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Article(id=1322927765254701094, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926217711726961, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.8.045, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793340158045, onlineDateStr=2026-10-30, pubDate=1754755200000, pubDateStr=2025-08-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793340158045, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793340158045, creator=13701087609, updateTime=1793340158045, updator=13701087609, issue=Issue{id=1322926217711726961, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='8', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1754755200000', pubDateStr='2025-08-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339789083, creator='13701087609', updateTime=1793340517761, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929274071679978, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926217711726961, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929274071679979, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926217711726961, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=228, endPage=231, ext={EN=ArticleExt(id=1322927766106144807, articleId=1322927765254701094, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Clinical Effect of Yinhua Qingdu Decoction（银花清毒汤）Combined with Acupuncture on Dry Eye Caused by MGD, columnId=1256183365644968140, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Platform of Provincial Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the clinical effect of Yinhua Qingdu Decoction（银花清毒汤）combined with acupuncture on dry eye caused by meibomian gland dysfunction（MGD）.

Methods

A total of 100 patients with MGD-induced dry eye admitted from January 2021 to December 2023 were included in this grouping trial.The patients were divided into Western medicine group（49 cases）and integrated traditional Chinese and Western medicine group（51 cases）by random number table method.All patients in the western medicine group were treated with metaromian gland massage and artificial tears.The patients in the integrated traditional Chinese and western medicine group were treated with meibomian gland massage and artificial tears，combined with the treatment of Yinhua Qingdu Decoction and acupuncture.The data of patients in each group was observed，including clinical treatment outcome，the changes in ocular function indexes（tear film rupture time and tear secretion，corneal fluorescence staining score），subjective dry eye symptom score，and ocular surface disease index before and after treatment，the ocular surface disease index（OSDI）score changes，the levesl of interleukin-10（IL-10）and interleukin-13（IL-13），the change of scores of National Eye Institute 25-Item Visual Function Questionnaire（NEI-VFQ-25）and adverse reactions.

Results

The total effective rate of the integrated Chinese and western medicine group was significantly higher than that of Western medicine group（P<0.05）.Before treatment，the ocular function indexes（tear film rupture time and tear secretion volume，corneal fluorescence staining score），subjective dry eye symptom score，OSDI score，the levels of IL-10 and IL-13 and NEI-VFQ-25 score were not significant（P>0.05）.After treatment，the ocular function indexes（tear film rupture time and tear secretion volume，corneal fluorescence staining score），dry eye subjective symptom score，OSDI score，IL-10 and IL-13 levels，and NEI-VFQ-25 score were improved in all groups.After treatment，the ocular function indexes（tear film rupture time，tear secretion，corneal fluorescence staining score），subjective dry eye symptom score，OSDI score，the levels of IL-10 and IL-13 and NEI-VFQ-25 score in the integrated traditional Chinese and Western medicine group were improved better than those in Western medicine group（P<0.05）.The rate of adverse reaction was higher in both groups（P>0.05）.

Conclusion

The combination of Yinhua Qingdu Decoction and acupuncture in the treatment of dry eye caused by MGD has significant clinical effect，which can effectively reduce the inflammatory response of patients，improve the symptoms，eye function and visual quality of patients，and reduce the adverse reaction of treatment，and the treatment is safe and feasible.

, authors=Junqing CHEN, Jian LAI, Rui ZHANG, Haiying DU, authorsList=Junqing CHEN, Jian LAI, Rui ZHANG, Haiying DU, authorCompany=null, correspAuthors=Jian LAI, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322927768907939889, articleId=1322927765254701094, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=银花清毒汤结合针刺治疗睑板腺功能障碍所致干眼疗效观察, columnId=1256183369033965799, journalTitle=中华中医药学刊, columnName=省级项目平台, runingTitle=null, highlight=null, articleAbstract=
目的

