联合治疗前后炎症性痤疮患者皮肤菌群特征及与炎症水平的相关性  

Correlation between skin flora characteristics and inflammation severity in patients with inflammatory acne after combined treatment

作　　者：韩斌[1] 施慧 姚晓东[2] 丁鹏[1] HAN Bin;SHI Hui;YAO Xiaodong;DING Peng(Nantong Maternal and Child Health Hospital,Nantong,Jiangsu 226008,China;不详)

机构地区：[1]南通市妇幼保健院皮肤科,江苏226008 [2]南通大学附属医院皮肤科

出　　处：《中国微生态学杂志》2025年第2期207-214,共8页Chinese Journal of Microecology

基　　金：南通市科学技术局通科计项目[(2019)5号(MSZ18129)]。

摘　　要：目的分析阿达帕林和过氧苯甲酰的联合用药方案与单一使用阿达帕林对炎症性痤疮患者治疗效果及对皮肤菌群和炎症水平的相关性,为该类患者的治疗提供参考。方法本研究纳入2023年5月至2024年5月在南通市妇幼保健院皮肤科就诊的中、重度痤疮患者80例。按照随机数表法分为治疗组和对照组,各40人。两组患者均口服异维A酸软胶囊,此外治疗组使用过氧苯甲酰凝胶+阿达帕林凝胶。对照组仅使用阿达帕林凝胶。两组患者均进行8周治疗并分别于治疗前、中、后期进行检测评价,对临床疗效、皮肤菌群变化、局部炎症因子表达进行检测,并对显著变化菌属与炎症因子进行相关性分析。结果治疗组患者总有效率为97.50%。GAGS量表评分及IGA量表分级结果表明,治疗组患者在治疗中期就已表现出比对照组更加显著的治疗效果,8周治疗结束后治疗组患者的治疗效果显著优于对照组(P<0.001)。皮损处炎症因子检测显示治疗前IL-1、IL-6、TNF-α水平均较高,治疗后这3种炎症因子的水平均显著下降,且治疗组与对照组相比下降更显著(均P<0.001)。皮肤菌群检测结果表明,治疗前两组患者皮肤菌群的丰富度和均匀度较低,葡萄球菌属(Staphylococcus)、普氏菌属(Prevotella)丰度较低,而丙酸杆菌属(Cutibacterium)、Snodgrassella、沙门菌属(Salmonella)在治疗前丰度较高;治疗后其丰度均降低。IL-1、IL-6、TNF-α与多种皮肤菌群具有强相关性。结论联合使用阿达帕林凝胶和过氧苯甲酰凝胶的治疗方案在改善炎症性痤疮患者的临床症状和调节皮肤菌群方面具有显著效果。Objective To compare the therapeutic effects of combined medication regimen of Adapalene and Benzoyl peroxide vs Adapalene alone on patients with inflammatory acne,and analyze the correlation between skin flora and severity of the disease.Methods This study included 80 patients with moderate to severe acne who visited the dermatology department of our hospital from May 2023,to May 2024.They were randomly divided into a treatment group and a control group,each consisting of 40 cases.All patients were given Isotretinoin soft capsures.The treatment group was given Adapalene gel and Benzoylperoxide gel;the control group was given Adapalene gel only.An 8-week treatment was conducted,and assessments were made before,during,and after treatment.The clinical efficacy,changes in skin flora and levels of local inflammatory factors were detected,and a correlation analysis was performed on the significantly changed bacterial genus and inflammatory factors.Results The total efficiency rate in the treatment group reached 97.50%.The results of the GAGS scale score and IGA scale grading showed that the treatment group showed a more significant therapeutic effect compared to the control group during the mid-treatment period,and the therapeutic effect was significantly better than that in the control group after 8 weeks of treatment(P<0.001).Detection of inflammatory factors at the lesion site also found that the expression levels of IL-1,IL-6 and TNF-αwere high before treatment,and significantly decreased after treatment,with a more significant decrease in the treatment group compared to the control group(all P<0.001).The results of skin microbiota detection showed that the richness and evenness of the skin microbiota were low before treatment;the abundance of Staphylococcus and Prevotella were low,while those of Cutibacterium,Snodgrassella and Salmonella were higher before treatment.After treatment,the richness and evenness of the skin flora recovered,and the abundance of each bacterial genus changed.The correlation analysis bet

关 键 词：痤疮 皮肤微生物群 联合用药 炎症因子 相关性分析 

分 类 号：R451[医药卫生—治疗学]