Efficacy of Deside Cream Combined with Compound Polymyxin B Ointment in the Treatment of Moderate-severe Atopic Dermatitis in Children
-
摘要:
目的 分析地奈德乳膏联合复方多粘菌素B软膏治疗儿童中重度特应性皮炎疗效。 方法 选取2019年1月至2020年3月昆明市儿童医院皮肤科中重度特应性皮炎儿童共82例,采用随机数字表法分为对照组(41例)和观察组(41例)。对照组给予地奈德乳膏,观察组在该基础上增加复方多粘菌素B软膏。比较两组患者皮肤干燥消失时间、瘙痒消失时间、湿疹样皮疹消失时间、治疗前后儿童皮损症状积分EASI水平、嗜酸性粒细胞水平、总有效率、不良反应。 结果 观察组皮肤干燥消失时间、瘙痒消失时间、湿疹样皮疹消失时间短于对照组(P < 0.05);治疗后儿童皮损症状积分EASI水平、嗜酸性粒细胞水平低于对照组( P < 0.05);观察组治疗总有效率高于对照组( P < 0.05);两组治疗过程的不良反应,差异无统计学意义( P > 0.05)。 结论 地奈德乳膏联合复方多粘菌素B软膏治疗儿童中重度特应性皮炎疗效确切,可以加速症状消失,改善皮损情况和血液学指标,且不良反应少,安全性高。 -
关键词:
- 地奈德乳膏 /
- 复方多粘菌素B软膏 /
- 儿童中重度特应性皮炎 /
- 疗效
Abstract:Objective To analyze the efficacy of deside cream combined with compound polymyxin B ointment in the treatment of moderate-severe atopic dermatitis in children. Methods A total of 82 children with severe atopic dermatitis in the dermatology department of Kunming Children's Hospital from January 2019 to March 2020 were selected and divided into control group(41 cases)and experimental group(41 cases)randomly. Deside cream was administered in control group, while deside combined with compound polymyxin B ointment were administer in experimental group. The disappearance time of dry skin, itching, eczema like rash, EASI level, eosinophil level, total effective rate and adverse reactions of children before and after treatment were compared between the two groups. Results The disappearance time of dry skin, itching and eczema-like rash in the experimental group was shorter than that in the control group(P < 0.05). After treatment, EASI level and eosinophil level were lower than those of the control group( P < 0.05). The total effective rate of the experimental group was higher than that of the control group( P < 0.05). There was no difference in adverse reactions between the two groups( P > 0.05). Conclusion Deside cream combined with compound polymyxin B ointment is effective in treating moderate-severe atopic dermatitis in children. It can accelerate the disappearance of symptoms, improve skin lesions and hematological indicators, with fewer adverse reactions and high safety. -
表 1 两组临床症状消失时间比较[(
$ {{\bar x}}\pm s$ ),d]Table 1. Comparisons of the time of disappearance of clinical symptoms[(
$ {{\bar x}}\pm s$ ),d]组别(n) 皮肤干燥
消失时间瘙痒消失
时间湿疹样皮疹
消失时间对照组(41) 9.21 ± 2.91 9.51 ± 2.21 11.35 ± 3.18 观察组(41) 6.21 ± 1.55 6.01 ± 1.02 8.67 ± 2.51 t 8.024 8.024 7.921 P 0.001* 0.001* 0.001* 与对照组比较,*P < 0.05。 表 2 两组治疗前后皮损症状积分EASI、嗜酸性粒细胞水平比较[(
$ {{\bar x}}\pm s$ ),分]Table 2. Comparison of EASI level and eosinophil level between the two groups before and after treatment[(