探讨银花清毒汤结合针刺治疗睑板腺功能障碍（meibomain gland dysfunction，MGD）所致干眼临床效果。

方法

总计纳入100例MGD所致干眼症患者（2021年1月—2023年12月收治）进行分组试验，采取随机数字表法将患者分为西医组（49例）与中西医结合组（51例）。西医组患者采取睑板腺按摩与人工泪液治疗；中西医结合组患者采取睑板腺按摩与人工泪液治疗，并结合银花清毒汤及针刺治疗。观察各组患者数据情况：临床治疗效果、治疗前后患者眼部功能指标（泪膜破裂时间及泪液分泌量、角膜荧光染色评分）变化、干眼主观症状评分以及眼表疾病指数（ocular surface disease index，OSDI）评分变化、白细胞介素-10（interleukin-10，IL-10）及白细胞介素-13（interleukin-13，IL-13）水平变化、视觉相关生活质量量表（national eye institute 25-item visual function questionnaire，NEI-VFQ-25）评分变化、治疗不良反应。

结果

中西医结合组患者治疗总有效率明显比西医组治疗总有效率更高（P<0.05）；治疗前各组患者眼部功能指标、干眼主观症状评分OSDI评分、IL-10及IL-13水平、NEI-VFQ-25评分相比，差异无统计学意义（均P>0.05），经治疗后各组患者眼部功能指标、干眼主观症状评分、OSDI评分、IL-10及IL-13水平、NEI-VFQ-25评分均改善，中西医结合组患者治疗后眼部功能指标、干眼主观症状评分、OSDI评分、IL-10及IL-13水平、NEIVFQ-25评分改善优于西医组（P<0.05）；中西医结合组患者与西医组患者治疗不良反应率均较低（P>0.05）。

结论

银花清毒汤结合针刺治疗睑板腺功能障碍（MGD）所致干眼临床效果显著，可较好降低患者炎症反应，改善患者症状及眼部功能、视觉质量，治疗不良反应少，治疗安全、可行。

, authors=陈俊卿, 来坚, 张蕊, 杜海英, authorsList=陈俊卿, 来坚, 张蕊, 杜海英, authorCompany=null, correspAuthors=来坚, authorNote=

陈俊卿（1985-），男，浙江杭州人，主治医师，硕士，研究方向：眼科相关疾病。

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来坚（1975-），男，浙江杭州人，主任医师，硕士，研究方向：眼科临床疾病。E-mail：。
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陈俊卿（1985-），男，浙江杭州人，主治医师，硕士，研究方向：眼科相关疾病。

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陈俊卿（1985-），男，浙江杭州人，主治医师，硕士，研究方向：眼科相关疾病。

