伊曲康唑联合吡美莫司治疗头面部脂溢性皮炎的效果观察及其对皮肤生理参数和炎性因子水平的影响  

Curative effect of itraconazole in combination with pimecrolimus and its influence on the skin physiological parameters and inflammatory factors in patients with scalp and facial seborrheic dermatitis complicated with chaff spores infection

作　　者：吴娟[1] 叶俊儒[2] 陈力[1] 陈灿[1] 陈静[1] 

机构地区：[1]成都医学院第一附属医院药剂科,成都市610500 [2]成都医学院第一附属医院皮肤科,成都市610500

出　　处：《广西医学》2017年第1期48-51,共4页Guangxi Medical Journal

基　　金：四川省卫生和计划生育委员会2015年科研课题(150048)

摘　　要：目的观察伊曲康唑联合吡美莫司治疗头面部脂溢性皮炎伴糠孢子菌感染的疗效及其对皮肤生理参数和炎性因子水平的影响。方法将68例脂溢性皮炎伴糠孢子菌感染患者随机分为对照组和研究组,每组34例。对照组患者给予伊曲康唑胶囊口服,并外用2%酮康唑洗剂,疗程4周;研究组患者在对照组治疗的基础上加用1%吡美莫司乳膏外用,疗程4周。比较两组患者的临床疗效、皮肤生理参数和炎性因子水平的变化。结果研究组患者的有效率为88.24%,高于对照组的61.76%(P<0.05);研究组的真菌镜检阴性率高于对照组,复发率低于对照组(P<0.05);但两组患者不良反应发生率比较差异无统计学意义(P>0.05)。治疗前两组患者皮肤含水量、白介素-10、经表皮失水量、皮脂分泌率、γ-干扰素和肿瘤坏死因子-α水平差异均无统计学意义(P>0.05),治疗后,观察组上述指标优于对照组,差异有统计学意义(P<0.05)。两组患者治疗后皮质醇水平、p H值比较无差异(P>0.05)。结论伊曲康唑联合吡美莫司可显著提高头面部脂溢性皮炎伴糠孢子菌感染的治疗效果,增加皮肤含水量,降低油脂分泌和炎性因子水平。Objective To observe the curative effect of itraconazole in combination with pimeerolimus and its influence on the skin physiological parameters and inflammatory factors in patients with scalp and facial seborrheic dermatitis complicated with chaff spores infection. Methods A total of 68 cases of seborrheic dermatitis complicated with chaff spores infection were randomly divided into control group or observation group ,with 34 cases in each group. Patients in the control group were treated with 100 mg itraconazole twice a day, 2% ketoconazole lotion was used externally twice in one week, and the treatments lasted for 4 weeks. On the basis of these treatments, patients in the observation group were further treated with 1% pimecrolimus cream twice a day for a course of 4 weeks. Clinical effects, skin physiological parameters, and inflammatory factor levels were compared between the two groups. Results The effective rate was higher in the observation group than in the control group （88.24% vs. 61.76%, P 〈 0. 05）, moreover, the negative rate of fungal microscopic examination was higher, and the rate of relapse was lower in the observation group （ all P 〈 0.05 ）, with no significant difference in the incidence of adverse reactions between the two groups （ P 〉 0.05 ）. There was no statistical significant difference in skin moisture content, transepidermal water loss, sebum secretion rate,interleukin-10, interferon-5,, or tumor necrosis factor-α between the two groups before treatment, but after treatment, all these indexes improved in the observation group compared to the control （ all P 〈 0.05 ）, but no significant difference was found in the levels of cortisol or pH between the two groups （ P 〉 0.05 ）. Conclusion A strategy of itraconazole in combination with pimecrolimus can significantly improve its therapeutic effect, by increasing skin moisture and reducing the excretion of oily matter and inflammatory factors level in patients with head and facial seborrheic dermatitis complicated

关 键 词：脂溢性皮炎 伊曲康唑 吡美莫司 皮肤生理参数 炎性因予 

分 类 号：R758.73[医药卫生—皮肤病学与性病学]