目的 观察夫西地酸乳膏联合复方丙酸氯倍他索软膏治疗手足角化性湿疹的疗效。方法 选取解放军总医院第三医学中心2019-09至2021-06收治的手足角化性湿疹患者84例,随机分为对照组(42例)和观察组(42例)。对照组采用复方丙酸氯倍他索软膏,观察组在对照组的基础上联合夫西地酸乳膏,疗程4周。比较两组治疗前、4周后的瘙痒、湿疹面积及严重程度指数(EASI)、皮肤病生活质量指数(DLQI)评分,以及炎性因子白细胞介素-2 (IL-2)、IL-4、IL-5、肿瘤坏死因子-α(TNF-α)等。评价两组的疗效及用药安全性。结果 观察组治疗有效率为88.10%,高于对照组的71.43%(P＜0.05)。4周后,观察组的瘙痒评分[(1.12±0.26)分]、EASI评分[(3.25±0.77)分]、DLQI评分[(16.34±3.28)分]均低于对照组[分别为(1.44±0.38)分、(5.33±1.12)分、(18.78±3.67)分],差异均有统计学意义(P＜0.05);观察组的炎性因子IL-2、IL-4、IL-5及TNF-α也均低于对照组(P＜0.05)。两组不良反应发生率(9.52% vs. 4.76%)比较,差异无统计学意义。结论 夫西地酸乳膏联合复方丙酸氯倍他索软膏治疗手足角化性湿疹,可减轻过敏及炎性反应,明显缓解瘙痒,有效且安全。
Abstract
Objective To analyze the effect of fusidic acid ointment combined with compound clobetasol propionate ointment in the treatment of hand and foot keratotic eczema.Methods Eighty patients with hand-foot keratotic eczema admitted to the Third Medical Center of PLA General Hospital were randomly divided into a control group (42 cases) and an observation group (42 cases). The control group was treated with compound clobetasol propionate ointment, while the observation group was treated with fusidic acid ointment combined with compound clobetasol propionate ointment. The course of treatment lasted for 4 weeks. The pruritus, eczema area and severity index(EASI) ,dermatological quality of life scale (DLQI) scores, inflammatory factors IL-2、IL-4、IL-5 and TNF-αwere compared between the two groups before and after 4 weeks of treatment, and the efficacy and safety of the two groups were also evaluated.Results The effective rate of treatment in the observation group was 88.10%, which was higher than 71.43% in the control group (P<0.05). After 4 weeks, the observation group's pruritus scores[(1.12±0.26)], EASI scores[(3.25±0.77)]and DLQI scores[(16.34±3.28)]were all lower than those of the control group[respectively(1.44±0.38),(5.33±1.12) and(18.78±3.67)] (P<0.05). Inflammatory factors IL-2, IL-4, IL-5 and TNF-α in the observation group were also lower than those in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (9.52% vs. 4.76%).Conclusions Fusidic acid ointment combined with compound clobetasol propionate ointment in the treatment of hand and foot keratotic eczema, which can reduce allergy and inflammation and can also reduce itching significantly, is effective and safe.
关键词
手足角化性湿疹 /
夫西地酸乳膏 /
复方丙酸氯倍他索软膏
Key words
hand and foot keratotic eczema /
fusidic acid ointment /
compound clobetasol propionate ointment
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基金
首都临床诊疗技术研究及转化应用项目(Z211100002921047);北京市海淀区卫生健康发展科研培育计划(HP2021-50-80403)
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