睑板腺热脉动系统与热敷疗法治疗睑板腺功能障碍的疗效比较

目的：对比分析LipiFlow睑板腺热脉动系统与传统的热敷疗法(warm compress)对睑板腺功能障碍(meibomian gland dysfunction，MGD)患者治疗的有效性及安全性。

方法：选取MGD患者50例，随机分为试验组及对照组。试验组进行单独一次LipiFlow睑板腺热脉动系统治疗； 对照组受试者每日在医生指导下使用热敷眼罩热敷治疗15min，每天1次，共2wk。对两组受试者在治疗前、治疗后4、8、12wk进行包括主观症状、泪膜破裂时间(TBUT)、脂质层厚度(LLT)、睑板腺缺失情况等8项指标的评估。采用重复测量数据的方差分析对两组的组间差异性及时间差异性进行分析。若两组存在组间差异性，进一步采用独立样本t检验； 若组内存在时间差异性，则采用LSD-t检验分析。

结果：两组受试者眼表疾病主观症状评分、睑板腺分泌物性状、Schirmer试验的改变差异均有统计学意义(P<0.05)。治疗后第12wk，试验组与对照组在OSDI、MGYSS、LLT、眼表染色评分、TBUT这些方面，改善程度的差值也具有统计学意义(P<0.05)。安全性方面，两组均未出现严重并发症或者不良医疗事件。

结论：单独一次睑板腺热脉动系统疗法和热敷疗法均能够有效且安全地治疗MGD。前者的疗效优于后者。

Comparative study between the Meibomian pulsation system and the warm compress treatment for MGD

AIM:To compare the efficacy and safety of LipiFlow pulsation system and traditional Meibomian warm compress treatment for patients with Meibomian gland dysfunction(MGD).

METHODS: Totally 50 patients with MGD were selected, whom were randomly divided into experimental group(25 cases)and control group(25 cases). The experimental group underwent a single treatment with the LipiFlow pulsation system. Subjects of the control group were subjected to a daily 15-minute warm compress treatment, lasting 2wk. Comparative analyses were made during moments before and 4, 8 and 12wk after treatments, according to the evaluation of eight indexes including subjective symptoms, tear film break-up time(TBUT), tear film lipid layer thickness(LLT), Meibomian deletions etc. Those analyses were made using LSD-t test, to analyze the effectiveness evaluation parameters at different time points. Independent samples t-test was employed to compare those statistic results between experimental group and control group.

RESULTS: Statistically significant differences were observed on Ocular Surface Disease Index(OSDI), the quality of Meibomian secretions and Schirmer test(P<0.05). There were also statistically significant differences on the difference in degree of improvements in OSDI, the Meibomian glands yielding liquid secretion, fluorescein staining score LLT, TBUT between the experimental group and control group(P<0.05). There were no differences on safety parameters between two groups.

CONCLUSION: A single treatment with the LipiFlow pulsation system and warm compress treatment are effective and safe for MGD, while the former is better.