卡泊三醇联合保湿润肤剂对寻常性银屑病皮肤屏障功能的影响

发布时间：2019-02-09 14:31

【摘要】：目的:探讨卡泊三醇联合含马齿苋的保湿润肤剂对寻常性银屑病的治疗作用及皮肤屏障功能的改善作用,寻找一种新的寻常性银屑病的联合治疗方案。方法:寻常性银屑病中度严重患者11例。采用自身对照设计,一侧躯体皮损单用卡泊三醇软膏每天早晚各1次;对侧皮损每晚外用卡泊三醇软膏1次,每天早晨外用含马齿苋的保湿润肤剂1次。均连续治疗4周。患者每2周随访1次作临床评分及自我评价,并于治疗第0、4周分别于两侧皮损取材,采用免疫组化和Western blot方法检测皮肤角蛋白(K)14、K17、丝聚合蛋白(filaggrin)、兜甲蛋白(loricrin)等屏障功能相关指标的变化。结果:第2周和第4周随访时,两组治疗方案患者的临床症状和自我评分差别无统计学意义,但卡泊三醇单用组患者的不良反应略高于联合用药组,主要表现为用药后皮肤的短暂刺激现象。皮肤屏障功能相关指标filaggrin和loricrin在寻常性银屑病患者皮损中的表达明显下调,而K14和K17表达增加,在治疗后均重新恢复,表明皮肤屏障功能在寻常性银屑病的发病机制中具有重要作用,并随临床治疗而好转。结论:卡泊三醇联合含马齿苋的保湿润肤剂能有效改善寻常性银屑病患者的临床症状和皮肤屏障功能,有助于减少药物的单用量,并缓解对皮肤的不良刺激等反应。
[Abstract]:Objective: to investigate the therapeutic effect of carpotriol combined with purslane moisturizer on psoriasis vulgaris and improve the function of skin barrier, and to find a new combined therapy for psoriasis vulgaris. Methods: 11 patients with moderate severe psoriasis vulgaris. In the self-control design, carpotriol ointment was used only once a day in one side of body skin lesions, and that of carpotriol ointment was used externally once a night in contralateral skin lesions, and wetting emollient containing Portulaca oleracea was used once a day in the morning. All patients were treated continuously for 4 weeks. The patients were followed up once every 2 weeks for clinical evaluation and self-evaluation. Skin keratin (K) 14 K17 and silk polymerin (filaggrin), were detected by immunohistochemical and Western blot methods respectively at the 4th week of treatment. Changes of barrier function related indexes such as (loricrin). Results: at the 2nd and 4th week follow-up, there was no significant difference in the clinical symptoms and self-scores between the two groups, but the adverse reactions in the carpotriol alone group were slightly higher than those in the combined treatment group. The main manifestation is the temporary irritation of the skin after medication. The expression of filaggrin and loricrin in psoriasis vulgaris was down-regulated, while the expression of K14 and K17 was increased and recovered after treatment. The results suggest that the skin barrier function plays an important role in the pathogenesis of psoriasis vulgaris and improves with clinical treatment. Conclusion: carpotriol combined with purslane moisturizer can effectively improve the clinical symptoms and skin barrier function of patients with psoriasis vulgaris. It is helpful to reduce the dosage of drugs and relieve the adverse skin irritation and other reactions.
【作者单位】：重庆医科大学附属第一医院皮肤性病科;
【基金】：重庆市卫生局医学科学基金(2010-2-014)资助项目
【分类号】：R758.63

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