT和FL评分分别为(14.7±3.7)和(13.4±2.5)mm(P=0.09),(14.2±2.8)和(8.6±2.4)s(P=0.00),(1.1±0.4)和(3.4±0.8)(P=0.00)。用药后2周,组1和组2的临床症状评分分别为(2.6±0.9)和(5.4±1.5)(P=0.00);用药后4周,组1和组2的临床症状评分分别为(1.4±0.7)和(3.8±1.3)(P=0.00)。结论短期应用聚乙二醇滴眼液联合妥布霉素地塞米松眼膏治疗睑板腺功能障碍性干眼有较好的疗效。

Objective To explore the clinical efficacy of polyethylene glycol eye drops combined with tobramycin dexamethasone ointment in treatment of meibomian gland dysfunction with dry eye.Design Retrospective comparative cases series.Participants Two hundred and thirty-eight cases(476 eyes) of meibomian gland dysfunction with dry eye.Method The participants were randomly divided into two groups: Group 1,120 patients(240 eyes) using polyethylene glycol eye drops and tobramycin dexamethasone ointment in treatment;group 2,118 cases(236 eyes) using polyethylene glycol eye drops and fusidic acid eye gel.Tear break-up time(BUT),Schirmer test(Schimer-I),corneal fluorescein staining(FL) and dry eye symptoms were recorded by questionaires and slit lamp microscope before and 2,4 weeks after medication.Main Outcome Measures BUT,Schirmer-I,FL score and dry eye symptoms.Results Before treatment,Schirmer-I,BUT,and FL score had no significant difference between group 1 and group 2(P>0.05).At 2 weeks after medication,the Schirmer-I,BUT,and FL score in group 1 and group 2 was(13.6±4.2) mm and(12.5±3.8) mm(P=0.45),(12.4±3.2) s and(5.6±2.8) s(P=0.00),and(1.3±0.7) and(4.7±1.1)(P=0.00),respectively.At 4 weeks after medication,the Schirmer-I,BUT,and FL score in group 1 and group 2 was(14.7±3.7) mm and(13.4±2.5) mm(P=0.09),(14.2±2.8) s and(8.6±2.4) s(P=0.00),and(1.1±0.4) and(3.4±0.8)(P=0.00),respectively.At 2 weeks after medication,the clinical symptoms score in group 1 and group 2 was(2.6 ±0.9) and(5.4±1.5),respectively(P=0.00);at 4 weeks after medication,the clinical symptoms score in group 1 and group 2 is(1.4±0.7) and(3.8±1.3)(P=0.00).Conclusion The short-term efficacy of polyethylene glycol eye drops combined with tobramycin dexamethasone ointment for the treatment of meibomian gland dysfunction dry eye is good.