目的：观察对比强脉冲光(IPL)联合睑板腺按摩与眼睑熏蒸按摩对睑板腺功能障碍(MGD)相关干眼的治疗效果。

方法：本研究为前瞻性随机对照临床试验。选取2018-03/08在西安市第四医院干眼门诊就诊的73例146眼MGD相关干眼患者，试验组38例76眼，给予IPL联合睑板腺按摩治疗(每3wk 1次，共3次)。对照组35例70眼给予眼睑熏蒸联合睑板腺按摩治疗(每天熏蒸、清洗睑缘，连续5d，第5d进行睑板腺按摩，间隔2wk后再次重复治疗，共3次)。本研究时间共12wk，记录首次治疗前及首次治疗后1、4、7、12wk时患者的眼表疾病指数(OSDI)评估、标准干眼评估问卷(SPEED)、非侵入泪膜破裂时间(NITBUT)、非侵入泪河高度测量(NITMH)、睑板腺缺失积分(MGS)、睑板腺分泌物评估(MGYSS)等数据，评估两种治疗方法的有效性及二者的疗效对比。

结果：两组间性别、年龄无差异(P>0.05)。两组治疗前各观察指标无差异(P>0.05)； 两组治疗后各时间点除NITMH、MGS外各项指标均较治疗前有明显改善(P<0.05)。试验组在治疗后1wk时各项指标与对照组无差异(P>0.05)； 试验组在治疗后4、7、12wk时，除NITMH、MGS外均优于对照组(P<0.05)。从指标变化趋势上看，试验组于首次治疗后疗效指标持续好转，于第12wk时疗效最佳，而对照组于首次治疗后第7wk疗效最佳，之后疗效减弱。治疗后两组均未见明显并发症。

结论：强脉冲光联合睑板腺按摩及眼睑熏蒸按摩两种治疗方式均对MGD相关干眼治疗方便、安全、有效，且强脉冲光联合睑板腺按摩疗效及维持时间优于眼睑熏蒸按摩治疗。

METHODS: This study was a prospective randomized controlled clinical trial. Totally 73(146 eyes)outpatients with MGD-related dry eyes were selected from March 2018 to August 2018 at Xi'an No.4 Hospital. 38 patients(76 eyes)in the experimental group were given IPL combined meibomian gland massage treatment(once every three weeks, three times in all), and 35 patients(70 eyes)in the control group were given eyelid fumigation combined meibomian gland massage treatment(fumigating and cleaning the eyelid margin every day for 5d, massaging the tarsal gland on the fifth day, repeating treatment after 2wk, totally 3 times). The study lasted 12wk. The ocular surface disease index(OSDI), standard dry eye assessment questionnaire(SPEED), non-invasive tear film rupture time(NITBUT), non-invasive lacrimal river height measurement(NITMH), meibomian gland loss score(MGS), meibomian gland secretion assessment(MGYSS)before and after the first treatment, the first week, the fourth week, the seventh week and the twelfth week were recorded to evaluate the curative effect of the two treatments.

RESULTS: There was no significant difference in gender and age between the two groups(P>0.05).There was no significant difference in data between the two groups before treatment(P>0.05). Indexes except NITMH and MGS each time point after treatment in the two groups were significantly improved compared with those before treatment, and the difference was statistically significant(P<0.05). There was no significant difference in each index between the experimental group and the control group at 1wk after treatment(P>0.05); at 4, 7 and 12wk after treatment, the experimental group was superior to the control group except for NITMH and MGS, and the difference was statistically significant(P<0.05). From the change trend of the indicators, the therapeutic effect of the experimental group continued to improve after the first treatment, and was the best at the 12^th week, while that of the control group was the best at the 7^th week after the first treatment, and then the curative effect was weakened. There were no obvious complications in both groups after treatment.

CONCLUSION: Both intense pulsed light combined with palpebral gland massage and eyelid fumigation massage are convenient, safe and effective for MGD-related dry eyes, and the curative effect and maintenance time of intense pulsed light combined with palpebral gland massage are better than that of eyelid fumigation massage.