他克莫司软膏联合柔润保湿霜治疗成人特应性皮炎34例的疗效观察
发布时间：2018-07-29 21:19
【摘要】：背景:特应性皮炎是一种与遗传因素相关的慢性、炎症性皮肤病,特征为难耐的瘙痒感和反复发作的湿疹样病变。虽然它往往于婴儿期发病,发病率约为34%,也常常见于成年期起病。AD是一种非致命性,但对患者及亲属产生相当大心理负担的皮肤病,并且有增加患者哮喘、过敏性鼻炎和其他免疫介导的炎症性疾病的风险,甚至引起精神健康障碍。外用皮质类固醇类药物治疗仍然是急性发作治疗的一线用药,随着研究的推进,我们需要一种安全有效的治疗手段,近年来非激素类外用免疫调节剂如他克莫司成为了炎症性皮肤病的新型治疗方法。目前公认的AD是一种具有多种临床表现的终身性疾病,主要的病因为表皮屏障功能的缺陷,现今的预防及治疗主要在表皮屏障功能的恢复,最好的治疗手段为润肤剂的使用。综上所述,我们进行了两种药物联合治疗的临床研究。目的:评价他克莫司软膏联合柔润保湿霜治疗成人AD的疗效。实验方法:选取2015年1月至2016年12月来我科门诊就诊的成人AD患者,随机将其分为对照组和治疗组,每组34人,两组在年龄、性别、病程等资料方面比较,差异无统计学意义(P0.05)。治疗组患者早、晚间给予0.1%或0.03%他克莫司软膏涂于患处并轻揉,30min后将薇诺娜柔润保湿霜涂于患处。对照组早晚间在患处仅外用他克莫司软膏,两组均治疗3周。分别在患者初次(基线)和治疗后1、2、3周分析总体改善率、湿疹面积和严重度指数(EASI)评分、受累体表面积百分数(BSA%)、医生的总体评估(PGE),同时应用视觉模拟尺(VAS)对瘙痒程度进行评估。结果:治疗结束时,治疗组与对照组治疗第1、2、3周的有效率分别为29.41%(10/34)、58.82%(20/34)、85.29%(29/34)和20.59%(7/34)、44.12%(15/34)、64.71%(22/34)。PGE评分第1、2、3周分别达到32.35%(11/34)、64.71%(22/34)、88.24%(30/34)和20.59%(7/34)、47.06%(16/34)、70.59%(24/34),EASI经治疗3周后治疗组和对照组评分分别由21.24和20.91减为为5.59和7.88。BSA%经治疗3周后治疗组和对照组分别由32.29%和32.82%减为9.47%和15.11%。疗程结束时,治疗组治疗成功率高达85.29%,其中有35.29%的患者达到痊愈,所观察的两组病例中未发现变差的病例。通过VAS对患者瘙痒程度进行评估,显示治疗3周后治疗组和对照组的评分分别由5.29和5.03下降为2.03和3.94。两组使用他克莫司的药物相关性不良反应发生率分别为8.82%和20.59%,主要表现为皮肤灼热、瘙痒加重或刺痛等局部刺激反应,多为轻到中度,无需特殊处置和停用药物,可逐渐自行缓解。结论:他克莫司联合薇诺娜柔润保湿霜治疗AD患者,两者发挥协同作用,疗效明确,优于单用他克莫司治疗AD患者,不良反应少。随治疗时间延长,治疗效果随之增加。
[Abstract]:Background: atopic dermatitis is a chronic inflammatory dermatosis associated with genetic factors characterized by intolerable itching and recurrent eczema-like lesions. Although it often occurs in infancy, with an incidence rate of about 34 and is often found in adult onset. AD is a non-fatal skin disease that imposes a considerable psychological burden on patients and relatives, and increases asthma in patients. Allergic rhinitis and other immune-mediated inflammatory diseases may even cause mental health disorders. Topical corticosteroid therapy is still the first line of treatment for acute seizures, and with the advance of research, we need a safe and effective treatment. In recent years, non-hormone topical immunomodulators such as tacrolimus have become a new treatment for inflammatory dermatosis. At present, AD is a life-long disease with many clinical manifestations. The main cause is the defect of epidermal barrier function. Nowadays, the prevention and treatment is mainly in the recovery of epidermal barrier function, the best treatment is the use of emollients. To sum up, we conducted a clinical study of two drug combinations. Objective: to evaluate the efficacy of tacrolimus ointment combined with Ruorun moisturizing cream in the treatment of adult AD. Methods: adult AD patients from January 2015 to December 2016 were randomly divided into control group and treatment group with 34 persons in each group. There was no significant difference in age, sex and course of disease between the two groups (P0.05). In the treatment group, 0.1% or 0.03% tacrolimus ointment was applied to the affected area in the morning and evening and gently rubbed for 30 minutes. The control group was treated with tacrolimus ointment for 3 weeks. The overall improvement rate, (EASI) score of eczema area and severity index, the percentage of affected body surface area (BSA%), the total evaluation of (PGE), and the degree of pruritus were evaluated by visual analog scale (VAS) at the first (baseline) and 1: 2 weeks after treatment. Results: at the end of the treatment, 娌荤枟缁勪笌瀵圭収缁勬不鐤楃1,2,3鍛ㄧ殑鏈夋晥鐜囧垎鍒负29.41%(10/34),58.82%(20/34),85.29%(29/34)鍜，
本文编号：2154054
[Abstract]:Background: atopic dermatitis is a chronic inflammatory dermatosis associated with genetic factors characterized by intolerable itching and recurrent eczema-like lesions. Although it often occurs in infancy, with an incidence rate of about 34 and is often found in adult onset. AD is a non-fatal skin disease that imposes a considerable psychological burden on patients and relatives, and increases asthma in patients. Allergic rhinitis and other immune-mediated inflammatory diseases may even cause mental health disorders. Topical corticosteroid therapy is still the first line of treatment for acute seizures, and with the advance of research, we need a safe and effective treatment. In recent years, non-hormone topical immunomodulators such as tacrolimus have become a new treatment for inflammatory dermatosis. At present, AD is a life-long disease with many clinical manifestations. The main cause is the defect of epidermal barrier function. Nowadays, the prevention and treatment is mainly in the recovery of epidermal barrier function, the best treatment is the use of emollients. To sum up, we conducted a clinical study of two drug combinations. Objective: to evaluate the efficacy of tacrolimus ointment combined with Ruorun moisturizing cream in the treatment of adult AD. Methods: adult AD patients from January 2015 to December 2016 were randomly divided into control group and treatment group with 34 persons in each group. There was no significant difference in age, sex and course of disease between the two groups (P0.05). In the treatment group, 0.1% or 0.03% tacrolimus ointment was applied to the affected area in the morning and evening and gently rubbed for 30 minutes. The control group was treated with tacrolimus ointment for 3 weeks. The overall improvement rate, (EASI) score of eczema area and severity index, the percentage of affected body surface area (BSA%), the total evaluation of (PGE), and the degree of pruritus were evaluated by visual analog scale (VAS) at the first (baseline) and 1: 2 weeks after treatment. Results: at the end of the treatment, 娌荤枟缁勪笌瀵圭収缁勬不鐤楃1,2,3鍛ㄧ殑鏈夋晥鐜囧垎鍒负29.41%(10/34),58.82%(20/34),85.29%(29/34)鍜，
本文编号：2154054
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