蛇丹合剂对兔耳痤疮模型的治疗作用

目的观察蛇丹合剂对兔耳痤疮模型病理改变的改善作用,探讨其治疗作用机理。方法取健康雄兔18只,按体重分层随机分为A,B,C三组,在其左耳涂用煤焦油进行造模2周,右耳不涂煤焦油作为正常对照。A组给予小剂量蛇丹合剂,B组给予大剂量蛇丹合剂,C组为模型对照组,治疗前后对兔耳进行肉眼及病理切片观察。结果外涂煤焦油2周后,兔左耳表面粗糙,可见粉刺、丘疹,且光镜下组织学改变与人类痤疮相似。灌药2周后,实验各剂量组肉眼可见粉刺、丘疹消退;光镜亦有相应改变;但模型对照组改善不明显。结论蛇丹合剂能有效改善兔耳痤疮模型的皮损及病理改变。     

姜黄消痤凝胶对兔耳粉刺模型的抗角化作用

目的采用煤焦油制造实验兔耳粉刺模型,观察姜黄消痤凝胶(AGC)对动物粉刺模型的抗角化作用。方法将30只雄性大耳白兔随机分为模型组、基质组、AGC低剂量组、AGC高剂量组和阳性对照组。造模成功后,模型组兔右外耳道不外搽任何药物作为模型对照,后四组分别在右外耳道每日外用空白凝胶基质1g,AGC1g,AGC2g和维A酸乳膏1g,连用3周后,肉眼和组织学观察AGC抗粉刺作用。结果外涂煤焦油2周后,兔耳表面粗糙、增厚,可见粉刺,组织学改变与人类粉刺相似;给药2周后AGC组和阳性组肉眼可见兔耳变薄、变软,粉刺减少或消退,组织学亦有相应变化。结论 AGC对实验性粉刺有缩小毛囊面积、皮脂腺直径、减轻表皮增厚和减轻真皮炎症细胞浸润等作用。     

十味平痤胶囊对兔耳痤疮模型抗角化作用的研究

目的建立兔耳痤疮模型,观察十味平痤胶囊的抗粉刺作用。方法采用Kligman法建立兔耳痤疮模型,以涂橄榄油作对照。造模成功后将家兔随机分为大、中、小剂量组、阳性对照组和阴性对照组,分别灌饲十味平痤胶囊、三蕊胶囊和生理盐水2周,在造模前后及灌胃前后分别切取组织于光镜、电镜下观察结果。结果外涂煤焦油2周后,兔耳表面粗糙,可见粉刺、丘疹,且光镜、电镜下组织学改变与人类痤疮相似;涂橄榄油处肉眼及光镜下改变不大。灌药2周后,实验各剂量组和三蕊胶囊组肉眼可见粉刺、丘疹消退;光镜及电镜下亦有相应改变。结论Kligman法造模稳定可靠、重复性强;十味平痤胶囊可纠正兔耳毛囊上皮的异常角化。     

复方紫金霜对兔耳粉刺模型治疗及P物质的影响

目的建立兔耳粉刺模型,观察复方紫金霜对实验性粉刺的治疗作用和对P物质(SP)的影响,以探讨其治疗机制。方法将2%煤焦油溶液外用于家兔左耳内侧,连续2周。2周后将家兔分为3组,分别在兔左耳内侧外涂复方紫金霜、5%硫磺粉刺洗剂和生理盐水治疗3周。同时,采用免疫组化SABC法检测治疗前后兔耳模型皮损中的SP。结果外涂煤焦油2周后,肉眼可见兔耳出现粉刺,在普通光镜下呈现与人类痤疮类似的病理改变;免疫组化染色可见SP呈阳性反应。外用药3周后紫金霜组兔耳粉刺大部分消退,基本接近正常对照兔,SP呈弱阳性或阴性;硫磺粉刺组粉刺部分减少,SP呈阳性或弱阳性;生理盐水组无明显变化,SP呈阳性。结论复方紫金霜对实验性粉刺治疗效果较好,可明显减少兔耳粉刺模型的毛囊角栓,减轻炎症反应,降低SP的表达。     

