0．1％他克莫司软膏不同疗程治疗面部糖皮质激素依赖性皮炎的临床观察  

Different courses of topical tacrolimus 0.1% ointment for facial corticosteroid-dependent dermatitis： aclinical observation

作　　者：徐贤挺[1] 林小敏[1] 许洁[1] 金永真[1] 李秉煦[2] 

机构地区：[1]温州市第二人民医院皮肤科,温州325000 [2]温州医学院附属第一医院皮肤科

出　　处：《中华皮肤科杂志》2011年第12期885-887,共3页Chinese Journal of Dermatology

摘　　要：目的观察0．1％他克莫司软膏不同疗程治疗面部糖皮质激素依赖性皮炎的临床疗效、安全性以及治疗结束后的病情反跳情况。方法将104例面部糖皮质激素依赖性皮炎患者随机分为3组，均给予0．1％他克莫司软膏外涂，每日2次，疗程分别为4周、8周、16周，比较3组的疗效。疗程结束后4周随访比较3组的反跳情况。结果共90例患者完成临床研究，其中疗程4周组32例、疗程8周组29例、疗程16周组29例，总有效率分别为75．00％、82．76％及86．21％，3组间有效率差异元统计学意义。3组的反跳率分别为46．88％、41．38％及20．69％，疗程16周组与疗程4周组、疗程8周组比较，差异均有统计学意义；疗程4周组与疗程8周组比较，差异无统计学意义。31．73％患者局部有刺激反应，均发生在治疗第1周。结论0．1％他克莫司软膏治疗面部糖皮质激素依赖性皮炎安全、有效，疗程延长，总有效率上升不明显，疗程4周即能获得明显而稳定的疗效。但疗程越长，治疗结束后的反跳率越低。Objective To evaluate the clinical efficacy and safety of different courses of topical tacrolimus 0.1% ointment in facial corticosteroid-dependent dermatitis and to observe the rebound in patients after treatment with these regimens. Methods A total of 104 patients with facial corticosteroid-dependent dermatitis were randomly divided into 3 groups to be treated with topical tacrolimus 0.1% ointment twice daily for 4, 8 and 16 weeks respectively. The patients were followed up every 2 weeks within the early 4 weeks of treatment and every 4 weeks thereafter. The rebound phenomena was observed in patients on week 4 after the withdrawal of tacrolimus. Results Finally, 90 patients completed this trial, including 32 patients in the 4- week group, 29 patients in the 8-week group and 29 patients in the 16-week group. No significant differences were observed between the 4-, 8- and 16-week groups in the total reponse rate （75.00%, 82.76%, 86.21%, respectively, X~ =1.35, P 〉 0.05）. The rebound rate in the 16-week group significantly differed from that in the 4- and 8-week group （20.69% vs. 46.88% and 41.38%, both P 〈 0.05）, while no statistical difference was noted between the 4- and 8-week groups. Local burning and itching were reported in 31.73% of these patients, and all of these irritant reactions occurred within the first week of treatment. Conclusions Topical tacrolimus 0.1% ointment is safe and effective for the treatment of facial corticosteroid-dependent dermatitis. The total response rate does not increase with the extended treatment course, and 4 weeks of treatment is enough for the marked and stable improvement of facial corticosteroid-dependent dermatitis, but the rebound rate is likely to be reduced by extended treatment course.

关 键 词：面部糖皮质激素依赖性皮炎 他克莫司软膏 疗程延长 治疗 临床观察 临床疗效 病情反跳 统计学 

分 类 号：R758.2[医药卫生—皮肤病学与性病学]