目的：干眼是由多种因素引起的一种眼表慢性炎症性疾病，其中眼部螨虫感染是干眼症的一个重要的危险因素。本研究的目的是探究茶树精油对干眼症患者感染的螨虫治疗效果。方法：选取2017年1月至2020年1月就诊的干眼症合并螨虫感染患者为入组对象。在干眼症合并螨虫感染患者的眼部获取67只螨虫，并随机将其分为五组，置于载玻片上进行药物干预，分别为：第一组是碘伏组(Iodophor,n = 13只)，第二组是复方新洁尔灭(Cotrimoxazole,n = 12只)，第三组是醋酸氯已定组(Chlorhexidine Acetate,n =13只)，第四组是鱼腥草滴眼液组(Houttuynia cordata,n = 14只)，第五组是茶树精油组(Melaleuca Oil,n = 15只)。分别于15 min、30 min、1 h、2 h、3 h、4 h、6 h观察螨虫的存活时间。结果：从药物干预后15 min到6小时内，前四组中螨虫的存活状况变化不大。然而在茶树精油组，随时间的变化，螨虫存活情况大幅度减少，且在用药后15分钟即见效，用药后2小时螨虫的生存率降为0。且茶树精油对螨虫的杀灭效果与前四组之间存在显著的差异性，进而螨虫治疗中，一般性的药物起效作用时间应该至少1小时。结论：茶树精油对螨虫有良好的杀灭作用，普通的睑缘清洁(碘伏、复方新洁儿灭、醋酸氯已定、鱼腥草滴眼液)对眼部螨虫的杀灭作用弱于茶树精油。

Purpose:Dry eye is a chronic inflammatory disease of the eye surface caused by many factors,among which eye mite infection is an important risk factor for dry eye.The purpose of this study was to explore the effect of Melaleuca Oil on the treatment of mites in patients with dry :From January 2017 to January 2020,dry eye patients with mites infection were selected as the enrolled mites were collected from the eyes of patients with dry eye disease associated with mites infection,and randomly divided into five for the medical intervention on the slide,they were respectively:the first group was Iodophor (n = 13); the second group was Cotrimoxazole (n = 12); the third group was Chlorhexidine Acetate (n = 13); the fourth group wasHouttuynia cordata(n = 14); and the fifth group was Melaleuca Oil (n = 15).The survival time of mites was observed at 15 min,30 min,1 h,2 h,3 h,4 h and 6 h,:The survival status of mites in the first four groups did not change significantly from 15 min to 6 h after drug ,in the Melaleuca Oil group,the survival rate of mites was significantly reduced with the change of time,and the effect was immediately effective 15 minutes after the treatment,and the survival rate of mites at 2 hours after the treatment was reduced to 0.In addition,the killing effect of Melaleuca Oil on mites is significantly different from that of the first four ,in the treatment of mites,the effective time of generic drugs should be at least 1 :Melaleuca Oil has a good killing effect on mites,while common eyelid cleaning (Iodophor,Cotrimoxazole,Chlorhexidine Acetate,Houttuynia cordata)has a weaker killing effect on eye mites than Melaleuca Oil.

1.引言

干眼是由多种因素引起的一种眼表慢性炎症性疾病，其中睑板腺功能障碍引起的干眼在临床上非常常见[1]。眼部螨虫感染是干眼症的一个重要的危险因素[2]。

茶树精油(tea tree oil,TTO)是从澳大利亚新南威尔士州和昆士兰州的桃金娘科互叶白千层的新鲜枝叶中以水蒸馏的方式提取出来的一种无色至淡黄色液体，具有尖锐的樟脑气味和薄荷醇的清凉感[3]。有的研究指出茶树精油主要由醇类、单萜烯和其他一些化合物组成，99%以上的总油量基于此。这些成分共同组成了其强大抑菌除螨活性的物质基础[4]。螨虫是一种体型微小动物，它主要是寄生在人体之中，一共分为两种类型，包括皮脂蠕形螨和毛囊蠕形螨[5]。Tighe 等[6]研究发现茶树精油的有效成分松油烯醇-4，能杀灭螨虫，缓解睑缘、角结膜炎症状，改善泪膜稳定性。然而关于茶树精油对眼部螨虫的治疗效果的直接研究甚少。

因此本研究的目的是探究茶树精油对干眼症合并螨虫感染的治疗效果。

2.方法学

2.1.研究对象及伦理

选取2017年1月至2020年1月在深圳市眼科医院就诊的干眼症合并螨虫感染患者为入组对象。

纳入标准：年龄18～80 岁；诊断为干眼患者合并螨虫感染(伴有睑板腺开口阻塞 ≥ 1 级)；能够配合研究者；知情同意；干眼症状至少持续了12 个月并且泪膜破裂时间(TBUT)小于10 s，同时睑板腺开口阻塞必须大于等于1 级。

排除标准：年龄 ＞ 80 岁或者＜18 岁；严重眼表疾病史或者眼部炎症史(除了角结膜干燥症)；1年内眼部手术史；1 个月内眼部药物使用史(不包括无防腐剂的人工泪眼)；睑缘附近有开放性伤口者；3 个月内全身抗炎药物使用史。