中华皮肤科杂志
中華皮膚科雜誌
중화피부과잡지
Chinese Journal of Dermatology
2013年
7期
466-469
,共4页
皮炎,特应性%皮肤屏障%水杨酸%氟米松
皮炎,特應性%皮膚屏障%水楊痠%氟米鬆
피염,특응성%피부병장%수양산%불미송
Dermatitis,atopic%Skin barrier%Salicylic acid%Flumethasone
目的 探讨水杨酸对皮肤屏障功能的影响及其联合氟米松软膏治疗特应性皮炎的疗效.方法 特应性皮炎患者64例,选择躯体两侧大小及严重程度相似的皮损,分别外用复方氟米松软膏(0.02％氟米松+3％水杨酸)、0.02％氟米松软膏、3％水杨酸软膏及基质软膏；选择患者躯体两侧非皮损区皮肤,分别外用3％水杨酸软膏及基质软膏.均为每日2次,连用3周.使用皮肤生理测试仪检测治疗前及治疗开始后第1、2、3周的经表皮水分丢失量(TEWL),观察治疗前后症状、体征总积分,判断疗效.30例健康人为对照组,选择双前臂屈侧健康皮肤,外用水杨酸及基质软膏,每日2次,连用3周,于用药前、用药后1、3周检测TEWL.结果 健康人皮肤用药前及用药后1、3周,各组TEWL比较,差异无统计学意义.特应性皮炎患者皮损区TEWL在第0、1、2、3周,复方氟米松组分别为(34.26±20.82)、(22.38±16.16)、(17.04±12.74)、(15.34±13.13)g·m-2·h-1,氟米松组分别为(33.02±16.71)、(24.63±17.08)、(20.37±9.53)、(19.06±9.17) g·m-2·h-1,水杨酸组分别为(34.16±18.03)、(26.49±8.59)、(21.91±8.46)、(21.20±9.38) g·m-2·h-1,基质组分别为(33.81±17.11)、(29.80±12.48)、(26.16±8.31)、(25.52±6.05)g·m-2·h-1；治疗前(0周)各组TEWL差异无统计学意义；治疗后各组TEWL下降值经重复测量数据方差分析,差异有统计学意义(F=39.57,P＜0.01)；随机单位组设计资料方差分析显示,治疗1、2、3周后TEWL下降值复方氟米松组均显著高于氟米松组(P＜0.05),水杨酸组显著高于基质组(P＜0.05或P＜0.01),水杨酸组与氟米松组比较,差异无统计学意义.特应性皮炎患者非皮损区TEWL,水杨酸组在第2、3周下降幅度显著高于基质组(P＜0.05).复方氟米松软膏组基愈率(53.1％)及有效率(84.4％)均高于氟米松组(分别为34.4％和64.1％),两组比较,基愈率χ2=4.57,P＜0.05；有效率r=6.90,P＜0.01.结论 3％水杨酸软膏对特应性皮炎患者皮肤屏障功能的损伤具有修复作用,复方氟米松软膏治疗特应性皮炎的疗效优于氟米松软膏.
