植物洗发剂治疗头皮脂溢性皮炎临床疗效观察

发布时间：2018-06-20 19:10

  本文选题：头皮脂溢性皮炎 + 白柳皮萃取精华　； 参考：《吉林大学》2017年硕士论文

【摘要】：背景头皮脂溢性皮炎是一种较常见的慢性炎症性皮肤病,病因及发病机制尚未完全清楚。研究发现与马拉色菌的定植感染、油脂分泌水平、机体免疫状态、年龄、气候条件等因素息息相关。抗真菌治疗是治疗头皮脂溢性皮炎的常用方法。Draelos ZD等,选取363例头皮脂溢性皮炎患者,予2%酮康唑洗发剂外用,每周2次,疗程1个月,患者临床症状均得到不同程度的改善,仅少数患者出现局部刺激症状,但均可耐受,证明酮康唑洗发剂疗效确切,可用来治疗头皮脂溢性皮炎,且安全性好,患者易于接受。硫氧吡啶锌亦是一种常用的抗真菌有效成分,于上世纪50年代被发现以来,含1%硫氧吡啶锌有效成分洗发剂,广泛用于治疗头皮脂溢性皮炎。由于硫氧吡啶锌具有抗真菌活性机制,且硫氧吡啶锌活性成分可在毛囊深部较长时间沉积和停留,故而起到持久、深部杀菌作用。研究表明:含2%酮康唑或1%硫氧吡啶锌有效抗菌成分的洗发剂疗效确切。近年来,随着我国中医中药的发展,人们对中草药抗真菌作用日益关注。Braga PC等报道白柳皮萃取精华、百里香花叶油对念珠菌有抑菌作用,但对马拉色菌是否有抑制作用未见文献报道。本文拟采用随机双盲对照试验观察含白柳皮萃取精华、百里香花叶油成分的植物洗发剂对头皮脂溢性皮炎的疗效,以便为临床应用提供依据。目的探讨植物洗发剂(含白柳皮萃取精华、百里香花叶油成分)治疗头皮脂溢性皮炎的临床疗效及其对皮损处分离的马拉色菌体外抗真菌活性。方法将自2015年10月-2016年3月,2016年10月-2016年12月就诊于吉林大学中日联谊医院皮肤科门诊,明确诊断为头皮脂溢性皮炎的90例患者随机分成3个治疗组,分别为含2%酮康唑组,含1%硫氧吡啶锌组,含白柳皮萃取精华、百里香花叶油有效成分的植物洗发剂组(以下简称植物洗发剂组),每组30例,所有患者均要求头皮接触洗发剂时间"g5分钟后冲净,适当按摩,每周3次,疗程4周。各组性别、年龄、临床严重程度评分均无统计学差异(P0.05)。于治疗前、治疗第2周、治疗第4周,由同一皮肤科医生评估临床严重程度、经皮水分丢失率、表皮含水量、p H值、油脂分泌水平等检测项目。将自头皮脂溢性皮炎患者分离、鉴定出的马拉色菌制作成含菌平板,37℃培养7天后测定各洗发剂的抑菌圈半径。结果植物洗发剂组临床疗效与含2%酮康唑、1%硫氧吡啶锌的洗发剂临床疗效相当,且未见局部及全身不良反应。3种洗发剂对3种马拉色菌均产生抑菌圈,以植物洗发剂组抑菌圈半径最大,差异有统计学意义(P0.05)。结论含白柳皮萃取精华、百里香花叶油等有效成分的植物洗发剂,疗效显著,安全性高,使用方便,抑菌效果好,可用于临床治疗头皮脂溢性皮炎。
[Abstract]:Background seborrheic dermatitis is a common chronic inflammatory dermatosis. It was found that Malassezia was closely related to colonization infection, lipid secretion level, immune status, age, climatic conditions and so on. Antifungal therapy is a common method for treating seborrheic dermatitis. Draelos ZD was used in 363 patients with seborrheic dermatitis. The patients were treated with 2% ketoconazole shampoo twice a week for one month. Only a few patients had local irritation symptoms, but were tolerable, which proved that ketoconazole shampoo was effective and safe in treating seborrheic dermatitis of scalp. Zinc thiopyridine is also a common antifungal active ingredient. Since its discovery in 1950s, 1% zinc thiopyridine shampoo has been widely used in the treatment of seborrheic dermatitis. Zinc thiopyridine has antifungal activity, and zinc thiopyridine can deposit and stay in the hair follicle for a long time, so it has a lasting and deep bactericidal effect. The results showed that the shampoo containing 2% ketoconazole or 1% zinc thiopyridine was effective. In recent years, with the development of traditional Chinese medicine in China, more and more attention has been paid to the antifungal effect of Chinese herbal medicine. Braga PC has reported that the extract of white willow peel and thyme mosaic oil have bacteriostatic effect on Candida. However, whether Malassezia has inhibitory effect has not been reported. In this paper, a randomized double-blind controlled trial was conducted to observe the therapeutic effect of plant shampoo containing extract of willow peel and thyme mosaic oil on seborrheic dermatitis of scalp in order to provide basis for clinical application. Objective to investigate the clinical efficacy of plant shampoo (including the extract of willow skin and thyme mosaic oil) in the treatment of seborrheic dermatitis and its antifungal activity against Malassezia isolated from skin lesions in vitro. Methods from October 2015 to March 2016, from October 2016 to December 2016, 90 patients with seborrheic dermatitis were randomly divided into 3 treatment groups, including 2% ketoconazole group. 1% thiopyridine zinc group, white willow skin extract, thyme mosaic oil active ingredient plant shampoo group (hereinafter referred to as plant shampoo group, 30 cases in each group), all patients required scalp contact shampoo time "g 5 minutes to rinse off," Massage 3 times a week for 4 weeks. There was no significant difference in gender, age and clinical severity score in all groups (P 0.05). Before treatment, 2 weeks and 4 weeks of treatment, the clinical severity, percutaneous water loss rate, skin moisture content and lipid secretion level were evaluated by the same dermatologist. Malassezia was isolated from patients with seborrheic dermatitis. The identified Malassezia was cultured at 37 鈩，

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