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articleTitle=养阴生津宣肺汤结合雷火灸治疗干眼症临床疗效及安全性研究, refAbstract=null), Reference(id=1322927779414671492, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927765254701094, doi=null, pmid=null, pmcid=null, year=2023, volume=29, issue=9, pageStart=29, pageEnd=33, url=null, language=null, rfNumber=［27］, rfOrder=26, authorNames=吴萨日娜, 李常胜, 吴斯琴毕力格, journalName=中医药导报, refType=null, unstructuredReference=吴萨日娜，李常胜，吴斯琴毕力格，等. 蒙医针刺疗法治疗干眼症模型大鼠的实验研究［J］. 中医药导报，2023，29（9）：29-33., articleTitle=蒙医针刺疗法治疗干眼症模型大鼠的实验研究, refAbstract=null), Reference(id=1322927779477586053, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927765254701094, doi=null, pmid=null, pmcid=null, year=2023, volume=40, issue=4, pageStart=1043, pageEnd=1052, url=null, language=null, rfNumber=［28］, rfOrder=27, authorNames=谭惠元, 董明国, 李光耀, journalName=广州中医药大学学报, refType=null, unstructuredReference=谭惠元，董明国，李光耀，等. 针灸结合中药治疗干眼症的系统评价与Meta分析［J］. 广州中医药大学学报，2023，40（4）：1043-1052., articleTitle=针灸结合中药治疗干眼症的系统评价与Meta分析, refAbstract=null), Reference(id=1322927779540500614, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927765254701094, doi=null, pmid=null, pmcid=null, year=2023, volume=40, issue=8, pageStart=1948, pageEnd=1953, url=null, language=null, rfNumber=［29］, rfOrder=28, authorNames=李惠真, 汪旬, 陈奕群, journalName=广州中医药大学学报, refType=null, unstructuredReference=李惠真，汪旬，陈奕群，等. 针刺治疗肝经郁热型干眼症的疗效及对焦虑情绪的影响［J］. 广州中医药大学学报，2023，40（8）：1948-1953., articleTitle=针刺治疗肝经郁热型干眼症的疗效及对焦虑情绪的影响, refAbstract=null), Reference(id=1322927779620192391, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927765254701094, doi=null, pmid=null, pmcid=null, year=2023, volume=40, issue=4, pageStart=63, pageEnd=67, url=null, language=null, rfNumber=［30］, rfOrder=29, authorNames=武峙璇, 林春范, 王殿一, journalName=中医药信息, refType=null, unstructuredReference=武峙璇，林春范，王殿一，等. 筋膜松解针法治疗角结膜干燥症临床观察［J］. 中医药信息，2023，40（4）：63-67., articleTitle=筋膜松解针法治疗角结膜干燥症临床观察, refAbstract=null), Reference(id=1322927779699884168, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927765254701094, doi=null, pmid=null, pmcid=null, year=2023, volume=33, issue=4, pageStart=332, pageEnd=336, url=null, language=null, rfNumber=［31］, rfOrder=30, authorNames=甘惠玄, 周达君, 杨雪艳, journalName=中国中医眼科杂志, refType=null, unstructuredReference=甘惠玄，周达君，杨雪艳. 方氏头皮针飞针疗法治疗干眼的临床观察［J］. 中国中医眼科杂志，2023，33（4）：332-336., articleTitle=方氏头皮针飞针疗法治疗干眼的临床观察, refAbstract=null)], funds=[Fund(id=1322927777250410601, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927765254701094, awardId=2024ZL644, language=CN, fundingSource=浙江省中医药科技计划项目(2024ZL644), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1322927769151209522, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927765254701094, xref=null, ext=[AuthorCompanyExt(id=1322927769163792435, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927765254701094, companyId=1322927769151209522, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Hangzhou Hospital of Traditional Chinese Medicine，Hangzhou 310013，Zhejiang，China), AuthorCompanyExt(id=1322927769172181044, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927765254701094, companyId=1322927769151209522, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=杭州市中医院，浙江 杭州 310007)])], figs=[ArticleFig(id=1322927773689446491, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927765254701094, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数显效有效无效总有效
西医组　　　492516841（83.67）
中西医结合组513514249（96.08）
χ2值---4.272 8
P值---0.038 7
), ArticleFig(id=1322927774062739548, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927765254701094, language=CN, label=表1, caption=

两组睑板腺功能障碍所致干眼症患者临床治疗效果比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数显效有效无效总有效
西医组　　　492516841（83.67）
中西医结合组513514249（96.08）
χ2值---4.272 8
P值---0.038 7
), ArticleFig(id=1322927774142431326, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927765254701094, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间泪膜破裂时间/（s）泪液分泌量/（mm/5 min）角膜荧光染色评分/（分）
西医组　　　49治疗前6.62±0.454.48±0.952.49±0.22
治疗后11.59±1.09*12.95±0.85*1.24±0.26*
中西医结合组51治疗前6.68±0.534.53±0.912.51±0.19
治疗后12.59±0.72*#14.43±0.92*#0.69±0.11*#
), ArticleFig(id=1322927774222123103, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927765254701094, language=CN, label=表2, caption=

两组睑板腺功能障碍所致干眼症患者眼部功能指标变化比较（）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间泪膜破裂时间/（s）泪液分泌量/（mm/5 min）角膜荧光染色评分/（分）
西医组　　　49治疗前6.62±0.454.48±0.952.49±0.22
治疗后11.59±1.09*12.95±0.85*1.24±0.26*
中西医结合组51治疗前6.68±0.534.53±0.912.51±0.19
治疗后12.59±0.72*#14.43±0.92*#0.69±0.11*#
), ArticleFig(id=1322927774482169952, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927765254701094, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间干眼主观症状评分OSDI 评分
西医组　　　49治疗前6.67±0.4931.24±4.44
治疗后2.96±0.44*15.95±2.12*
中西医结合组51治疗前6.72±0.5331.18±4.57
治疗后1.45±0.32*#13.25±1.00*#
), ArticleFig(id=1322927774570250337, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927765254701094, language=CN, label=表3, caption=

