多步骤连续物理治疗联合除螨抗炎治疗蠕形螨睑缘炎临床疗效

Clinical Effect of Multistep Continuous Physiotherapy Combined with Anti-Mite and Anti-Inflammation in the Treatment of Demodex Blepharitis

目的:探讨多步骤连续物理治疗联合除螨抗炎治疗蠕形螨睑缘炎患者的临床疗效。方法:回顾性分析2018年1月至2020年10月就诊的76例(152眼)蠕形螨睑缘炎患者的临床资料,根据患者治疗方式不同分为A、B两组,选择自行居家完成物理除螨抗炎(4-松油醇湿巾和妥布霉素地塞米松眼膏)用药治疗者为A组,选择规范的多步骤连续物理治疗联合除螨抗炎(4-松油醇湿巾和妥布霉素地塞米松眼膏)治疗者为B组,其中多步骤连续物理治疗在医院门诊完成,指导患者居家完成眼睑清洁除螨及抗炎用药。观察两组治疗前与治疗1个月、3个月后症状体征变化(裂隙灯下检查睑缘清洁程度情况、睑板腺开口异常情况及结膜充血情况)以及蠕形螨光学显微镜检查计数情况并进行统计学分析。结果:治疗前,两组患者症状体征程度接近,差异无统计学意义(P>0.05)。治疗1月、3月时两组症状体征总分逐渐下降,B组下降较多,两组与治疗前比较,差异均有统计学意义(P均<0.05);治疗3月时,两组间评分比较差异有统计学意义(P<0.05)。治疗3月时B组有效率达84.2%,A组有效率42.1%,差异有统计学意义(P<0.05)。治疗3月,两组蠕形螨计数均较治疗前明显下降,差异有统计学意义(P均<0.05),两组间蠕形螨计数差异有统计学意义(P<0.05)。所有患者在治疗过程中未出现激素性高眼压、过敏反应、角结膜损伤等相关并发症。结论:多步骤连续物理治疗联合除螨抗炎治疗能够提高蠕形螨睑缘炎患者的治疗有效率,改善患者的症状和体征,可作为常规物理治疗方法与除螨抗炎相结合在临床推广应用。

Objective:To investigate the clinical effect of multistep continuous physiotherapy combined with anti-mite and anti-inflammation in the treatment of demodex blepharitis.Methods:The clinical data of 76 patients(152 eyes)with demodex blepharitis admitted from January 2018 to October 2020 were retrospectively analyzed.Patients were divided into groups A and B according to their different treatment methods.Group A was selected to complete physical mite removal and anti-inflammatory in the treatment at home by themselves(4-Turpentine alcohol wipes and Tobramycin dexamethasone eye cream).Group B was selected for the multistep continuous physiotherapy with the combination of anti-mite and anti-inflammation(4-Turpentine alcohol wipes and Tobramycin dexamethasone eye cream).Multistep continuous physiotherapy was conducted clinically.Patients were instructed to complete eyelid cleaning and anti-mite and anti-inflammatory at home.The symptoms and signs(under the slit lamp examination eyelid edge clean degree,meibomian gland abnormalities and conjunctival congestion situation)of the two groups were observed before and after treatment for 1 month and 3 months and the results of light microscope examination of demodex were recorded,and statistical analysis was performed.Results:Before the treatment,symptoms and signs of the two groups of patients were close,and there was no statistically significant difference(P>0.05).At the end of 1 month and 3 month,symptoms and signs scores decreased significantly in both groups,and the decrease was outstanding in group B.Compared with before treatment in both groups,the difference had statistical significance(P<0.05).After 3 months,scores comparison between the two groups was statistically significant(P<0.05).The effective treatment rate of group B was 84.2%,and that of group A was 42.1%,the difference was statistically significant(P<0.05).Treatment for 3 months,creep mite count in both groups was significantly decreased,the difference was statistically significant(P<0.05).The treating process shows no complications such as glucocorticoid-induced high intraocular pressure and allergic reactions.Conclusion:Multi-step continuous physical therapy combined with anti-mite and anti-inflammatory therapy can significantly improve the therapeutic efficiency of patients with demodex blepharitis and improve the patient's symptoms and signs,which can be used as a routine physical therapy.