目的：观察茶树油眼贴联合睑缘深度清洁对蠕形螨睑缘炎的临床治疗效果。

方法：前瞻性随机双眼对照临床研究。收集2018-11/2019-05就诊西安市人民医院(西安市第四医院)干眼门诊的蠕形螨睑缘炎患者32例64眼，男14例，女18例，年龄12～65(平均37±14)岁。采用随机法将受试者的一只眼纳入研究组，另一只眼纳入对照组。研究组采用茶树油眼贴治疗(1次/d)联合睑缘深度清洁(1次/mo)，对照组仅使用茶树油眼贴治疗。记录两组治疗前、治疗3mo后受试者的主观症状、蠕形螨计数、睑缘清洁程度、睑缘异常、首次非侵入式泪膜破裂时间(NITBUT-first)、泪河高度(TMH)、眼红指数(Redness)、睑板腺红外线照相检查、泪液分泌试验(SⅠt)、角膜染色(FL)结果。

结果：治疗3mo后，两组蠕形螨计数均较治疗前明显下降，研究组蠕形螨计数低于对照组(均P<0.05)； 两组睑缘清洁程度均得到明显改善，且研究组评分低于对照组(均P<0.05)； 两组受试者主观症状评分明显改善(均P<0.05)。治疗3mo后，研究组NITBUT-first、眼红指数、FL均得到明显改善(均P<0.05)，对照组眼红指数、FL得到明显改善(均P<0.05)，NITBUT-first中位数较治疗前有所增加，但差异无统计学意义； 两组间眼表泪液指标的改善程度、TMH、SⅠt均无明显变化。睑板腺缺失程度评分(MGS)在治疗前后及两组间均无明显差异。受试者治疗过程中未出现接触性皮炎、过敏反应、角结膜损伤等相关并发症。

结论：茶树油眼贴贴敷双眼，可明显降低睫毛毛囊蠕形螨数量、减少鳞屑，改善患者症状、增加泪膜稳定性、减轻眼表炎症； 睑缘深度清洁可进一步清除睑缘袖套状鳞屑，维持睑缘清洁程度，改善睑缘异常，从而加强茶树油眼贴的除螨效果。茶树油眼贴联合睑缘深度清洁治疗蠕形螨睑缘炎，是一种简便易行、安全有效的治疗方式。

METHODS: This was a prospective, randomized and self-controlled study. Thirty-two patients(sixty-four eyes)diagnosed in demodex blepharitis were enrolled in the study. We randomly assigned one eye of the participants to the study group, which received tea tree oil eye patch once a day combined with monthly eyelid margin deep cleaning, and the other eye to the control group, which received tea tree oil eye patch therapy only. OSDI score of each subject, demodex mite counts, eyelid margin cleanness degree, eyelid margin abnormal score, non-invasive tear break-up time-first, tear meniscus height, redness, meibography score and Schirmer I test of each eye were evaluated before, and three months after the treatment.

RESULTS: Three months after treatment, demodex mite counts in both groups were significantly decreased(P<0.05), the counts were lower in the study group(P<0.05). Significant improvements were observed in the eyelid margin cleanness degree of the two groups(P<0.05), and the degree was lower in the study group(P<0.05). The OSDI score decreased significantly after treatment(P<0.05). The NITBUT-first, redness and FL of the study group were significantly improved after treatment(P<0.05), and the redness and FL of the control group were significantly improved after treatment(P<0.05), NITBUT-first was longer after treatment but there was no statistical difference. The tear film parameters were no significant differences between the two groups. No significant changes were found in tear meniscus height, Schirmer I test and meibomian gland loss score after treatment. No obvious complications were observed in the study.

CONCLUSION: Tea tree oil eye patch therapy is effective in treating demodex blepharitis. With eyelid margin deep cleaning device combining, can further strengthen the efficacy of tea tree oil in eliminating mites and cylindrical cuffs, maintain the eyelid margin cleanness, and improve the abnormality of eyelid margin, which is a convenient,effective and safe treatment for demodex blepharitis.