针刺联合强脉冲光治疗中重度睑板腺功能障碍相关性干眼效果研究

Study on effect of acupuncture combined with intense pulsed light therapy on dry eyes associated with moderate to severe meibomian gland dysfunction

目的观察针刺联合强脉冲光治疗中重度睑板腺功能障碍(MGD)相关性干眼的临床效果。方法选取2018年7月至2019年7月该院收治的20例(40眼)中重度MGD相关性干眼患者,将其左眼作为治疗眼,右眼作为对照眼。治疗眼给予针刺联合强脉冲光治疗,对照眼接受针刺及能量为零的安慰治疗,双眼均给予睑板腺按摩及玻璃酸钠、普拉洛芬眼液滴眼治疗,通过比较治疗眼和对照眼治疗前、治疗后6个月眼表疾病指数(OSDI)评分、泪膜破裂时间(TBUT)、SchirmerI试验(SIT)及角膜荧光染色(CFS)评分等评价疗效。结果治疗眼和对照眼治疗后6个月OSDI、CFS评分均较治疗前明显下降,TBUT、SIT值均较治疗前明显增加;且治疗眼治疗后6个月OSDI评分较对照眼下降更明显,TBUT较对照眼增加也更明显,差异均有统计学意义(P<0.05)。结论针刺联合强脉冲光是治疗中重度MGD相关性干眼的一种新方法,较单纯采用针刺法,更能增强泪膜稳定性,改善干眼症状,减少眼表损伤。

Objective To observe the clinical effect of acupuncture combined with intense pulsed light(IPL)in the treatment of dry eyes associated with moderate to severe meibomian gland dysfunction(MGD).Methods Twenty patients(40 eyes)with moderate to severe MGD admitted to the hospital from July 2018 to July 2019 were selected,their left eye served as the treatment eye and the right eye as the control eye.The treatment eye was given acupuncture combined with IPL treatment,the control eye received acupuncture and zero-energy placebo treatment,both eyes were given meibomian gland massage and sodium hyaluronate,pranoprofen eye drops.The efficacy was evaluated by comparing the OSDI score,tear film rupture time(TBUT),Schirmer I test(SIT),and corneal fluorescence staining score(CFS)before treatment(BL)and in 6 months after treatment(T1)between the treatment eye and the control eye.Results The OSDI score and CFS score at T1 in the treatment eye and control eye were lower than those at BL,and the values of the TBUT and SIT were significantly increased compared with those at BL.Moreover the OSDI score decrease at T1 in the treatment eye was more significant compared with that in the control eye,the TBUT increase was also more significant compared with that in the control eye,and the differences were statistically significant(P<0.05).Conclusion Acupuncture combined with IPL is a new method for the treatment of moderate to severe MGD-related dry eye.Compared with simple acupuncture,it can enhance tear film stability,improve the dry eye symptoms,and reduce the ocular surface damage.