透明质酸修护生物膜辅助治疗干燥性湿疹的多中心对照研究  

Adjuvant therapy of xerotic eczema with a hyaluronan-containing emulsion： a multicenter controlled study

作　　者：刘付华[1] 施为[2] 乌日娜[3] 李福秋[4] 王刚[5] 吴艳[6] 顾华[1] 涂颖[1] 刘海洋[1] 孙立[3] 张冲[2] 王冰[4] 吕莎[4] 俞晨[5] 何黎[1] 

机构地区：[1]昆明医科大学第一附属医院皮肤科、云南省皮肤病性病研究所,650032 [2]中南大学湘雅医院皮肤科 [3]内蒙古医科大学附属医院皮肤科 [4]第四军医大学西京皮肤医院 [5]北京大学第一医院皮肤科 [6]中国科学院昆明植物所

出　　处：《中华皮肤科杂志》2013年第6期433-436,共4页Chinese Journal of Dermatology

基　　金：云南省省院省校合作基金（2009AD013）

摘　　要：目的探讨透明质酸修护生物膜辅助治疗干燥性湿疹的结果。方法5家医院82例干燥性湿疹分为试验组和对照组。试验组外搽糠酸莫米松乳膏和透明质酸修护生物膜，对照组仅外搽糠酸莫米松乳膏，每天2次，14d后停用糠酸莫米松乳膏，试验组继续外搽透明质酸修护生物膜，分别于首诊、治疗后7、14、28、42、56d随访。比较两组皮损SCORAD评分、总改善率、受试者自评、复发率、经皮水分丢失（TEwL）值及角质层含水量。结果①试验组比对照组皮损SCORAD评分显著改善，42d时SCORAD评分，试验组（4．42±2．64）、对照组（6．03±4．02），56d时试验组（3．49±2．78），对照组（6．06±4．28），两组比较，差异有统计学意义（P均〈0．05）；②试验组改善率高于对照组，停用糠酸莫米松乳膏后，试验观察56d时，差异有统计学意义（均P〈0．05）；③停用糠酸莫米松乳膏后，观察28、42、56d时试验组均无复发，对照组复发率分别为11.4％、11．4％、20％，两组比较，差异有统计学意义（均P〈0．05）；④试验组TEWL下降低于对照组，56d时，试验组TEWL（10．35±2．02）与对照组TEWL（17．28±4．06）比较，差异有统计学意义（P〈0．05）；试验组角质层含水量高于对照组，42d时试验组角质层含水量（29．10±5．39）、对照组（23．12±4．76），56d时，试验组角质层含水量（31．79±4．09）、对照组（22．87±4．85），两组比较，差异有统计学意义（均P〈0．05）。试验组未发生不良反应。结论透明质酸修护生物膜可以辅助治疗干燥性湿疹，降低复发率，促进皮肤屏障功能的恢复，安全性高。Objective To evaluate the therapeutic effect of a hyaluronan-containing emulsion on xerotic eczema. Methods A multicenter, randomized, open study was carried out. Eighty-two patients with xerotic eczema were divided into two groups： experimental group topically treated with a hyaluronan-eontaining emulsion combined with mometasone furoate cream, control group topically treated with mometasone furoate cream only. Both drugs were applied twice a day for 14 days. Patients were evaluated at the baseline, and at 7, 14, 28, 42 and 56 days after the initiation of treatment. Treatment outcomes included SCORAD score, transepidermal water loss （TEWL） value, water content of the stratum corneum, total response rate, patient＇s self-evaluation and recurrence rate. Results The SCORAD score was 4.42 ± 2.64 on day 42 and 3.49± 2.78 on day 56 in the experimental group, significantly lower than that in the control group （6.03 ± 4.02 on day 42 and 6.06 ± 4.28 on day 56, both P 〈 0.05）. The total response rate in the experimental group was statistically different from that in the control group on day 56 （P 〈 0.05）. Follow up on day 28, 42 and 56 revealed significant differences in the recurrence rate between the control group and the experimental group （11.4% vs. 0, 11.4% vs. 0, 20% vs. 0, all P 〈 0.05）. Reduced TEWL was observed on day 56 （10.35 ± 2.02 vs. 17.28 ± 4.06, P 〈 0.05）, while elevated water content of stratum corneum was noted on day 42 （29.10 ± 5.39 vs. 23.12 ± 4.76, P〈 0.05） and day 56 （31.79± 4.09 vs. 22.87 ± 4.85, P〈 0.05） in the experimental group compared with the control group. No adverse reactions occurred in the experimental group. Conclusions Topical application of the hyaluronan-eontaining emulsion can restore epidermal harrier function, reduce the recurrence of xerotic eczema, and may serve as a safe adjuvant therapy for xerotic eczema.

关 键 词：透明质酸 辅助治疗 多中心对照研究 生物膜 干燥性 修护 湿疹 糠酸莫米松乳膏 

分 类 号：R758.23[医药卫生—皮肤病学与性病学]