目的：评估区域超声热疗对睑板腺功能障碍（Meibomain Gland Dysfunction, MGD）在一定治疗量及治疗时段内的有效性；方法：本次研究招募了60例MGD患者（共120眼）随机分为两组：30例行区域超声热疗作为治疗组，其余30例行热敷治疗作为对照组。在治疗前及治疗后三个月中对患者的主观症状，客观体征进行评估，包括眼表疾病指数评估(Ocular Surface Disease Index, OSDI)、泪膜脂质层厚度（Tear-film Lipid Layer Thickness, LLT）、泪膜破裂时间(Tear Break-Up Time, TBUT)及泪液分泌试验Ⅰ(Schirmer I test , SIt)。分析以上检查结果与治疗疗效及治疗时段的相关性。结果：两组治疗后三个月与治疗前相比较，治疗组TBUT、SIT较对照组显著提高，OSDI问卷调查分数较对照组显著降低，差异具有统计学意义(P<0.05)，虽然泪膜脂质厚度（LLT）在两组比较中差异性无统计学意义(P>0.05)，但其对睑板腺脂质层分泌还是具有改善作用，并且治疗组在治疗后第三月的LLT水平显著高于治疗前，差异具有统计学意义。结论：区域超声热疗对MGD治疗是有效的，并且治疗时间需要每周进行一次，每次15分钟、治疗时段应大于三个月，这样可以对睑板腺功能具有改善作用，患者眼表症状也有所缓解。

Objective : To evaluate the efficacy of regional ultrasound hyperthermia in the treatment of meibomian gland dysfunction (MGD) in a certain treatment amount and within a certain treatment period. Methods: In this study, 60 patients (120 eyes) with MGD were randomly divided into two groups: 30 patients with regional ultrasound hyperthermia as the treatment group and the other 30 patients with hot compress as the control group. The subjective symptoms and objective signs of the patients were evaluated before and three months after treatment, including ocular surface disease index (OSDI), tear-film lipid layer thickness (LLT), tear break-up time (TBUT) and schirmer I test (SIt). The correlation between the above examination results and treatment efficacy and treatment period was analyzed. Results : Three months after treatment, the TBUT and SIT in the treatment group were significantly higher than those in the control group, and the score of OSDI questionnaire in the treatment group was significantly lower than that in the control group, with a statistically significant difference (P < 0.05). Although there was no significant difference in tear-film lipid layer thickness between the two groups, it could improve the secretion of meibomian gland lipid layer, and the level of LLT in the treatment group at the third month after treatment was significantly higher than that before treatment, and the difference was statistically significant (P < 0.05). Conclusion: Regional ultrasound hyperthermia is effective in the treatment of MGD. The treatment should be carried out once a week for 15 minutes each time, and the treatment period should be more than three months, which can improve the meibomian gland function and relieve the ocular surface symptoms of the patients. Keywords: Meibomian gland dysfunction; Ocular surface disease index; Regional ultrasound hyperthermia; Meibomian gland massage

国家卫生计生委医药卫生科技发展研究中心(编号:W2017MGD06)