To observe the therapeutic effect of Huashi Runmu Decoction (化湿润目汤) in the treatment of meibomian gland dysfunction (MGD) associated with evaporative dry eye (EDE) and its influence on interferon regulatory factors in tears.

From January 2022 to January 2024, 102 patients with MGD associated with EDE were selected and randomly divided into two groups: western medicine group (treated with ofloxacin eye drops and sodium hyaluronate eye drops) and comprehensive group (treated with ofloxacin eye drops, sodium hyaluronate eye drops and Huashi Runmu Decoction), with 51 cases in each. The syndrome scores, the levels of interferon regulatory factor 4 (IRF-4) in tears, tear film break-up time (BUT), and tear secretion volume were compared before and after treatment, as well as the grading of meibomian gland function, treatment effect and adverse reactions between the two groups.

After treatment, the total syndrome scores and the levels of IRF-4 in tears were lower than those before treatment in both groups (P<0.05), with the comprehensive group being lower than the western medicine group (P<0.05). The BUT of both groups were longer after treatment (P<0.05), with the comprehensive group being longer than the western medicine group (P<0.05). The tear secretion volume increased after treatment in both groups, with the comprehensive group being higher than the western medicine group (P<0.05). The proportion of grade 1 meibomian gland function was higher in the comprehensive group (P<0.05), and the proportion of grade 3 was lower than in the Western medicine group (P<0.05). The overall treatment effectiveness rate was higher in the comprehensive group (P<0.05). There were no significant adverse reactions in the Western medicine group, while the comprehensive group had one case of mild diarrhea, which improved without treatment.

Huashi Runmu Decoction can improve the syndrome scores, BUT, tear secretion volume, meibomian gland function and treatment effect in the patients with MGD associated with EDE, reduce the levels of IRF-4 in tears, and does not increase adverse reactions.