两组睑板腺功能障碍所致干眼症患者治疗前后干眼主观症状评分以及OSDI评分比较（）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间干眼主观症状评分OSDI 评分
西医组　　　49治疗前6.67±0.4931.24±4.44
治疗后2.96±0.44*15.95±2.12*
中西医结合组51治疗前6.72±0.5331.18±4.57
治疗后1.45±0.32*#13.25±1.00*#
), ArticleFig(id=1322927774649942114, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927765254701094, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间IL-10IL-13
西医组　　　49治疗前2.15±0.3721.65±4.27
治疗后2.97±0.24*14.28±2.25*
中西医结合组51治疗前2.19±0.4021.59±4.30
治疗后3.52±0.55*#10.10±2.06*#
), ArticleFig(id=1322927774872240227, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927765254701094, language=CN, label=表4, caption=

两组睑板腺功能障碍所致干眼症患者治疗前后IL-10及IL-13水平比较（）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间IL-10IL-13
西医组　　　49治疗前2.15±0.3721.65±4.27
治疗后2.97±0.24*14.28±2.25*
中西医结合组51治疗前2.19±0.4021.59±4.30
治疗后3.52±0.55*#10.10±2.06*#
), ArticleFig(id=1322927774930960484, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927765254701094, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗前治疗后
西医组　　　4935.23±4.1270.56±3.33*
中西医结合组5135.18±4.0777.83±2.95*#
), ArticleFig(id=1322927775295864933, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927765254701094, language=CN, label=表5, caption=

两组睑板腺功能障碍所致干眼症患者治疗前后NEI-VFQ-25评分比较（）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗前治疗后
西医组　　　4935.23±4.1270.56±3.33*
中西医结合组5135.18±4.0777.83±2.95*#
), ArticleFig(id=1322927777007140967, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927765254701094, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数恶心头痛皮炎总不良反应
西医组　　　490101（2.04）
中西医结合组511012（3.92）
χ2值---0.303 8
P值---0.581 5
), ArticleFig(id=1322927777099415656, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322927765254701094, language=CN, label=表6, caption=

两组睑板腺功能障碍所致干眼症患者临床不良反应比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数恶心头痛皮炎总不良反应
西医组　　　490101（2.04）
中西医结合组511012（3.92）
χ2值---0.303 8
P值---0.581 5
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银花清毒汤结合针刺治疗睑板腺功能障碍所致干眼疗效观察
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陈俊卿 , 来坚 , 张蕊 , 杜海英
中华中医药学刊 | 省级项目平台 2025,43(8): 228-231
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中华中医药学刊 |省级项目平台 2025 , 43 (8) : 228 -231
银花清毒汤结合针刺治疗睑板腺功能障碍所致干眼疗效观察
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陈俊卿, 来坚 , 张蕊, 杜海英
作者信息
  • 杭州市中医院，浙江 杭州 310007
通讯作者:
来坚（1975-），男，浙江杭州人，主任医师，硕士，研究方向：眼科临床疾病。E-mail：。
作者简介:

陈俊卿（1985-），男，浙江杭州人，主治医师，硕士，研究方向：眼科相关疾病。

Clinical Effect of Yinhua Qingdu Decoction（银花清毒汤）Combined with Acupuncture on Dry Eye Caused by MGD
Junqing CHEN, Jian LAI , Rui ZHANG, Haiying DU
Affiliations
  • Hangzhou Hospital of Traditional Chinese Medicine，Hangzhou 310013，Zhejiang，China
出版时间: 2025-08-10 doi: 10.13193/j.issn.1673-7717.2025.8.045
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摘要
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目的

探讨银花清毒汤结合针刺治疗睑板腺功能障碍（meibomain gland dysfunction，MGD）所致干眼临床效果。

方法

总计纳入100例MGD所致干眼症患者（2021年1月—2023年12月收治）进行分组试验，采取随机数字表法将患者分为西医组（49例）与中西医结合组（51例）。西医组患者采取睑板腺按摩与人工泪液治疗；中西医结合组患者采取睑板腺按摩与人工泪液治疗，并结合银花清毒汤及针刺治疗。观察各组患者数据情况：临床治疗效果、治疗前后患者眼部功能指标（泪膜破裂时间及泪液分泌量、角膜荧光染色评分）变化、干眼主观症状评分以及眼表疾病指数（ocular surface disease index，OSDI）评分变化、白细胞介素-10（interleukin-10，IL-10）及白细胞介素-13（interleukin-13，IL-13）水平变化、视觉相关生活质量量表（national eye institute 25-item visual function questionnaire，NEI-VFQ-25）评分变化、治疗不良反应。