目的 探討水楊痠對皮膚屏障功能的影響及其聯閤氟米鬆軟膏治療特應性皮炎的療效.方法 特應性皮炎患者64例,選擇軀體兩側大小及嚴重程度相似的皮損,分彆外用複方氟米鬆軟膏(0.02％氟米鬆+3％水楊痠)、0.02％氟米鬆軟膏、3％水楊痠軟膏及基質軟膏；選擇患者軀體兩側非皮損區皮膚,分彆外用3％水楊痠軟膏及基質軟膏.均為每日2次,連用3週.使用皮膚生理測試儀檢測治療前及治療開始後第1、2、3週的經錶皮水分丟失量(TEWL),觀察治療前後癥狀、體徵總積分,判斷療效.30例健康人為對照組,選擇雙前臂屈側健康皮膚,外用水楊痠及基質軟膏,每日2次,連用3週,于用藥前、用藥後1、3週檢測TEWL.結果 健康人皮膚用藥前及用藥後1、3週,各組TEWL比較,差異無統計學意義.特應性皮炎患者皮損區TEWL在第0、1、2、3週,複方氟米鬆組分彆為(34.26±20.82)、(22.38±16.16)、(17.04±12.74)、(15.34±13.13)g·m-2·h-1,氟米鬆組分彆為(33.02±16.71)、(24.63±17.08)、(20.37±9.53)、(19.06±9.17) g·m-2·h-1,水楊痠組分彆為(34.16±18.03)、(26.49±8.59)、(21.91±8.46)、(21.20±9.38) g·m-2·h-1,基質組分彆為(33.81±17.11)、(29.80±12.48)、(26.16±8.31)、(25.52±6.05)g·m-2·h-1；治療前(0週)各組TEWL差異無統計學意義；治療後各組TEWL下降值經重複測量數據方差分析,差異有統計學意義(F=39.57,P＜0.01)；隨機單位組設計資料方差分析顯示,治療1、2、3週後TEWL下降值複方氟米鬆組均顯著高于氟米鬆組(P＜0.05),水楊痠組顯著高于基質組(P＜0.05或P＜0.01),水楊痠組與氟米鬆組比較,差異無統計學意義.特應性皮炎患者非皮損區TEWL,水楊痠組在第2、3週下降幅度顯著高于基質組(P＜0.05).複方氟米鬆軟膏組基愈率(53.1％)及有效率(84.4％)均高于氟米鬆組(分彆為34.4％和64.1％),兩組比較,基愈率χ2=4.57,P＜0.05；有效率r=6.90,P＜0.01.結論 3％水楊痠軟膏對特應性皮炎患者皮膚屏障功能的損傷具有脩複作用,複方氟米鬆軟膏治療特應性皮炎的療效優于氟米鬆軟膏.
목적 탐토수양산대피부병장공능적영향급기연합불미송연고치료특응성피염적료효.방법 특응성피염환자64례,선택구체량측대소급엄중정도상사적피손,분별외용복방불미송연고(0.02％불미송+3％수양산)、0.02％불미송연고、3％수양산연고급기질연고；선택환자구체량측비피손구피부,분별외용3％수양산연고급기질연고.균위매일2차,련용3주.사용피부생리측시의검측치료전급치료개시후제1、2、3주적경표피수분주실량(TEWL),관찰치료전후증상、체정총적분,판단료효.30례건강인위대조조,선택쌍전비굴측건강피부,외용수양산급기질연고,매일2차,련용3주,우용약전、용약후1、3주검측TEWL.결과 건강인피부용약전급용약후1、3주,각조TEWL비교,차이무통계학의의.특응성피염환자피손구TEWL재제0、1、2、3주,복방불미송조분별위(34.26±20.82)、(22.38±16.16)、(17.04±12.74)、(15.34±13.13)g·m-2·h-1,불미송조분별위(33.02±16.71)、(24.63±17.08)、(20.37±9.53)、(19.06±9.17) g·m-2·h-1,수양산조분별위(34.16±18.03)、(26.49±8.59)、(21.91±8.46)、(21.20±9.38) g·m-2·h-1,기질조분별위(33.81±17.11)、(29.80±12.48)、(26.16±8.31)、(25.52±6.05)g·m-2·h-1；치료전(0주)각조TEWL차이무통계학의의；치료후각조TEWL하강치경중복측량수거방차분석,차이유통계학의의(F=39.57,P＜0.01)；수궤단위조설계자료방차분석현시,치료1、2、3주후TEWL하강치복방불미송조균현저고우불미송조(P＜0.05),수양산조현저고우기질조(P＜0.05혹P＜0.01),수양산조여불미송조비교,차이무통계학의의.특응성피염환자비피손구TEWL,수양산조재제2、3주하강폭도현저고우기질조(P＜0.05).복방불미송연고조기유솔(53.1％)급유효솔(84.4％)균고우불미송조(분별위34.4％화64.1％),량조비교,기유솔χ2=4.57,P＜0.05；유효솔r=6.90,P＜0.01.결론 3％수양산연고대특응성피염환자피부병장공능적손상구유수복작용,복방불미송연고치료특응성피염적료효우우불미송연고.
