他克莫司联合高能窄谱红光治疗面部复发难治性皮炎的效果  

Efficacy of Tacrolimus Combined with High-energy Narrow-spectrum Red Light in the Treatment of Recurrent Refractory Facial Dermatitis

作　　者：宋慧丽[1] 李健[1] 孙燕[1] 冯红[1] SONG Hui-li;LI Jian;SUN Yan;FENG Hong(Department of Dermatology,the Second Hospital of Shijiazhuang,Shijiazhuang 050000,China)

机构地区：[1]石家庄市第二医院皮肤科,石家庄050000

出　　处：《临床误诊误治》2020年第10期58-61,共4页Clinical Misdiagnosis & Mistherapy

基　　金：2017年度河北省医学科学研究重点课题计划(20170985)。

摘　　要：目的观察他克莫司联合高能窄谱红光治疗面部复发难治性皮炎的效果及安全性。方法选择我院收治的面部复发难治性皮炎患者108例,据治疗方法的不同分为观察组和对照组各54例。对照组予枸地氯雷他定片联合0.1%丁酸氢化可的松治疗,观察组予他克莫司联合高能窄谱红光治疗。治疗后比较2组临床疗效,治疗前后皮肤屏障功能、IgE水平和嗜酸粒细胞(EOS)计数变化,治疗期间不良反应发生情况,以及治疗后半年复发率。结果2组治疗后1、2、3、4周总有效率均逐步提高,且观察组治疗后1、2、3、4周总有效率分别高于对照组治疗后同时间(P<0.05或P<0.01);治疗后1、2、3、4周2组皮肤角质层含水量逐渐增加,经皮水分丢失值逐渐降低,且观察组变化幅度大于对照组,差异均有统计学意义(P<0.05或P<0.01);治疗后1、2、3、4周,2组IgE水平和EOS计数均降低,且观察组变化幅度大于对照组,差异均有统计学意义(P<0.05或P<0.01);观察组治疗期间总不良反应发生率为23.53%远低于对照组的69.23%(χ^2=21.611,P<0.001);治疗后随访半年,观察组复发率为37.25%低于对照组的53.85%(χ^2=21.145,P=0.002)。结论他克莫司联合高能窄谱红光能快速消除面部复发难治性皮炎患者的症状体征,提高疗效,抑制I型变态反应,促进创面修复,改善皮肤屏障功能,降低复发率,且不良反应轻微。Objective To observe the efficacy and safety of Tacrolimus combined with high-energy narrow-spectrum red light in the treatment of recurrent,refractory facial dermatitis.Methods A total of 108 patients with recurrent,refractory facial dermatitis admitted to our hospital were divided into observation group(n=54)and control group(n=54)according to different treatment methods.The control group was treated with Desloratadine citrate tablets combined with 0.1%hydrocortisone butyrate,and the observation group was treated with Tacrolimus combined with high-energy narrow spectrum red light.After treatment,the clinical effect,the changes of skin barrier function,IgE level and eosinophil(EOS)count before and after treatment,the occurrence of adverse reactions during the treatment,and the 6-month recurrence rate after the treatment were compared between the two groups.Results The total effective rate of both groups at 1,2,3,and 4 weeks after treatment were gradually improved,and the rate of the observation group at 1,2,3,and 4 weeks after treatment was higher than that of the control group at the same time point after treatment(P<0.05 or P<0.01).The water content of the cuticle in the skin of the two groups was increased gradually at 1,2,3,and 4 weeks after treatment,the loss of water through the skin was decreased,and the fluctuation range of the observation group was larger than that of the control group,with statistical significance(P<0.05 or P<0.01).At 1,2,3 and 4 weeks after treatment,the IgE level and EOS count of the two groups were reduced,and the fluctuation range of the observation group was significantly greater than that of the control group(P<0.05 or P<0.01).The total adverse reaction rate of the observation group during the treatment was 23.53%which was far lower than 69.23%of the control group(χ^2=21.611,P<0.001).At 6-month follow-up,the recurrence rate of the observation group was 37.25%which was significantly lower than 53.85%of the control group(χ^2=21.145,P=0.002).Conclusion Tacrolimus combined with hig

关 键 词：皮炎 他克莫司 高能窄谱红光 IGE 嗜酸粒细胞 

分 类 号：R753.35[医药卫生—皮肤病学与性病学]