结果

中西医结合组患者治疗总有效率明显比西医组治疗总有效率更高（P<0.05）；治疗前各组患者眼部功能指标、干眼主观症状评分OSDI评分、IL-10及IL-13水平、NEI-VFQ-25评分相比，差异无统计学意义（均P>0.05），经治疗后各组患者眼部功能指标、干眼主观症状评分、OSDI评分、IL-10及IL-13水平、NEI-VFQ-25评分均改善，中西医结合组患者治疗后眼部功能指标、干眼主观症状评分、OSDI评分、IL-10及IL-13水平、NEIVFQ-25评分改善优于西医组（P<0.05）；中西医结合组患者与西医组患者治疗不良反应率均较低（P>0.05）。

结论

银花清毒汤结合针刺治疗睑板腺功能障碍（MGD）所致干眼临床效果显著，可较好降低患者炎症反应，改善患者症状及眼部功能、视觉质量，治疗不良反应少，治疗安全、可行。

睑板腺功能障碍  /  干眼  /  临床治疗效果  /  眼部功能  /  炎症  /  视觉质量  /  不良反应
Objective

To investigate the clinical effect of Yinhua Qingdu Decoction（银花清毒汤）combined with acupuncture on dry eye caused by meibomian gland dysfunction（MGD）.

Methods

A total of 100 patients with MGD-induced dry eye admitted from January 2021 to December 2023 were included in this grouping trial.The patients were divided into Western medicine group（49 cases）and integrated traditional Chinese and Western medicine group（51 cases）by random number table method.All patients in the western medicine group were treated with metaromian gland massage and artificial tears.The patients in the integrated traditional Chinese and western medicine group were treated with meibomian gland massage and artificial tears，combined with the treatment of Yinhua Qingdu Decoction and acupuncture.The data of patients in each group was observed，including clinical treatment outcome，the changes in ocular function indexes（tear film rupture time and tear secretion，corneal fluorescence staining score），subjective dry eye symptom score，and ocular surface disease index before and after treatment，the ocular surface disease index（OSDI）score changes，the levesl of interleukin-10（IL-10）and interleukin-13（IL-13），the change of scores of National Eye Institute 25-Item Visual Function Questionnaire（NEI-VFQ-25）and adverse reactions.

Results

The total effective rate of the integrated Chinese and western medicine group was significantly higher than that of Western medicine group（P<0.05）.Before treatment，the ocular function indexes（tear film rupture time and tear secretion volume，corneal fluorescence staining score），subjective dry eye symptom score，OSDI score，the levels of IL-10 and IL-13 and NEI-VFQ-25 score were not significant（P>0.05）.After treatment，the ocular function indexes（tear film rupture time and tear secretion volume，corneal fluorescence staining score），dry eye subjective symptom score，OSDI score，IL-10 and IL-13 levels，and NEI-VFQ-25 score were improved in all groups.After treatment，the ocular function indexes（tear film rupture time，tear secretion，corneal fluorescence staining score），subjective dry eye symptom score，OSDI score，the levels of IL-10 and IL-13 and NEI-VFQ-25 score in the integrated traditional Chinese and Western medicine group were improved better than those in Western medicine group（P<0.05）.The rate of adverse reaction was higher in both groups（P>0.05）.

Conclusion

The combination of Yinhua Qingdu Decoction and acupuncture in the treatment of dry eye caused by MGD has significant clinical effect，which can effectively reduce the inflammatory response of patients，improve the symptoms，eye function and visual quality of patients，and reduce the adverse reaction of treatment，and the treatment is safe and feasible.