Objective To evaluate the effect of salicylic acid on skin barrier function and the efficacy of salicylic acid combined with flumetasone ointment for the treatment of atopic dermatitis (AD).Methods Sixtyfour patients with AD (including 31 males and 33 females) aged 18 to 58 years were recruited into the present study.Four lesional areas of similar size and severity were selected at the similar body sites of both sides of each patient,and randomly classified into four groups to be topically treated with compound flumetasone ointment (containing 0.02％ flumetasone and 3％ salicylic acid,compound flumetasone group),flumetasone 0.02％ ointment (flumetasone group),salicylic acid 3％ ointment (salicylic acid group) and vehicle (control group),respectively;two normal skin areas were chosen from apparently normal skin on the similar body sites of both sides of each patient and topically treated with salicylic acid 3％ ointment (salicylic acid group) and vehicle (control group) respectively.All of these preparations were applied twice a day for 3 weeks.Transepidermal water loss (TEWL) was measured by a Tewameter MPA580 (Courage & Khazaka,Germany) at the baseline as well as on week 1,2 and 3 after initiation of treatment.Symptom and sign scores were evaluated before and after the treatment.Meanwhile,two normal skin areas were selected on bilateral forearm of 30 healthy controls and treated with 3％ salicylic acid ointment (salicylic acid group) and vehicle (control group) respectively twice a day for 3 weeks,and TEWL was measured before treatment as well as on week 1 and 3 after initiation of treatment.Results In the healthy controls,TEWL value showed no significant difference between the salicylic acid group and control group at any of these time points.As far as the lesional skin was concerned,no statistical difference was observed in TEWL value at the baseline between the four groups ((34.26 ± 20.82) vs.(33.02 ±16.71) vs.(34.16 ± 18.03) vs.(33.81 ± 17.11) g· m-2· h-1,P ＞ 0.05),but significant difference was noted after treatment (repeated measurement data analysis of variance,F =39.57,P ＜0.01),with the TEWL value being (22.38 ± 16.16),(17.04 ± 12.74),and (15.34 ± 13.13) g·m-2·h-1 respectively in the compound flumetasone group on week 1,2 and 3,(24.63 ± 17.08),(20.37 ± 9.53),(19.06 ± 9.17) g·m-2·h-1 respectively in the flumetasone group,(26.49 ± 8.59),(21.91 ± 8.46),(21.20 ± 9.38) g·m-2·h-1 respectively in the salicylic acid group,and (29.80 ± 12.48),(26.16 ± 8.31),(25.52 ± 6.05) g·m-2·h-1 respectively in the control group.In detail,the decrease in TEWL value was stronger in the compound flumetasone group than in the flumetasone group on week 1,2,and 3 (all P ＜0.05),in the salicylic acid group than in the control group (P ＜0.05 or 0.01),but similar between the flumetasone group and salicylic acid group.In non-lesional skin,the salicylic acid group showed a more intense decrease in TEWL value compared with the control group on week 2 and 3 (both P ＜0.05).Both the cure rate and response rate were significantly higher in the compound flumetasone group than in the flumetasone group (53.1％ vs.34.4％,x2 =4.57,P＜0.05;83.1％ vs.64.1％,x2 =6.90,P＜0.01).Conclusions The salicylic acid 3％ ointment shows a reparative effect on skin barrier in patients with AD,and the compound flumetasone ointment is superior to the flumetasone ointment in the treatment of AD.
