目的：探讨优化强脉冲光联合茶树精油眼贴治疗蠕形螨性睑缘炎的治疗效果。

方法：前瞻性临床研究。选取蠕形螨性睑缘炎患者283例566眼，随机分为3组：A组94例188眼给予优化强脉冲光治疗，B组96例192眼给予茶树精油眼贴治疗，C组93例186眼给予优化强脉冲光联合茶树精油眼贴治疗。治疗6wk后，对患者睫毛蠕形螨数量计数、主观症状评分、临床体征评分、泪膜破裂时间、角膜荧光素染色等进行分析，比较三组治疗前后的差异性。

结果：三组蠕形螨性睑缘炎患者治疗前蠕形螨计数、主观症状评分、临床体征评分、泪膜破裂时间、角膜荧光素染色等均无差异(P>0.05)，具有可比性。治疗后三组蠕形螨数量均较治疗前明显减少(P<0.05)，C组与A组、B组均具有差异(P<0.01)； 三组患者主观症状评分及临床体征评分均较治疗前有改善(P<0.05)，C组比A组、B组改善的更显著(P<0.01)； 泪膜破裂时间B组无明显改善，C组较A组、B组显著延长(P<0.01)； 三组患者治疗前后角膜荧光素染色评分均较治疗前明显改善(P<0.05)，但三组间比较无差异。所有患者均未见明显并发症发生。

结论：优化强脉冲光联合茶树精油在螨虫性睑缘炎治疗中相互协同，疗效显著，明显优于单纯优化强脉冲光治疗和单一使用茶树精油治疗。

METHODS: Prospective clinical study. Totally 283 patients(566 eyes)with Demodex blepharitis were selected and randomly divided into three groups. Group A(94 cases, 188 eyes)was treated with optimal pulse technology, group B(96 cases, 192 eyes)was treated with tea tree essential oil paste, and group C(93 cases, 186 eyes)was treated with optimal pulse technology combined with tea tree essential oil paste. After 6wk of treatment, the number of Demodex, subjective symptom score, clinical sign score, tear film rupture time and corneal fluorescein staining were analyzed.

RESULTS: There was no significant difference in Demodex count, symptom score, sign score, tear film rupture time and corneal fluorescein staining among the three groups before treatment(P>0.05). After treatment, the number of Demodex among the three groups were significantly reduced(P<0.05), and there were significant differences among group C, group A and group B(P<0.05). The scores of subjective symptoms and signs of the three groups were significantly improved after treatment(P<0.05), and the improvement of group C was more significant than that of group A and group B(P<0.05). After treatment, tear break-up time of the group B not significantly improved, tear break-up time that of group C was significantly longer than that of groups A and B(P<0.05); Fluorescent staining scores of three groups before and after treatment were significantly improved(P<0.05). The statistical results of group C were better than those of groups A and B, but there was no difference among the three groups. No obvious complications occurred in all patients.

CONCLUSION: The effect of optimal pulse technology combined with tea tree essential oil in the treatment of acariasis blepharitis is significant, which is significantly better than that of single optimal pulse technology therapy and single use of tea tree essential oil.