meibomian gland dysfunction  /  dry eyes  /  clinical treatment effect  /  eye function  /  inflammation  /  visual quality  /  adverse reaction
陈俊卿, 来坚, 张蕊, 杜海英. 银花清毒汤结合针刺治疗睑板腺功能障碍所致干眼疗效观察. 中华中医药学刊, 2025 , 43 (8) : 228 -231 . DOI: 10.13193/j.issn.1673-7717.2025.8.045
Junqing CHEN, Jian LAI, Rui ZHANG, Haiying DU. Clinical Effect of Yinhua Qingdu Decoction（银花清毒汤）Combined with Acupuncture on Dry Eye Caused by MGD[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (8) : 228 -231 . DOI: 10.13193/j.issn.1673-7717.2025.8.045
正文
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睑板腺功能障碍（meibomain gland dysfunction，MGD）为眼科比较常见的眼表疾病，疾病发生后患者出现眼痒、眼红及异物感、畏光流泪、烧灼感、干涩刺痛与视力波动等症状，临床容易将该病误诊为眼疲劳、慢性结膜炎与角膜炎等，需进行鉴别诊断，早期诊断，给予患者有效治疗，以改善患者病情[1-3]。而临床研究发现，睑板腺为睑板腺功能障碍发病的主要原因，而近年MGD所致干眼症发病率日益上升，危害严重，需积极采取有效方法治疗[4-6]。临床治疗MGD所致干眼症多采取睑板腺按摩与人工泪液治疗，取得一定疗效，但并未达到最佳治疗效果[7-9]。为了进一步提升MGD所致干眼症患者的治疗效果，临床在给予患者睑板腺按摩与人工泪液治疗的同时，给予患者中医方法治疗，取得较好效果[10-12]。临床经验发现，给予MGD所致干眼症患者银花清毒汤结合针刺治疗取得较好效果，值得研究。故而本次纳入100例MGD所致干眼症患者进行分组，探讨银花清毒汤结合针刺治疗效果，报道如下。
1　资料与方法
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1.1　一般资料
总计纳入100例MGD所致干眼症患者（2021年1月—2023年12月收治）以随机数字表法分为两组，分别为西医组（49例）、中西医结合组（51例）。西医组49例，男21例，女28例，年龄39～70（59.72±4.23）岁，病程6～36（15.23±2.17）个月。中西医结合组51例，男22例，女29例，年龄37～71（59.68±4.32）岁，病程5～48（15.29±2.22）个月。中西医结合组与西医组患者临床资料比较，P>0.05。
1.2　诊断标准
西医参照《眼表疾病学》[13]诊断MGD所致干眼症：患者出现干涩、眼红及眼痛、异物感、畏光、眼痒及视疲劳、分泌物及泪流、视物模糊等症状。中医参照《中医病证诊断疗效标准》[14]中MGD所致干眼症：睑弦红肿溃烂、痒痛兼作、垢腻胶黏及睫毛脱落、舌红苔黄腻、脉弦滑数。
1.3　纳入排除及脱落标准
纳入标准：①患者符合MGD所致干眼症临床诊断；②患者可接受睑板腺按摩与人工泪液、银花清毒汤及针刺治疗；③患者自愿加入本次研究；④伦理批准研究进行（批件号：2020LH023）。排除标准：①既往眼部外伤史、手术史患者；②合并风湿疾病、糖尿病、严重性皮肤疾病等患者；③合并角膜炎与结膜炎患者；④眼睑内外翻、闭合不全患者；⑤无法配合研究患者等。脱落标准：①自愿退出研究患者；②接受其他治疗患者；③参与其他研究患者等。
1.4　治疗方法
