医用保湿剂对老年皮肤瘙痒症患者的疗效及对鳞屑中CE、KLK5水平的影响  

Effect of Medical Moisturizer on Elderly Patients with Pruritus and Its Influence on Levels of CE and KLK5 in Scales

作　　者：刘文芳[1,2] 张海祥 刘尊 李丙南[2] 芮炳峰 LIU Wenfang;ZHANG Haixiang;LIU Zun;LI Bingnan;RUI Bingfeng(Surgery Teaching and Research Office,Cangzhou Medical College,Cangzhou 061001,China;Department of Dermatology,Cangzhou People's Hospital,Cangzhou 061000,China)

机构地区：[1]沧州医学高等专科学校外科教研室,河北沧州061001 [2]沧州市人民医院皮肤科,河北沧州061000

出　　处：《医学综述》2022年第8期1640-1645,共6页Medical Recapitulate

基　　金：河北省重点研发计划自筹项目(172777188)。

摘　　要：目的分析医用保湿剂治疗老年皮肤瘙痒症(SP)患者的临床疗效及对鳞屑中不成熟角质套膜(CE)、人组织激肽释放酶5(KLK5)水平的影响。方法选取2018年1月至2019年8月沧州市人民医院收治的78例SP患者作为研究对象,根据治疗方法不同分为观察组和对照组,每组39例。其中,对照组予以咪唑斯汀和安慰剂(甘油)治疗,观察组予以咪唑斯汀和医用保湿剂(透明质酸修护生物膜)治疗。比较治疗前后两组患者的瘙痒情况(瘙痒面积、瘙痒程度及瘙痒持续时间)、皮肤屏障功能[CE、KLK5、经皮水分丢失(TEWL)及表皮含水量]变化和临床疗效,以及皮肤病生活质量指数(DLQI)评分变化。结果不同时点间、组间瘙痒面积、瘙痒程度及瘙痒持续时间评分的主效应差异有统计学意义(P<0.01),且组间和时点间存在交互作用(P<0.01),治疗4周后两组瘙痒面积、瘙痒程度及瘙痒持续时间评分明显降低,且观察组低于对照组(P<0.05)。不同时点间、组间不成熟CE比例、KLK5、TEWL及表皮含水量水平的主效应差异有统计学意义(P<0.01),且组间和时点间存在交互作用(P<0.01),治疗4周后两组不成熟CE比例及TEWL水平低于治疗前,且观察组低于对照组(P<0.05);KLK5及表皮含水量水平高于治疗前,且观察组高于对照组(P<0.05)。观察组的总有效率为94.87%(37/39),对照组为79.49%(31/39),观察组的总有效率高于对照组(χ^(2)=5.638,P=0.040)。不同时点间、组间DLQI评分的主效应差异有统计学意义(P<0.01),且组间和时点间存在交互作用(P<0.01),治疗4周、治疗8周后两组DLQI评分均下降,且观察组低于对照组(P<0.05)。结论采用医用保湿剂治疗SP患者临床疗效显著,可明显改善其临床症状及皮肤屏障功能,提高患者生活质量。Objective To analyze the clinical efficacy of medical moisturizers in the treatment of elderly patients with senile pruritus(SP)and their effects on immature cornified envelope(CE)and human kallikrein 5(KLK5)levels in scales.Methods A total of 78 SP patients admitted to Cangzhou People's Hospital from Jan.2018 to Aug.2019 were included,and divided into a observation group and a control group according to different treatment methods,with 39 cases in each group.The control group was treated with mizolastine and placebo(glycerol),and the observation group was treated with mizolastine and medical moisturizer(hyaluronic acid repair biofilm).The pruritus(pruritic area,pruritus degree and pruritus duration),skin barrier function[CE,KLK5,transepidermal water loss(TEWL)and epidermal water content]before and after treatment and clinical efficacy were compared between the two groups,as well as dermatological life quality index(DLQI)score change.Results There were significant differences in the main effect of itching area,itching degree and itching duration scores between different time points,between groups,and there were interactions between time points and groups(P<0.01).The itching area,itching degree and itching duration score was significantly decreased after 4 weeks of treatment,and the observation group was lower than the control group(P<0.05).There were significant differences in the main effect of the proportion of immature CE,KLK5,TEWL and epidermal water content between different time points,between groups,and there were interactions between time points and groups(P<0.01).After 4 weeks of treatment,the immature CE proportion and TEWL level were lower than those before treatment,and the observation group was lower than the control group(P<0.05);the levels of KLK5 and epidermal water content were higher than those before treatment,and the observation group was higher than the control group(P<0.05).The total effective rate of the observation group was 94.87%(37/39),and that of the control group was 79.49%(31/39),the

关 键 词：皮肤瘙痒症 医用保湿剂 不成熟角质套膜 人组织激肽释放酶5 老年人 

分 类 号：R758.31[医药卫生—皮肤病学与性病学]