无菌针灸针探通术治疗睑板腺阻塞的临床疗效

摘要

目的 探讨无菌针灸针探通术治疗阻塞性睑板腺功能障碍的临床疗效.方法 前瞻性随机对照研究.将符合纳入标准的61例(122眼)阻塞性睑板腺功能障碍(O-MGD)患者随机分为观察组31例(62眼)与对照组30例(60眼).观察组患者接受无菌针灸针探通睑板腺联合人工泪液治疗;对照组患者接受睑板腺按摩联合人工泪液治疗.在治疗前和治疗后2、4周,对研究对象进行泪膜破裂时间(BUT)检查、基础泪液分泌量(S Ⅰ t)测定、角膜荧光素染色(CFS)评分、眼表面疾病指数(OSDI)和睑板腺积分评价,并比较2组患者检测指标与临床疗效的差异.数据采用重复测量的方差分析、卡方检验和Ridit分析.结果 ①治疗前观察组与对照组患者之间各参数差异均无统计学意义;②与治疗前相比,治疗后2、4周观察组和对照组的CFS评分(F组内=118.1,P＜0.05)和睑板腺积分(F组内=474.6,P＜0.05)均明显降低,而BUT(F组内=67.8,P＜0.05)、SⅠt(F组内=54.8,P＜0.05)明显增加;③治疗后2、4周观察组的CFS评分、OSDI指数和睑板腺积分均显著低于对照组(F 组间=58.5、8.2、206.8,P＜0.05),而BUT、SⅠt显著高于对照组(F组间=300.2、8.7,P＜0.05);④治疗后2、4周观察组患者的总有效率分别为98.4％和95.2％,高于对照组的25.0％和21.7％,且差异均有统计学意义(Z=7.73、7.76,P＜0.01).结论 无菌针灸针探通术联合人工泪液治疗O-MGD有效,值得在临床上推广应用.%Objective To study the therapeutic effect of abacterial acupuncture needle probing for obstructive meibomain gland dysfunction (O-MGD).Methods This was a prospective randomized,controlled thal.A total of 61 patients (122 eyes) with O-MGD were selected and were randomly divided into an observation group (62 eyes) and control group (60 eyes).Patients in the observation group were treated with abacterial acupuncture needle probing with artificial tears,while patients in the control group were treated with meibomian gland massage combined with artificial tears.The tear break-up time (BUT),Schirmer [test (S Ⅰ t),corneal fluorescein staining (CFS),ocular surface disease index (OSDI) and the meibomian gland score were measured for all patients before treatment and 2 and 4 weeks after treatment.Results Insignificant differences were observed between the groups for all clinical test indexes before treatment.The value of CFS and the meibomian gland score after treatment were significantly lower than those before treatment (F=118.1,474.6,P＜0.05),while the value of BUT and S Ⅰ t were significantly higher than those before treatment (F--67.8,54.8,P＜0.05).At 2 and 4 weeks after treatment,the values of CFS,OSDI and the meibomian gland score in the observation group were significantly lower than those in the control group (F=58.5,8.2,206.8,P＜0.05),while the values of BUT and S Ⅰ t in the observation group were higher than those in the control group (F=300.2,8.7,P＜0.05).After 2 and 4 weeks of treatment,the overall effective rates in the observation group were 98.4％ and 95.2％,which were statistically significant compared to 25.0％ and 21.7％ in the control group (Z=7.73,7.76,P＜0.01).Conclusion Both abacterial acupuncture needle probing and meibomian gland massage combined with artificial tears have effects on O-MGD,while the abacterial acupuncture needle probing is more effective.