西医组：患者采取睑板腺按摩与人工泪液治疗。睑板腺按摩治疗：按摩前42℃湿热敷患眼20 min，按摩5 min，清除分泌物，按摩下眼睑完成后以相同方法进行上眼睑板腺按摩，按摩完成后滴玻璃酸钠滴眼液，每周进行1次，共计4次。泪液治疗：给予玻璃酸钠滴眼液（Santen Pharmaceutical Co，Ltd，注册证号H20171192）外滴眼，3次/d，1滴/次，治疗4周。中西医结合组：患者采取睑板腺按摩与人工泪液治疗，方法同西医组，并结合银花清毒汤及针刺治疗。银花清毒汤组方：茯苓30 g，蒲公英20 g，地肤15 g，金银花10 g，蛇床子10 g，天花粉10 g，苍耳子10 g，茵陈10 g，荆芥10 g，百部9 g，黄柏6 g，艾叶5 g。煎煮药液，1剂/d，熏蒸患者眼部，1次/d，10 min/次，内服药汁，2次/d，200 mL/次，治疗4周。针刺治疗：取穴上睛明、承泣、鱼腰、攒竹、阳白、丝竹空、太阳。上睛明、承泣针刺0.5寸，平刺鱼腰、攒竹及丝竹空，针刺深度0.5寸，采取平补平泻法；阳白透鱼腰，阳白穴平刺进针，贯穿阳白、鱼腰二穴，针下得气后进行上下提插捻转，操作20 s。每周针刺1～2次，治疗4周。
1.5　观察指标
①观察两组患者临床治疗效果[15]。显效：治疗后眼部不适等症状均消失，睑板腺功能恢复正常，泪膜破裂时间>10 s。有效：治疗后眼部不适等症状显著好转，睑板腺功能良好，5 s<泪膜破裂时间<10 s；无效：治疗后未达到显效与有效的标准。总有效率＝显效率+有效率。②观察两组患者治疗前后泪膜破裂时间及泪液分泌量、角膜荧光染色评分等眼部功能指标变化[16]。泪液分泌量测定：取无菌试纸进行泪液分泌试验，泪液分泌液在10 mm/5 min及以上表示患者泪液分泌量正常。泪膜破裂时间测定：应用钴蓝光经荧光素钠染色法检查各组患者泪膜破裂时间，患者瞬目数次以后平视前方，观察第一个泪膜破裂点时间，3次取平均值。若泪膜破裂时间>10 s，表示患者的泪膜功能正常。角膜荧光染色评分：观察患者的角膜染色情况，未染色为0分，若1～5个荧光素染色点则为1分，若为6～30个荧光素染色点则为2分，若超过30个荧光素染色点则为3分，分值越高表示患者的角膜破损越为严重。③观察两组患者治疗前后干眼主观症状评分[17]以及眼表疾病指数（ocular surface disease index，OSDI）评分变化[18]。干眼主观症状评分标准：主要评估患者主诉干涩、眼红以及异物感、眼痛及眼痒、畏光与分泌物、视疲劳、泪流及视物模糊等项目，每项为1分，总分为10分，越高表示患者的症状越为严重。OSDI评分标准：包括视力下降与畏光等项目，各项0～4分，调查总分×25，满分为0～100分，分值越低表示越佳。④观察两组患者治疗前后白细胞介素-10（interleukin-10，IL-10）及白细胞介素-13（interleukin-13，IL-13）水平变化。取患者反射泪液进行测定，测定方法为酶联免疫吸附法。⑤观察两组患者治疗前后视觉相关生活质量量表（national eye institute 25-item visual function questionnaire，NEI-VFQ-25）评分[19]变化。量表评分包括12个维度，25个项目，各项0～4分，总分为100分，越高表示患者的视觉质量越佳。⑥观察两组患者治疗不良反应情况。
1.6　统计学方法
两组研究数据均录入SPSS 26.0软件处理，计量数据（泪膜破裂时间及泪液分泌量、角膜荧光染色评分等眼部功能指标、干眼主观症状评分以及OSDI评分、IL-10及IL-13水平、NEI-VFQ-25评分）及计数数据（临床治疗效果与不良反应发生率等）分别实施t/χ2检验，当P<0.05时，说明数据比较差异存在统计学意义。
2　结果
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2.1　临床治疗效果比较
表1显示，与西医组总有效率对比，中西医结合组指标更高（P<0.05）。
2.2　眼部功能指标变化比较
表2显示，治疗前各组患者泪膜破裂时间及泪液分泌量、角膜荧光染色评分等眼部功能指标对比，差异无统计学意义（均P>0.05），各组患者治疗后指标均改善，而中西医结合组患者指标改善程度优于西医组（P<0.05）。
2.3　治疗前后干眼主观症状评分、OSDI评分比较
表3显示，治疗前各组患者的干眼主观症状评分、OSDI评分相比差异无统计学意义（均P>0.05），各组患者治疗后干眼主观症状评分以及OSDI评分均改善，中西医结合组患者治疗后的干眼主观症状评分以及OSDI评分均优于西医组（P<0.05）。
2.4　治疗前后IL-10及IL-13水平比较
表4显示，各组患者治疗前IL-10及IL-13水平比较差异无统计学意义（均P>0.05），治疗后各组患者IL-10水平上升，IL-13水平下降，中西医结合组患者治疗后的IL-10水平高于西医组，IL-13水平低于西医组（P<0.05）。
2.5　治疗前后NEI-VFQ-25评分比较
