加减五花汤改善面部糖皮质激素依赖性皮炎患者皮肤屏障功能的临床观察

作者	单位
陈书悦	浙江中医药大学附属杭州第三医院杭州310009
宋为民	浙江中医药大学附属杭州第三医院杭州310009
杜晓航	浙江中医药大学附属杭州第三医院杭州310009
韩长元	浙江中医药大学附属杭州第三医院杭州310009
许爱娥	浙江中医药大学附属杭州第三医院杭州310009

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中文摘要:

目的研究加减五花汤治疗面部糖皮质激素依赖性皮炎的临床疗效及对面部皮肤屏障功能的改善作用。方法75例患者随机分为治疗组38例和对照组37例。治疗组口服加减五花汤和左西替利嗪片;对照组单用相同剂量的左西替利嗪片;30天为1个疗程。测定两组治疗前、中、后皮肤红斑量、经皮水分丢失量(TEWL)。结果治疗组失访5例,对照组失访7例。30天时治疗组总有效率为69.7%(23/33例),客观症状评分(分)由治疗前的5.48±1.60降至治疗后的1.24±1.62,主观症状评分(分)由治疗前的7.06±1.54降低至治疗后的1.55±1.72,对照组总有效率为10.0%(3/30例),客观及主观症状评分(分)分别由治疗前的5.57±1.25、6.77±1.36降至治疗后的3.27±1.55和3.07±1.36;治疗组疗效显著优于对照组(P<0.01)。治疗组治疗后皮肤红斑量均显著降低(P<0.05),而对照组该指标下降不明显。治疗组TEWL在治疗15天时即有降低;30天时两组该数值均降低,而治疗组下降更明显(P<0.05)。结论加减五花汤治疗面部糖皮质激素依赖性皮炎具有较明显的临床疗效,可降低皮肤红斑量,修复受损的皮肤屏障功能。

英文摘要:

ObjectiveTo observe the clinical efficacy of modified Wuhua Decoction(WHD) on corticosteroid addictive dermatitis(CsAD) and in improving patients′ facial skin barrier function.MethodsSeventy-five patients were randomly assigned to two groups,the 38 in the treated group treated with WHD together with oral administration of levocetirizine tablet,while the 37 in the control group treated with levocetirizine tablet alone in the same way,30 days as a course.Skin erythema dose(ED) and transepidermal water loss(TEWL) of patients were measured before and after treatment.ResultsFive cases in the treated group and 7 cases in the control group were dropped out.The total effective rate was 69.7%(23/33 cases) in the treated group and 10.0%(3/30 cases) in the control group respectively,with the score of objective symptoms reduced from 5.48±1.60 before treatment to 1.24±1.62 after treatment and the score of subjective symptoms reduced from 7.06±1.54 to 1.55±1.72 in the treated group,while in the control group,the two indexes reduced from 5.57±1.25 to 3.27±1.55 and from 6.77±1.36 to 3.07±1.36 respectively,showing significant difference between the two groups and the efficacy in the treated group was better than that in the control group(P<0.01).Skin ED decreased significantly in the treated group after treatment,and insignificantly in the control group.TEWL began to decrease on the 15th day in the treated group,while it was unchanged in the control group;on the 30th day,although a decrease was shown in both groups,its reduction was lower in the treated group(P<0.05).ConclusionWHD has significant clinical efficacy on CsAD,it could reduce the skin ED and quickly recover the injured facial skin barrier function.

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