1％吡美莫司乳膏治疗面部脂溢性皮炎和激素依赖性皮炎的疗程、疗效及其对皮肤屏障功能影响观察

发布时间：2018-02-01 06:35

本文关键词： 皮炎脂溢性激素依赖性疗程疗效吡美莫司皮肤屏障　出处：《复旦大学》2010年硕士论文　论文类型：学位论文

【摘要】： 研究背景面部脂溢性皮炎、激素依赖性皮炎是皮肤科门诊常见疾病,治疗尚缺乏有效的药物,病情往往容易反复或复发。考虑到面部脂溢性皮炎、激素依赖性皮炎的发病特点,我们需要一种安全、有效的治疗手段,近年非激素类外用免疫调节剂如吡美莫司成为了炎症性皮肤病的新型治疗方法。目前对于吡美莫司乳膏治疗面部脂溢性皮炎、激素依赖性皮炎国内外研究较少,没有公认的治疗方案,且无研究比较吡美莫司乳膏治疗面部脂溢性皮炎、激素依赖性皮炎在不同疗程下的疗效、直接停药或减量治疗的疗效、治疗前后皮肤屏障功能的变化。目的对1%吡美莫司乳膏治疗面部脂溢性皮炎、激素依赖性皮炎的治疗方案进行初探；观察1%吡美莫司乳膏治疗激素依赖性皮炎前后皮肤屏障功能变化。方法分别将脂溢性皮炎患者、激素依赖性皮炎患者随机分为三组比较：方案1：1%吡美莫司乳膏ext bid*2w+6101霜ext bid*2w;方案2：1%吡美莫司乳膏ext bid*2w+1％吡美莫司乳膏ext qd*2w；方案3：1%吡美莫司乳膏ext bid*4w。在患者初次就诊、2周后、4周后、6周后对其进行主观及客观症状严重程度评分及生活质量问卷调查。在激素依赖性皮炎患者中随机选取9人测试初次及治疗4周后左侧颧部TEWL值、pH值、角质层水分值。结果脂溢性皮炎三组病例经过不同的治疗方案,治疗4周时严重度临床评分皆明显下降。方案3组比方案1组、方案2组严重度临床评分减轻程度大。方案1组与方案2组比较减轻程度无统计学差异。停药随访期三组病例严重度评分变化程度无统计学差异。三组病例经过4周治疗生活质量都明显好转,但好转程度无明显差异。激素依赖性皮炎三组病例经过不同的治疗方案,治疗4周时严重度临床评分皆明显下降。方案2组、方案3组都比方案1组严重度临床评分减轻程度大；方案2组与方案3组严重度临床评分减轻程度无统计学差异；停止治疗后随访期三组严重度评分变化无统计学差异。三组病例治疗4周以后生活质量都明显好转,但好转程度无明显差异。结论 1%吡美莫司乳膏治疗面部脂溢性皮炎推荐1天使用2次,疗程4周,疗效较好；治疗激素依赖性皮炎推荐1天使用2次,使用2周后减量为1天使用1次,再使用2周,疗效较好；治疗激素依赖性皮炎4周后皮肤屏障功能有所好转。其中TEWL改善率更为明显。
[Abstract]:Research background Seborrheic dermatitis of face, hormone dependent dermatitis is a common disease in dermatology outpatient department, the treatment is still lack of effective medicine, the condition is often easy to repeat or relapse. Considering the seborrheic dermatitis of face. We need a safe and effective treatment for hormone dependent dermatitis. In recent years, non-hormone topical immunomodulators such as pimeimostids have become a new treatment for inflammatory dermatosis. At present, there is little research on corticosteroid dependent dermatitis in the treatment of seborrheic dermatitis. There is no accepted treatment, and there is no study comparing the efficacy of pimecrolimus cream in the treatment of facial seborrheic dermatitis, hormone dependent dermatitis under different courses of treatment, direct withdrawal or reduction. Changes of skin barrier function before and after treatment. Purpose A preliminary study on the treatment of 1% pimecrolimus cream for seborrheic dermatitis and hormone dependent dermatitis was made, and the changes of skin barrier function before and after treatment with 1% pimeimosine cream were observed. Method Patients with seborrheic dermatitis and patients with hormone dependent dermatitis were randomly divided into three groups: 1: 1: 1% pimecrolimus cream ext bid*2w 6101 cream ext bid for 2 weeks; Scheme 2: 1% pimecrolimus cream ext bid*2w 1% pimeimus cream ext QDX for 2 ws; Regimen 3: 1% pimecrolimus cream ext bid for 4 ws. 4 weeks after the first visit. After 6 weeks, subjective and objective symptom severity and quality of life (QOL) were investigated. Nine patients with hormone dependent dermatitis were randomly selected to test the TEWL value of left zygomatic region after initial and 4 weeks treatment. Ph value, cuticle water value. Results The clinical scores of seborrheic dermatitis in three groups were significantly decreased after 4 weeks of treatment. There was no significant difference in severity score between group 1 and group 2. There was no significant difference in severity score between group 1 and group 2. After 4 weeks treatment, the quality of life was obviously improved. But there was no significant difference in the degree of improvement. Three groups of patients with hormone dependent dermatitis were treated with different treatment plans, the severity of clinical scores were significantly decreased after 4 weeks of treatment. The severity of clinical score in group 3 was lower than that in group 1. There was no significant difference in the severity of clinical score between group 2 and group 3. There was no significant difference in severity scores among the three groups during the follow-up period after cessation of treatment, but the quality of life of the three groups improved significantly after 4 weeks of treatment, but there was no significant difference in the degree of improvement. Conclusion 1% pimecrolimus cream was recommended for treatment of seborrheic dermatitis of face twice a day for 4 weeks. The treatment of hormone dependent dermatitis is recommended to be used twice a day, 2 weeks later, once a day after 2 weeks use, and 2 weeks later, the curative effect is better. The skin barrier function was improved 4 weeks after treatment of hormone dependent dermatitis, and the improvement rate of TEWL was more obvious.
【学位授予单位】：复旦大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R758.2

【相似文献】