保湿剂在变态反应性接触性皮炎治疗中的应用及其对免疫因子的影响  

Application of humectant in treatment of allergic contact dermatitis and its effect on immune factors

作　　者：曾颖 付桂莉[1] 郑源泉[1] 卢静静[1] 王攀 柯欢 ZENG Ying;FU Gui-Li;ZHENG Yuan-Quan;LU Jing-Jing;WANG Pan;KE Huan(Wuhan Children′s Hospital,Tongji Medical College of Huazhong University of Science&Technology Wuhan Maternal and Child Healthcare Hos-pital,Wuhan 430015,China)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院(武汉市妇幼保健院),武汉430015

出　　处：《中国免疫学杂志》2021年第11期1371-1375,共5页Chinese Journal of Immunology

基　　金：武汉市卫生健康科研基金(WX19Y01)资助。

摘　　要：目的:探讨鱼肝油软膏在变态反应性接触性皮炎(ACD)治疗中的应用及其对免疫因子水平的影响。方法:选取ACD患儿76例,随机分为ACD1组和ACD2组,每组各38例。另选取健康儿童38例设为对照组。ACD1组患儿给予弱效糖皮质激素等治疗,ACD2组在弱效糖皮质激素治疗的基础上,增加鱼肝油软膏涂抹患处。两组患儿均治疗4周。比较对照组及ACD1组、ACD2组治疗前后的血清免疫因子水平,包括IL-1β、IL-2、IL-4、IL-10、IL-17、IFN-γ、TNF-α;比较ACD1组、ACD2组治疗前后的局部皮损症状评分;比较两组治疗4周内的不良反应发生率及治疗8周内的复发率。结果:治疗前,ACD1组与ACD2组血清IL-1β、IL-2、IL-17、IFN-γ、TNF-α水平均高于对照组,IL-4、IL-10水平均低于对照组(P<0.05或P<0.01)。治疗后,ACD1组与ACD2组血清中IL-1β、IL-2、IL-17、IFN-γ、TNF-α均有不同程度的降低,IL-4、IL-10均有不同程度的升高(P<0.05或P<0.01);且ACD2组血清IL-1β、IL-2、IL-17、IFN-γ、TNF-α水平均低于ACD1组,IL-4、IL-10水平均高于ACD1组(P<0.05)。治疗后,ACD1组与ACD2组局部瘙痒、烧灼感、红斑、丘疹、水疱、皮损面积等症状的体征评分均不同程度地降低(P<0.05或P<0.01);且ACD2组上述评分均低于ACD1组(P<0.05)。治疗后,ACD2组总有效率高于ACD1组(94.74%vs 86.84%,P<0.05),复发率低于ACD1组(0 vs 10.53%,P<0.05)。两组均未出现明显的药物不良反应。结论:鱼肝油软膏应用于ACD的临床治疗具有较好的效果,其可有效改善机体的炎症反应程度,缓解局部病灶症状,降低复发率和不良反应发生率,效果优于常规治疗方法,对于ACD的临床治疗具有一定的参考价值和借鉴意义。Objective:To explore the application of cod liver oil ointment in treatment of allergic contact dermatitis(ACD and its effect on level of immune factors.Methods:76 children with ACD were selected,and were randomly divided into ACD1 group and ACD2 group,with 38 in each group.Another 38 healthy children were selected as control group.Children in ACD1 group were treated with weak glucocorticoid,and children in ACD2 group were treated with cod liver oil ointment on basis of weak glucocorticoid.Both groups were treated for 4 weeks.Levels of serum immune factors in control group,ACD1 group and ACD2 group before and after treatment were compared,including IL-1β,IL-2,IL-4,IL-10,IL-17,IFN-γ,TNF-α.Local lesion symptoms score before and after treatments were compared in ACD1 group and ACD2 group.Incidence of adverse reactions within 4 weeks and recurrence rate within 8 weeks were compared between the two groups.Results:Before treatment,levels of serum IL-1β,IL-2,IL-17,IFN-γ,TNF-αof ACD1 group and ACD2 group were higher than those of control group,while levels of IL-4,IL-10 were lower than those of control group(P<0.05 or P<0.01).After treatment,levels of serum IL-1β,IL-2,IL-17,IFN-γ,TNF-αin ACD1 group and ACD2 group decreased,while serum IL-4,IL-10 increased in different degrees(P<0.05 or P<0.01).Levels of serum IL-1β,IL-2,IL-17,IFN-γ,TNF-αin ACD2 group were lower than those in ACD1 group,while levels of IL-4,IL-10 were higher than those in ACD1 group(P<0.05).After treatment,scores of local pruritus,burning sensation,erythema,papule,blister,skin lesion area and other symptoms in ACD1 group and ACD2 group were decreased in varying degrees(P<0.05 or P<0.01),and the above scores in ACD2 group were lower than those in ACD1 group(P<0.05).After treatment,total effective rate of ACD2 group was higher than that of ACD1 group(94.74%vs 86.84%,P<0.05),while the recurrence rate was lower than that of ACD1 group(0 vs 10.53%,P<0.05).There was no significant adverse drug reaction in both groups.Conclusion:It has good effect of

关 键 词：变态反应性接触性皮炎(ACD) 鱼肝油软膏 糖皮质激素 免疫因子 

分 类 号：R758.22[医药卫生—皮肤病学与性病学]