睑板腺功能障碍(meibomian gland dysfunction，MGD)是眼科常见疾病，是蒸发过强型干眼的主要原因。基于人群流行病学的调查显示：MGD亚洲的发病率为46.2%~69.3%。目前，MGD治疗的方式包括眼睑清洁、热敷、睑板腺按摩、人工泪液、抗生素等，其中热敷为常用的家庭治疗方法。由于不同的热敷方式、温度、时间、频次及依从性，导致应用热敷治疗MGD到目前为止还没有统一标准。另外，热敷的不良反应如视物模糊、皮肤烫伤等，也没有引起临床足够重视。因此，为提高热敷的临床疗效及减少其不良反应，未来进行热敷的规范化指导或治疗很有必要。

Meibomian gland dysfunction (MGD) is a common ophthalmic disease, which is the main cause of evaporative dry eye. Population-based studies have suggested that the prevalence of MGD is high in Asia, with a reported incidence of 46.2% to 69.3%. Current modalities of MGD treatment include lid hygiene, warm compresses,massage, artificial lubricants, systemic and topical antibiotics, etc., among which warm compress is a common at-home treatment. Due to different eyelid warming methods, temperature, durations of heat application, frequency and compliance, there is no uniform standard for the application of warm compress to the treatment of MGD.In addition, adverse events of warm compress, such as blurred vision and thermal damage, have not attracted enough attention in clinical practice. Therefore, in order to improve the clinical efficacy of warm compress and reduce its adverse events, it is necessary to conduct standardized guidance or treatment of warm compress in the future. Based on the above considerations, this article will briefly review the application of warm compress to the treatment of MGD.

目的：观察中药超声雾化联合针灸治疗睑板腺功能障碍(meibomain gland dysfunction，MGD)的临床疗效。方法：选取在新华医院就诊的7 7例(154眼)双 眼MGD患者，随机分为对照组(27例5 4眼)、中药超声雾化治疗组(雾化组；2 5例5 0眼)和中药超声雾化联合针灸治疗组(联合治疗组；2 5例5 0眼)。对照组接受睑板腺按摩治疗，雾化组在睑板腺按摩的基础上行中药超声雾化治疗，联合治疗组为进一步加用针灸治疗，治疗周期为4周。治疗前后收集患者双眼泪膜破裂时间(tear breakup time，BUT)、双眼基础泪液分泌试验数据(Schirmer I test，SIT)、双眼角膜荧光素染色评分(fluorescent，FL)、睑板腺分泌物性状评分(Meibomian Glandyielding Secretion Score，MGYSS)、睑缘异常评分(Eyelid Margin Abnormality Score，EMAS)以及主观症状积分等资料，并评价临床疗效。结果：治疗前三组BUT、SIT、F L、MGYSS、EMAS和主观评价得分等组间差异均无统计学意义(均P >0.05)。治疗4周后，各组受试者的BUT、SIT、F L评分、MGYSS评分、EMAS评分和主观评价评分与治疗前相比差异均具有统计学意义(均P < 0.05)；联合治疗组的上述指标分别与雾化组及对照组相比，差异均有统计学意义(P <0.05)。治疗后对照组的总有效率为51.85%(28眼/54眼)，雾化组为84%(42眼/50眼)，联合治疗组为96%(48眼/50眼)，联合治疗组总有效率与雾化组相比差异有统计学意义(P <0.05)。结论：中药超声雾化联合针灸治疗在改善MGD患者的睑板腺功能和减轻患者的干眼症状方面具有较好的临床疗效。

Objective: To observe the clinical efficacy of ultrasonic atomization fumigation of traditional Chinese medicine combined with acupuncture in the treatment of meibomian gland dysfunction (MGD). Methods: A total of 77 MGD patients (154 eyes) in Xinhua Hospital were selected and randomly divided into a control group (27 cases,54 eyes), a ultrasonic atomization of traditional Chinese medicine group (atomization group; 25 cases, 50 eyes),and a ultrasonic atomization of traditional Chinese medicine combined with acupuncture group (combined treatment group; 25 cases, 50 eyes). The control group received meibomian gland massage, the atomization group received meibomian gland massage and ultrasonic atomization of traditional Chinese medicine, and the combined treatment group received additional acupuncture treatment. The treatment period was 4 weeks. Tear breakup time (BUT), basal tear secretion test data (Schirmer I Test, SIT), corneal fluorescein staining score (FL), and Meibomian Gland Yielding Secretion Score (MGYSS), Eyelid Margin Abnormality Score (EMAS), Subjective Symptom Score (SSS) were collected and conduct clinical efficacy were evaluated. Results: There were no significant differences in BUT, SIT, FL, MGYSS, EMAS and SSS among the three groups (all P>0.05).After treatment of 4 weeks, the BUT, SIT, FL, MGYSS, EMAS and SSS in each group were improved significantly compared to baseline (P<0.05). The above indicators in combined treatment group were significantly different from atomization group (P<0.05) and control group (P<0.05). The total effective rates after treatment were 51.85% (28/54) in control group, 84% (42/50) in atomization group, and 96% (48/50) in combined treatment group. The difference in total effective rate between combined treatment group and atomization group was significant (P<0.05). Conclusion: Ultrasonic atomization of traditional Chinese medicine combined with acupuncture presents good clinical effects in improving the meibomian gland function of patients with MGD and alleviating the dry eye symptoms.

