他克莫司软膏联合口服中药治疗面部激素依赖性皮炎临床观察(1)
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[摘要]目的:评价单纯外用他克莫司软膏和外用他克莫司软膏联合口服中药治疗面部激素依赖性皮炎的临床疗效。方法:将60例患者随机分成单纯外用他克莫司软膏治疗组和外用他克莫司软膏联合口服中药治疗组,两组患者分别于治疗后进行临床疗效评估及治疗结束后进行4周随访观察。结果:4周治疗结束时,单纯西药治疗组的有效率为73.2%,中西药联合治疗组的有效率为93.3%,两组疗效差异有显著性(P<0.05)。结论:外用他克莫司软膏联合口服中药治疗面部激素依赖性皮炎优于单纯外用他克莫司软膏治疗。
[关键词]面部激素依赖性皮炎;中药;湿热毒蕴证;他克莫司软膏
[中图分类号]R286[文献标识码]A[文章编号]1008-6455(2010)08-1214-02
Cinical observation of topical Tacrolimus ointment therapy combination with oral Chinese medicine treatment in facial corticosteroid -dependent dermatitis
JIN Li,YANG Lan,WANG Ping
(Department of Dermatology,Beijing TCM Hospital,Capital Medical University,Beijing,100010,China)
Abstract: Objective To observe the clinical effectiveness of topical Tacrolimus ointment therapy combination with or without oral Chinese medicine treatment in facial corticosteroid -dependent dermatitis.MethodsSixty patients with facial corticosteroid -dependent dermatitis were randomly divided into topical Tacrolimus ointment therapy group and topical Tacrolimus ointment therapy combination with oral Chinese medicine treatment group. The patients in these two groups received continuous treatment for 4 weeks and follow-up for additional 4 weeks. ResultsTotal effective rate was 73.2% in topical Tacrolimus ointment therapy group, and was 93.3% in topical Tacrolimus ointment therapy combination with oral Chinese medicine treatment group. There was a significant differencebetween the two groups in the total effective rates(P<0.05).ConclusionsThe curative effect of the topical Tacrolimus ointment combined with oral Chinese medicine group is better than the topical Tacrolimus ointment group.
Key words:facial corticosteroid -dependent dermatitis;Chinese medicine;damp-heat brewing internally pattern;topical Tacrolimus ointment
面部激素依赖性皮炎是由于长期反复不规范地外用皮质类固醇激素引起的皮肤炎症,其特征是对激素的依赖。他克莫司是目前临床治疗特应性皮炎有效的外用免疫调节剂,可通过抑制T淋巴细胞而逆转激素外用导致的不良反应,有临床资料表明他克莫司在面部激素依赖性皮炎的治疗中取得了一定疗效[1-2]。我们通过外用他克莫司软膏联合口服中药治疗本病也取得了较为满意的效果,为了客观地评价外用他克莫司软膏联合口服中药治疗面部激素依赖性皮炎的临床疗效,我科于2007年4月～2010年4月完成了60例面部激素依赖性皮炎患者的随机临床观察,现将结果报道如下。
1临床资料和方法
1.1 入选标准:①临床上明确诊断为面部激素依赖性皮炎的患者;②年龄18～55岁,男女不限;③愿意接受他克莫司软膏治疗且能遵守治疗方案者;④口头知情同意。
1.2 排除标准:①对他克莫司及其赋形剂过敏;②患有脂溢性皮炎、痤疮等影响疗效观察者;③治疗中需要接受面部湿敷或外用激素制剂治疗者;④已系统使用过雷公藤制剂、激素或四环素类等药物,抗生素停药不足1个月者;⑤外用过激素、非甾体类抗炎药物,停药不足1周者;⑥有严重的心、肝、肾疾病者。
1.3 病例:入选患者符合下列西医临床诊断标准及中医辨证标准。西医临床诊断标准:①面部使用激素制剂>1个月;②停用激素后 2～10天原有皮损复发或加重;③主观症状有皮肤灼热、瘙痒、疼痛、干皱或紧胀感;④客观症状有毛细血管扩张、红斑或潮红、脱屑、丘疹、脓疱、色素沉着或表皮萎缩 ......
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