目的：分析不同方法治疗中重度睑板腺功能障碍性干眼的临床效果。

方法：回顾性病例研究。选取2020-03/2021-09在西安国际医学中心医院眼科门诊就诊的睑板腺功能障碍性干眼患者72例144眼，根据睑板腺缺失面积占比分为中度组(1/3<睑板腺缺失<2/3，37例74眼)和重度组(睑板腺缺失≥2/3，35例70眼)，根据治疗方法不同分为A组(睑板腺熏蒸按摩治疗)和B组(睑板腺熏蒸按摩联合强脉冲光治疗)。分别于治疗前、治疗后1mo进行眼表疾病指数(OSDI)问卷评分，检测非侵入性泪河高度(NITMH)和非侵入性平均泪膜破裂时间(NIBUTav)，并进行眼红分析。

结果：与治疗前比较，治疗后1mo A组和B组患者OSDI评分均显著降低，NIBUTav及眼红分析结果均显著改善(P<0.001)，而NITMH均无显著变化(P>0.05)； 中度组患者中A组和B组患者OSDI评分均显著降低，NIBUTav及眼红分析结果均显著改善(P<0.01)，而NITMH均无显著变化(P>0.05)； 重度组患者中，A组患者NIBUTav显著改善(P<0.001)，其余各观察指标均无显著变化(P>0.05)，而B组患者OSDI评分明显降低，NIBUTav和眼红分析结果显著改善(P<0.001)，但NITMH无显著变化(P>0.05)。

结论：两种治疗方法治疗中度睑板腺功能障碍性干眼均有效，但重度睑板腺功能障碍性干眼需在睑板腺熏蒸按摩基础上联合强脉冲光治疗。

METHODS: The clinical data of 72 patients(144 eyes)with MGD related dry eye treated from March 2020 to September 2021 in the ophthalmology clinic of Xi'an International Medical Center Hospital were retrospectively analyzed. They were divided into moderate group(1/3RESULTS: Compared with pre-treatment, the OSDI scores of patients in group A and group B were significantly decreased at 1mo after treatment, and the results of NIBUTav and R-scan analysis were significantly improved(P<0.001), while the NITMH had no significant change(P>0.05). In the moderate group, the OSDI scores of group A and group B were significantly decreased, and the results of NIBUTav and R-scan analysis were significantly improved(P<0.01), while NITMH had no significant change(P>0.05). In the severe group, NIBUTav of the patients in group A improved significantly(P<0.001), while there was no significant change in other observation parameters(P>0.05), while the OSDI scores of the patients in group B were significantly decreased. And the results of NIBUTav and R-scan analysis were significantly improved(P<0.001), but there was no significant change in NITMH(P>0.05).

CONCLUSION: Both therapies were effective for moderate meibomian gland dysfunction related dry eye, while severe meibomian gland dysfunction related dry eye should be treated with fumigation massage of meibomian gland combined with intense pulsed light.