观察不同频次睑缘深度清洁联合4松油醇湿巾治疗蠕形螨睑缘炎临床效果

The Clinical Effects of Eyelid Margin Deep Cleaning with Different Frequencies Combined with Terpinen-4-ol Eye Wipes in Treating Demodex Blepharitis

摘要: 目的：观察不同频次睑缘深度清洁联合4松油醇湿巾治疗蠕形螨睑缘炎临床效果。方法：前瞻性随机对照临床研究。收集2022年3月至2022年9月临床诊断为眼蠕形螨感染睑缘炎患者42例(84眼)，按照连续就诊顺序随机分为研究组与对照组各21例(42眼)。研究组给予每周1次睑缘深度清洁(连续4次)联合4松油醇湿巾(每日2次涂擦睑缘)；对照组给予两周1次睑缘深度清洁(连续2次)联合4松油醇湿巾(每日2次涂擦睑缘)。在治疗前与治疗1月后对所有研究对象的主观症状、眼表疾病指数、眼部蠕形螨计数、睑缘清洁程度、睑缘体征、泪膜破裂时间、角膜荧光素染色、泪河高度、眼红指数、睑板腺红外线照相检查进行评分，观察两组治疗效果。结果：与治疗前相比，两组治疗1月后蠕形螨数量均下降明显，睑缘体征均有改变，睑缘清洁程度均有改善，眼表疾病指数评分显著下降，差异均有统计学意义(P < 0.001)；两组之间比较，研究组蠕形螨数量减少程度及眼表疾病指数评分下降程度，与对照组相比，差异有统计学意义(P < 0.001)。其他检测指标，两组之间有差异，但没有统计学意义。所有患者治疗过程中未出现过敏反应、接触性皮炎、角结膜损伤等相关并发症。结论：不同频次睑缘深度清洁联合4松油醇湿巾治疗蠕形螨睑缘炎均有效改善患者症状和体征，临床治疗安全有效。其次，一周一次深度清洁联合4松油醇湿巾在控制螨虫数量及患者症状体征改善程度上优于两周一次频率治疗方法。

Abstract: Objective: To evaluate the clinical effects of eyelid margin deep cleaning with different frequencies combined with terpinen-4-ol eye wipes in treating demodex blepharitis. Methods: This was a pro-spective, randomized, controlled study. A total of 42 patients (84 eyes) diagnosed with demodex blepharitis were recruited between March 2022 and September 2022, and the patients were ran-domised assigned to the treatment group and control group (21 patients, 42 eyes for each group). The treatment group received eyelid margin cleaning using Deep Cleaning Device once a week, four times consequently, combined with terpinen-4-ol eye wipes (clean the eyelid margin twice a day); The control group received eyelid margin cleaning using Deep Cleaning Device once every two weeks, four times consequently, combined with terpinen-4-ol eye wipes (clean the eyelid mar-gin twice a day). The following examinations were performed to evaluate the effects: Ocular sur-face disease index (OSDI), demodex mite counts, eyelid margin cleanness degree, eyelid margin abnormal score, tear film break-up time, corneal fluorescein staining, tear meniscus height, red-ness, meibography score. Results: One month after treatment, demodex mite counts in both groups decreased significantly, signs of eyelid margin abnormalities and eyelid margin cleanness degree improved significantly, the OSDI score decreased significantly (all P < 0.001). Demodex mite counts, and the OSDI score were lower in the study group (P < 0.001), the other signs were all improved after treatment, but there was no statistical difference between the study group and the control group. No obvious complications, such as allergic reaction, contact dermatitis, corneal and conjunc-tival injury, were observed in this study. Conclusion: Eyelid margin deep cleaning with different frequencies combined with terpinen-4-ol eye wipes can improve the symptoms and signs of de-modex blepharitis, which is a safe and effective method in treating demodex blepharitis. Eyelid margin deep cleaning once a week combined with terpinen-4-ol eye wipes was superior to twice a week in controlling the demodex counts and the patient’s discomfort symptoms.