参麦润目组方对睑板腺功能障碍相关干眼的临床研究

Clinical research of Shenmai Runmu Prescription on MGD-related dry eye

目的探讨参麦润目组方对睑板腺功能障碍(MGD)相关干眼的临床疗效。方法采用前瞻性病例对照研究,选取100例MGD相关干眼患者,分成中药组与对照组。中药组患者口服参麦润目组方,并联合中药熏蒸;对照组患者口服ω-3脂肪酸,配合OPT强脉冲光疗。通过患者眼部主观症状、泪膜破裂时间(BUT)、泪河高度(TMH)、角膜荧光染色(FL)、睑板腺评分(MGS)、以及MGD程度与分级等观察。结果(1)总有效率:中药组为96%,对照组为72%,中药组优于对照组,差异有统计学意义(χ^(2)=10.714,P=0.005);(2)主观症状积分:治疗后2组间比较,中药组优于对照组(t=-25.459,P=0.000),治疗前后组内比较,差异均有统计学意义(t_(中药组)=25.375,t_(对照组)=17.296,均P=0.000);(3)干眼相关指标:治疗后2组间比较,中药组4项干眼相关指标均优于对照组,差异均有统计学意义(t_(BUT)=7.638,t_(TMH)=34.868,t_(FL)=-36.722,t_(MGS)=-40.009,均P=0.000)。治疗前后组内比较,中药组及对照组4项干眼指标均有改善,差异均有统计学意义(P<0.05);(4)MGD程度及分级情况:治疗后,中药组MGD程度及分级均优于对照组(χ^(2)_(程度)=5.005,P=0.025;χ^(2)_(分级)=11.314,P=0.003);(5)不良反应:治疗过程中,2组患者均有极少部分并发症发生,经检查系偶发事件。结论参麦润目组方可以改善MGD相关干眼患者的眼部主、客观症状,值得临床推广使用。

OBJECTIVE To explore the clinical effect of Shenmai Runmu prescription on MGD-related dry eye.METHODS A study was selected in a prospective follow-up control case study.One hundred patients with MGD-related dry eyes were selected and divided into Chinese Medicine group(CMG)and control group(CG).The patients of CMG were treated with Shenmai Runmu prescription combined with Traditional Chinese Medicine fumigating.The patients of CG were treated withω-3 fatty acid combined with OPT intense pulse phototherapy.clinic curative effect was evaluated through subjective symptoms scores,BUT,TMH,FL,meibomian gland scores,MGD graduation and classification.RESULTS(1)The total effective rate:The total effective rate of CMG(96%)was better than that of CG(72%),and the difference was statistically significant(χ^(2)=10.714,P=0.005).(2)Subjective symptom scores:The scores of CMG were lower than those of CG(t=-25.459,P=0.000).There was significant difference between the two groups before and after treatment(t_(CMG)=25.375,t_(CG)=17.296,all P=0.000).(3)Dry eye related indexes:After treatment,the four dry eye related indexes of CMG were better than those of CG,and the differences were statistically significant(t_(BUT)=7.638,t_(TMH)=34.868,t_(FL)=-36.722,t_(MGS)=-40.009,all P=0.000).Before and after treatment,the four dry eye indexes of CMG and CG were improved,and the differences were statistically significant(P<0.05).(4)MGD degree and grading:After treatment,the degree and grading of MGD of CMG were better than those of CG(χ^(2)degree=5.005,P=0.025;χ^(2)classify=11.314,P=0.003).(5)Adverse reactions:During the treatment,few complications occurred in both groups,which were accidental events after the examination.CONCLUSIONS Shenmai Runmu prescription can improve subjective and objective symptoms of MGD related dry eye patients which is worthy of clinical promotion.