5％茶树油眼膏治疗蠕形螨相关鳞屑性睑缘炎

The use of 5% tea oil ointment in the treatment of scaly blepharitis associated with ocular demodicosis

目的探讨5％茶树油眼膏治疗蠕形螨相关鳞屑性睑缘炎的临床疗效。方法前瞻性临床研究。选择2007年6月至2013年6月在福建医科大学附属第二医院就诊的240例鳞屑性睑缘炎患者，平均年龄（48．7±13．7）岁。所有患者睫毛蠕形螨镜检均为阳性，有不同程度的眼部不适（以眼表症状积分表示）。治疗方法：使用5％茶树油眼膏擦拭双眼睑缘，每晚1次，每2周随访1次，治疗4周后进行疗效评价，随访3个月。评价指标包括眼表不适症状改善情况、蠕形螨计数、睑缘清洁度以及不良事件发生情况。治疗前后各数据比较采用配对t检验。结果240例患者中180例（75．0％）不适症状消失，38例（15．8％）明显缓解，治疗前眼表症状积分为（8．2±3．2）分，治疗4周后降至（0．3±0．8）分（f=12．28，P〈O．01）；212例（88．3％）患者睑缘变清洁；治疗前蠕形螨镜检计数为（612±4．8）只／4根睫毛，治疗后降至（0．7±0．6）只，4根睫毛（t=6．96，P〈O．01）。所有患者均未出现过敏或不良反应。结论5％茶树油眼膏擦拭睑缘能有效缓解蠕形螨相关鳞屑性睑缘炎的临床症状，降低眼部蠕形螨寄生数量，是治疗蠕形螨相关鳞屑性睑缘炎的安全有效方法。

Objective To discuss the clinical efficacy of 5% tea tree oil ointment in treating scaly blepharitis, which is associated with demodex. Methods In this prospective clinical study, a total of 240 outpatients diagnosed with scaly blepharitis in the Second Affiliated Hospital of Fujian Medical University between June 2007 and June 2013 were included in the study. The mean age was 48.7±13.7 years. Demodex was positive in every eyelash sample. The degree of ocular discomfort was judged by an ocular discomfort score. The method of treatment： Lid scrub with 5% tea tree oil ointment bilaterally once every night. Patients returned for evaluations every two weeks, and the success of the treatment was evaluated at the end of four weeks. Total follow-up time was 3 months. The final assessment included an evaluation of changes in the ocular discomfort score, demodex count, eyelid hygiene conditions and side effects. A paired t-test was used for comparison of data before and after the treatment. Results One hundred eighty of 240 patients （75.0%） had complete relief of symptoms after treatment, and 38（15.8%） had significant improvement. The mean ocular discomfort score was 8.2±3.2 before treatment, which dropped to 0.3±0.8 after treatment （t=12.28, P〈0.01 ）. The eyelids of 212 patients （88.3%） became free of dandruff. The demodex count was 6.2±4.8 for every four eyelashes before treatment and declined to 0.7±0.6 for every four eyelashes after treatment （t=6.96, P〈0.01）. None of the patients experienced an allergic reaction or had adverse reactions during or after the treatment. Conclusion Lid scrub with 5% tea tree oil ointment can effectively relieve the symptoms of scaly blepharitis, which is associated with demodex infestation and greatly diminishes the number of demodex mites. This shows that the treatment is safe and effective.