$ {{\bar x}}\pm s$ ),scores]组别(n) 时期 皮损症状积分
EASI水平嗜酸性粒
细胞水平观察组(41) 治疗前 11.13 ± 2.91 0.56 ± 0.14 治疗后 2.56 ± 0.21*# 0.03 ± 0.01*# 对照组(41) 治疗前 11.23 ± 2.78 0.54 ± 0.13 治疗后 4.58 ± 0.27* 0.11 ± 0.03* 与治疗前相比,*P < 0.05;与对照组相比, #P < 0.05。 表 3 两组总有效率比较[n(%)]
Table 3. Comparison of total efficiency between the two groups[n(%)]
组别(n) 显效 有效 无效 总有效率(%) 对照组(41) 10(24.4) 24(58.5) 7(17.1) 82.9 观察组(41) 24(58.5) 16(39.0) 1(2.4) 97.6 χ2 5.967 P 0.021 -
[1] 杨艳,李嘉彦,周欣,等. 窄谱中波紫外线联合吡美莫司乳膏对成人型特应性皮炎患者PBMC产生Eotaxin和CCR3表达的影响[J].皮肤性病诊疗学杂志,2020,27(1):5-9. doi: 10.3969/j.issn.1674-8468.2020.01.002 [2] 刘燕南,何雯,李碧桃. 喂养干预辅助治疗婴儿特应性皮炎临床观察[J].昆明医科大学学报,2015,36(8):107-110. doi: 10.3969/j.issn.1003-4706.2015.08.029 [3] James Holmes,Lucy C Fairclough,Ian Todd. Correction to:Atopic dermatitis and autoimmunity:The occurrence of autoantibodies and their association with disease severity[J]. Archives of Dermatological Research:Founded in 1869 as Archiv Für Dermatologie Und Syphilis,2020,312(5):87. [4] 路坦,申春平,田晶,等. 保湿润肤剂在儿童中重度特应性皮炎治疗中的辅助作用[J].中国皮肤性病学杂志,2019,33(7):757-760. [5] 中华医学会皮肤性病学分会儿童皮肤病学组. 中国儿童特应性皮炎诊疗共识(2017版)[J].中华皮肤科杂志,2017,50(11):784-789. doi: 10.3760/cma.j.issn.0412-4030.2017.11.002 [6] 王珊,马琳. 湿包裹治疗在儿童重度特应性皮炎中的应用[J].中国皮肤性病学杂志,2017,31(12):1377-1379. [7] A Wollenberg,L A Beck,A Blauvelt,et al. Assessing the need for routine safety testing for patients being treated with dupilumab for moderate‐to‐severe atopic dermatitis[J]. British Journal of Dermatology,2020,182(6):34-36. [8] 杨丽娟,朱东宁,贾煜,等. 远程随访辅助治疗婴儿特应性皮炎效果观察[J].人民军医,2019,62(7):642-644. [9] 张珍珍,李萍,严星强. 儿童特应性皮炎的流行病学研究现状[J].国际流行病学传染病学杂志,2020,47(2):174-177. doi: 10.3760/cma.j.cn331340-20190928-00169 [10] 吴宝玉,吴倩,刘慧. 探讨儿童特应性皮炎的临床治疗[J].中国卫生标准管理,2019,10(2):78-80. doi: 10.3969/j.issn.1674-9316.2019.02.034 [11] H Alexander,A S Paller,C Traidl‐Hoffmann,et al. The role of bacterial skin infections in atopic dermatitis:expert statement and review from the international eczema council skin infection group[J]. British Journal of Dermatology,2020,182(6):11-15. [12] 申春平,王华,王榴慧,等. 地奈德乳膏与丁酸氢化可的松乳膏治疗婴幼儿特应性皮炎的多中心、随机、平行对照临床研究[J].中华皮肤科杂志,2019,52(1):11-15. doi: 10.3760/cma.j.issn.0412-4030.2019.01.003 [13] 吴媛媛,郑洁,肖风丽. 儿童特应性皮炎2620例疾病严重程度相关因素分析[J].中华皮肤科杂志,2019,52(12):915-919. [14] 张焕梅,赵俊萍,林妙青,等. 地奈德乳膏联合复方多粘菌素B软膏治疗儿童中重度特应性皮炎疗效分析[J].皮肤病与性病,2020,42(1):82-84. doi: 10.3969/j.issn.1002-1310.2020.01.048 [15] 乔娜,卢凤艳,尹逊国. 蓝科肤宁联合复方多粘菌素B软膏治疗婴幼儿急性湿疹的临床疗效观察[J].皮肤病与性病,2018,40(3):374-376. doi: 10.3969/j.issn.1002-1310.2018.03.035 [16] 赵滨. 复方多粘菌素B软膏治疗细菌性皮肤感染的疗效及安全性[J].实用中西医结合临床,2018,18(5):52-54. [17] 叶飞,秦建平. 丙酸氟替卡松联合复方多黏菌素B治疗湿疹临床观察[J].皮肤病与性病,2017,39(2):126-128. doi: 10.3969/j.issn.1002-1310.2017.02.022