表5显示，各组患者治疗前NEI-VFQ-25评分比较差异无统计学意义（均P>0.05），治疗后各组患者NEI-VFQ-25评分均提升，中西医结合组患者治疗后NEI-VFQ-25评分高于西医组（P<0.05）。
2.6　临床不良反应比较
表6显示，中西医结合组患者治疗总不良反应率与西医组治疗总不良反应率均较低（P>0.05）。
3　讨论
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中医将MGD所致干眼疾病归属于“神水将枯”“白涩症”等范畴[20-21]。其发病与脏腑功能失调及眼部气血津液输布障碍相关[22-23]。肾属水，主津液，肾气不足则津液异常，目失濡养，导致干涩、痒等病症[23-24]。本次给予MGD所致干眼患者银花清毒汤治疗，取得较好临床疗效。银花清毒汤是由土茯苓、蒲公英、地肤子、金银花、蛇床子、天花粉、苍耳子、茵陈、荆芥、百部、黄柏、艾叶组成，其中土茯苓可利水渗湿，健脾，宁心安神；蒲公英可清热解毒；地肤子可清热利湿、止痒；金银花可清热解毒、疏散风热；蛇床子可散寒祛风、燥湿杀虫、温肾壮阳；天花粉可清热泻火、生津止渴；苍耳子可散风寒、通鼻窍、祛风湿；茵陈可清利湿热；荆芥可解表散风、透疹；百部可清热解毒、止痛；黄柏可清热燥湿、泻火除蒸、解毒；艾叶可温经止血、散寒止痛、祛湿止痒[25]。本方诸药配伍具有较好清热解毒、燥湿止痒、止痛、健脾补肾等功效，利于MGD所致干眼患者恢复。
针刺疗法属于中医外治之法，治疗MGD所致干眼具有较好疗效[26-27]。而本次针刺主要取穴上睛明、承泣、鱼腰、攒竹、阳白、丝竹空、太阳，针刺上睛明具有祛风清热以及明目等作用；针刺承泣具有疏风清热、通络明目功效；针刺鱼腰可清肿明目、通络止痛；针刺攒竹可明目、活血止痛；针刺阳白可祛风泄热、清头明目；针刺丝竹空可疏风清热、止痛；针刺太阳可清头散风、止痛，缓解疲劳[28-29]。诸穴合刺具有较好清热、明目、止痛、通络等功效，结合银花清毒汤可较好提升MGD所致干眼患者临床治疗效果[30-31]。本次数据显示，中西医结合组患者治疗总有效率明显比西医组治疗总有效率更高，提示银花清毒汤结合针刺治疗MGD所致干眼效果显著。各组患者治疗后泪膜破裂时间、泪液分泌量以及角膜荧光染色评分等眼部功能指标、干眼主观症状评分以及OSDI评分均改善，而中西医结合组患者改善优于西医组，提示银花清毒汤结合针刺治疗MGD所致干眼可较好改善患者临床症状及眼部功能。炎症为MGD所致干眼发病主要机制，IL-10为抑炎因子，参与炎症和免疫反应，MGD所致干眼发病后IL-10水平下降，IL-13水平上升，而本次治疗后患者IL-10及IL-13水平均改善，与银花清毒汤具有较好清热解毒功效有关。中西医结合组患者NEI-VFQ-25评分改善优于西医组，可见银花清毒汤结合针刺治疗MGD所致干眼症患者视觉质量。中西医结合组患者与西医组患者治疗不良反应率均较多，提示本次治疗较为安全可靠。
综上所述，银花清毒汤结合针刺治疗MGD所致干眼效果良好，患者症状及眼部功能、视觉质量均改善，治疗安全可靠。
基金
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  • 浙江省中医药科技计划项目(2024ZL644)
文献
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参考文献 引证文献
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2025年第43卷第8期
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doi: 10.13193/j.issn.1673-7717.2025.8.045
  • 首发时间：2026-10-30
  • 出版时间：2025-08-10
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浙江省中医药科技计划项目(2024ZL644)
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    杭州市中医院，浙江 杭州 310007

通讯作者:

来坚（1975-），男，浙江杭州人，主任医师，硕士，研究方向：眼科临床疾病。E-mail：。
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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