目的：观察强脉冲光(intense pulse light，IPL)治疗睑板腺功能障碍(meibomian gland dysfunction，MGD)性干眼的临床效果。方法：选取2019年10月至2019年12月在东莞市东南部中心医院眼科门诊就诊的MGD性干眼患者64例(64只右眼)，随机分为对照组与观察组，每组32例。对照组采用睑板腺按摩联合常规药物治疗，观察组采用IPL联合睑板腺按摩及常规药物治疗，两组疗程均为6周；观察两组患者治疗前后干眼症状、体征及睑板腺功能变化。结果：治疗后两组干眼症状、体征及睑板腺功能均较治疗前明显改善，差异有统计学意义(P>0.05)；观察组治疗后2、4周干眼症状、体征及睑板腺功能评分改善优于对照组，差异有统计学意义(P<0.05)；治疗后6周两组各项观察指标差异无统计学意义(P>0.05)。经过6周治疗，观察组有效率为87.5%(28/32)，对照组有效率75%(24/32)，差异有统计学意义(P=0.021)。治疗期间两组均未发生不良反应。结论：IPL联合睑板腺按摩对MGD性干眼能有效减轻眼部不适症状、改善睑板腺功能，较单纯睑板腺按摩起效更快、效果更佳。

Objective: To observe the clinical effect of intense pulse light (IPL) on MGD dry eyes. Methods: Sixty-four patients(64 right eyes) with MGD dry eye from October 2019 to December 2019 were collected and randomly divided into control group (n=32) and observation group (n=32). The control group was treated with meibomian gland massage combined with conventional medicine, while the observation group was treated with IPL combined with meibomian gland massage and conventional medicine. The course of treatment of both groups was 6 weeks. The dry eye symptoms, dry eye signs and meibomian gland function changes were observed before and after treatment in both groups. Results: The dry eye symptoms, physical signs and meibomian gland function of the two groups after treatment were significantly improved compared with those before treatment (P>0.05). The improvement of dry eye  symptoms, physical signs and meibomian gland function in observation group were better than those of the control group at two and four weeks after treatment (P<0.05), while there was no statistically significant difference between the two groups at 6 weeks after treatment (P>0.05). The effective rate in observation group was 87.5% (28/32) after 6 weeks treatment, while control group was 75% (24/32), the difference was statistically significant (P=0.021). No adverse reactions occurred in both groups during the treatment. Conclusion: IPL combined with meibomian gland massage can effectively reduce the ocular discomfort and improve the function of meibomian gland in MGD dry eyes,which is faster and more effective than meibomian gland massage alone.

睑板腺功能障碍(meibomian gland dysfunction，MGD)是一种慢性、弥漫性的睑板腺病变，通常以睑板腺终末导管的阻塞或分泌的睑脂数量或质量发生改变为特征，临床上可以引起泪膜异常、角膜上皮损害、眼部刺激等干眼表现。MGD病因复杂且受多种因素影响，因此MGD发病机制的研究对于指导临床工作至关重要。本文对研究MGD的动物模型进行了介绍，并根据一些基础研究对MGD相关的细胞及分子机制等方面进行综述。

Meibomian gland dysfunction (MGD) is a chronic and diffuse disease of the eyelid gland. It is usually characterized by obstruction of the terminal duct of the eyelid gland or changes in the quantity/quality of the eyelid fat secreted. It can clinically cause dry eye symptoms such as abnormal tear film, corneal epithelial damage and eye irritation. The etiology of MGD is complex and affected by a variety of factors. Therefore, the study on the pathogenesis of MGD is of great importance to guide clinical work. This article introduces the animal research model of MGD, and reviews the cellular and molecular mechanisms related to MGD based on some basic research.

目的：对比两种不同部位M22优化脉冲激光治疗方法治疗睑板腺功能障碍(meibomian gland dysfunction，MGD)所致干眼的疗效。方法：回顾性分析汕头博德眼科医院干眼门诊患者105例，包括常规治疗组和改良治疗组两个组别，常规治疗组激光部位为下睑，改良治疗组激光部位为联合上下睑，所有患者行M22优化脉冲光治疗一个疗程(每月1次，共3次)，治疗前后均采用keratograph 5M干眼分析仪分析评估患者的泪河高度情况、泪膜破裂时间(break-up time，BUT)、角膜荧光染色(corneal fluorescence staining，CFS)和睑板腺排出能力等参数。采用t检验分析对比治疗前后变化情况。结果：患者治疗后泪河高度较强脉冲光治疗前明显增高，BUT时间延长，角膜荧光染色和睑板腺排出能力评分均有好转，每组治疗后与治疗前差异有统计学意义(P<0.01)，两组间治疗前后各参数差异比较均没有统计学意义。结论：两种不同部位M22优化脉冲激光治疗方法在治疗MGD导致的干眼方面有较好的效果，是较安全有效地治疗方法，两种不同方法治疗效果无明显差异。

Objective: To study the efficacy of two methods of M22 optimal pulsed technology in the treatment of dry eye caused by meibomian gland dysfunction (MGD). Methods: A total of 105 patients collected from Shantou Balder Eye Hospital were divided into two groups. The treatment position of the conventional group was lower eyelid, the other group was combined with upper and lower eyelid. All patients accepted M22 Optimal Pulsed Technology treatment for three times, once a month. Keratograph 5M dry eye analyzer was used to assess the height of tears river, break-up time (BUT), corneal fluorescence Staining(CFS)and meibomian gland expressibility. The results before and after laser treatment were compared using t-test in this study. Results: After treatment, the height of tear river, BUT, CFS and meibomian gland expressibility were improved. There was a statistically significant difference between each group after and before treatment (P<0.01). There was no significant difference before and after treatment between the two groups. Conclusion: The two methods of M22 Optimal Pulsed Technology are effective in treating dry eyes caused by MGD. There is no significant difference in the therapeutic effect between two methods.