痤疮发病机制及其药物治疗的研究进展

发布时间：2018-06-24 17:13

本文选题：痤疮 + 发病机制　；参考：《中国药房》2017年20期

【摘要】：目的:了解痤疮的发病机制及其药物治疗的研究进展,为其临床治疗提供参考。方法:查阅近年来国内外相关文献,就痤疮的发病机制及其药物治疗的研究进展进行归纳和总结。结果:痤疮的发病机制主要为雄激素分泌异常、痤疮丙酸杆菌的大量繁殖、炎症损害和免疫失常及毛囊皮脂腺导管角化异常等。痤疮的局部治疗药物中维A酸类药物与抗菌药物可联用于治疗轻、中度痤疮,其中全反式维A酸、阿达帕林与他扎罗汀是治疗轻度痤疮的首选药物,全反式维A酸常联合外用抗菌药物治疗中度痤疮,阿达帕林和克林霉素分别与过氧化苯甲酰联用、果酸参与的联合给药方案也用于治疗痤疮。口服治疗药物中维A酸类药物主要用于重度痤疮,第一代的异维A酸较第二代疗效更好,但均有致畸作用;口服抗菌药物适用于中、重度痤疮患者,多西环素与米诺环素是首选药物,米诺环素联用过氧化苯甲酰疗效好;大环内酯类抗菌药物口服后不良反应较多,故常作为外用药;口服激素类药物中的抗雄激素类药物用于女性患者,但长期使用会引发高胰岛素血症;螺内酯有潜在的安全问题,西咪替丁抗雄激素效果较弱,不作为治疗痤疮的常用药物;糖皮质激素类药物常用于暴发性痤疮或聚合性痤疮的治疗,使用剂量须严格控制。结论:痤疮的治疗应根据痤疮的发生原因和严重程度选择合理的用药方案,增加疗效并减少不良反应的发生,并注意药物相互作用,提高用药安全性。
[Abstract]:Objective: to study the pathogenesis of acne and its drug therapy, and to provide reference for its clinical treatment. Methods: to review the relevant literature at home and abroad in recent years, summarize and summarize the pathogenesis of acne and the research progress of drug therapy. Results: the main pathogenesis of acne was abnormal secretion of androgen, propionibacterium acnes, inflammatory damage and immune disorders, abnormal keratosis of hair follicle sebaceous gland, etc. In the local treatment of acne, retinoic acid and antimicrobial agents can be combined to treat mild and moderate acne, in which all-trans retinoic acid, Adaphalin and tazarotene are the first choice for the treatment of mild acne. All trans retinoic acid (ATRA) is often combined with antimicrobial agents in the treatment of moderate acne. Adapaline and clindamycin are combined with benzoyl peroxide respectively. Retinoic acid is mainly used in severe acne, the first generation of isotinic acid is better than the second generation, but all have teratogenic effect. Oral antimicrobial agents are suitable for moderate and severe acne patients. Doxycycline and minocycline are the first choice of drugs, minocycline combined with benzoyl peroxide has good efficacy, macrolides have more adverse reactions after oral administration, so they are often used as external drugs. The antiandrogen drugs used in oral hormone drugs are used in female patients, but long-term use will lead to hyperinsulinemia, spironolactone has potential safety problems, cimetidine androgen effect is weak, not as a commonly used drug for the treatment of acne. Glucocorticoids are often used in the treatment of fulminant acne or acne polymerization. The dosage of glucocorticoids should be strictly controlled. Conclusion: the treatment of acne should be based on the cause and severity of acne to choose a reasonable medication plan to increase the efficacy and reduce the occurrence of adverse reactions and to pay attention to drug interaction and improve the safety of drug use.
【作者单位】：福州总医院药学科;福建中医药大学药学院;厦门大学医学院;
【基金】：军队医疗机构制剂标准提高科研专项课题(No.14ZJZ17)
【分类号】：R758.733

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