Objective To observe the effect of thunder-fire moxibustion combined with meibomian gland massage in improving meibomian gland dysfunction(MGD) and explore its mechanism. Methods Seventy-two MGD patients with 144 eyes in the Jinhua Hospital of Traditional Chinese Medicine from February 2019 to January 2021 were selected and randomly divided into an experimental group(n=36

72 eyes) and a control group(n=36

72 eyes). Patients in the control group received 0.1% fluo-rometholone eye drops and 0.1% sodium hyaluronate eye drops

1-2 drops per time

four times per day

and the meibomian glands were massaged once per day. Patients in the experimental group received additional thunder-fire moxibustion on the basis of the treatment of the control group

10 cones per time

once per day. One month after treatment

meibomian gland function was assessed

and the levels of interleukin-6(IL-6) and prostaglandin E_2(PGE_2) in tears were detected. Results After treatment

the scores of Ocular Surface Disease Index

meibomian hyperemia

meibomian gland opening

meibomian gland loss

and meibomian gland secretion function were lower than those before treatment in the two groups

and the scores of the experimental group were lower than those of the control group(P<0.05). After treatment

the tear break-up time and tear meniscus height were higher than those before treatment in the two groups

which were higher in the experimental group than those in the control group(P<0.05). The post-treatment levels of IL-6 and PGE_2 were lower than those before treatment in the two groups

and the levels in the experimental group were lower than those in the control group(P<0.05). Conclusion Thunder-fire moxibustion combined with meibomian gland massage can significantly improve the function of the meibomian glands and lower the levels of IL-6 and PGE_2 in tears.