Study On TCM Syndrome Of Meibomian Gland Dysfunction

Objectives:To initially discuss the TCM syndrome differentiation rules and relevant factors through examining the TCM syndrome indicators of meibomian gland dysfunction (MGD) patients.Methods:Medical literature database was searched on the computer and MGD-related literature in TCM Ophthalmology was consulted to collect 93 indicators for the MGD-related signs and symptoms in the literature.On the basis of the literature research result, authoritative domestic criteria were referred to and expert consultation and argumentation were conducted. The MGD TCM Syndrome Survey Form was designed to include general information, MGD diagnosis indicators and information on four diagnostic methods of TCM. Information of 154 patients diagnosed with MGD at the Department of Ophthalmology of a hospital was collected according to the selection criteria and recorded on the MGD TCM Syndrome Survey Form.The syndrome variable data were put into the computer to set up a database. SPSS 17.0 software was adopted to carry out descriptive statistical analysis. After the data were sorted out, clustering analysis was conducted on the data including 42 indicators. TCM theories and professional knowledge were used to differentiate the syndrome cluster centers to determine five cluster syndromes. The distribution and relevant factors for the five TCM syndromes were then analyzed.Results:Altogether 154 patients with complete materials were selected, including 78 male patients (50.60%) and 76 female patients (49.40%) at an average age of (49.23+16.89). The 154 patients were divided into MGD graded according to the MGD diagnosis criteria. The grades were asymptomatic MGD with 10 patients (6.49%), minor changes with 101 patients (65.58%), medium changes with 37 patients (24.03%) and severe changes with 6 cases (3.89%). The Kruskal-Wallis H test indicated MGD grades was not significantly correlated with gender but with age and the higher grade, the older the patients.Statistical analysis was conducted on the data materials for the indicators of TCM syndrome differentiation on 154 patients. Variables with small frequencies in the indicators were deleted (less than 5%,p<0.05). The effective indicators were sorted out to get information on 42 syndrome differentiation indicators. Then, SPSS17.0 software was adopted to carry out Ward’s method (sample cluster analysis) on the effective indicators and get relatively appropriate five cluster centers based on clinical professional features:25 cases of the syndrome of wind heat attacking the exterior,40 cases of the syndrome of damp-heat of spleen and stomach,32 cases of the syndrome of spleen and kidney yin deficiency,30 cases of the syndrome of the phlegm-damp obstructing the eyelids and 27 cases of the syndrome of spleen and stomach qi deficiency. The Kruskal-Wallis H test detected no significant correlation between the five cluster syndromes with MGD patterns and there was no difference in the distribution of syndromes in terms of age and gender. However, in the MGD, the syndrome of damp-heat of spleen and stomach was different from the other syndromes because minor and medium changes were more common in this syndrome while minor changes dominated the other four syndromes.Conclusions:1.Male and female patients share similar proportions in the MGD grades but with the increase of age, the clinical symptoms of MGD also become more serious.2. There are five types of MGD syndromes:the syndrome of wind heat attacking the exterior, the syndrome of damp-heat of spleen and stomach, the syndrome of spleen and kidney yin deficiency, the syndrome of the phlegm-damp obstructing the eyelids, and the syndrome of spleen and stomach qi deficiency. Age and gender differences among the five syndromes are not significant.3.The patients of the syndrome of damp-heat of spleen and stomach are slightly more serious in clinical manifestation than patients of the other syndromes.