三黄凝胶对大鼠耳廓痤疮模型的抗角化作用

目的:观察三黄凝胶对大鼠耳廓痤疮模型的抗角化作用。方法:大鼠右耳廓皮内涂抹油酸,连续造模3 w。造模成功后,模型组、正常组不涂抹任何药物,三黄凝胶高、中、低剂量组分别在大鼠耳廓造模处涂抹不同剂量的三黄凝胶,阳性组涂抹0.025%维A酸乳膏,连续治疗2 w后,肉眼和组织学观察三黄凝胶抗痤疮作用。结果:低、中、高剂量组、阳性对照组与模型组相比较均有差异;与阳性对照组相比较,低中剂量组与其无差异(P>0.05),而高剂量组治疗效果进一步增强,具有统计学意义(P<0.05)。结论:三黄凝胶可减轻油酸致大鼠耳廓痤疮模型的过度角化和表皮层厚度,并有一定的量效关系。     

清肺饮颗粒对家兔实验性耳痤疮影响的研究

目的建立家兔实验性耳痤疮模型,观察复方清肺饮颗粒治疗痤疮的作用。方法家兔左耳内侧涂浓煤焦油溶液0.5ml,1次/d,连续2周,建立耳痤疮动物模型。耳痤疮模型建立成功后将家兔随机分为清肺饮颗粒大、中、小剂量组、解毒痤疮丸组、模型实验组、正常对照组,分别灌饲清肺饮颗粒、解毒痤疮丸和蒸馏水2周,在造模前后及药物治疗前后,取家兔左右耳廓相同部位耳片,称重后计算耳片重量差值,光镜下观察耳廓组织病变。结果外涂煤焦油1周后,兔耳表面粗糙,增厚,可见粉刺、丘疹,组织学改变与人类痤疮相似;给药2周后,清肺饮颗粒不同剂量组和解毒痤疮丸组均可不同程度抑制痤疮模型家兔耳重量的增加,并明显改善耳痤疮炎性病理变化。结论清肺饮颗粒对家兔实验性耳痤疮有治疗作用,可用于痤疮的防治。     

中药痤疮冲剂对兔耳实验模型抗角化作用的研究

目的 建立痤疮实验动物模型,并用来观察中药的抗粉刺作用.方法 采用Kligman法煤焦油外涂于白色家兔耳管开口处,每日1次,连续2周,然后将白色家兔分为两组,第1组灌饲痤疮冲剂2周,第2组不做任何处理.结果 外涂煤焦油2周后,肉眼可见兔耳呈粉刺样发疹,光镜、电镜下观察其改变与人类粉刺相似.又经过 2周后,第1组粉刺样改变明显减轻,第2组未见明显改变.结论 兔耳粉刺实验动物模型具可重复性,并能用于观察药效;中药痤疮冲剂能减少粉刺动物模型的毛囊角栓和减轻真皮炎症.     

龙血竭凝胶对兔耳痤疮模型TNF-α、IL-6和MFGE8的影响

目的探讨龙血竭凝胶对兔耳痤疮模型TNF-α、IL-6和MFGE8的作用效果。方法24只新西兰家兔随机分为空白组4只和模型组20只,模型组以煤焦油涂抹和痤疮丙酸杆菌接种制备兔耳痤疮模型后,随机分为模型组、阳性药组、龙血竭凝胶高、中、低剂量组[根据对痤疮丙酸杆菌(P.acne)、金黄色葡萄球菌(S.aureus)、表皮葡萄球菌(S.epidermidis)的MIC确定],每组4只,涂抹给药,空白组和模型组给予空白凝胶基质,持续14 d。观察兔耳厚度及病理组织结构,ELISA法检测血清中TNF-α、IL-6含量,Western blot检测耳片组织中MFGE8表达。结果龙血竭凝胶对痤疮丙酸杆菌的MIC为62.5 mg/mL,对金黄色葡萄球菌的MIC为125 mg/mL,对表皮葡萄球菌的MIC为31.25 mg/mL。故以31.25、62.5、125 mg/mL为低、中、高剂量给药,14 d后发现,中、高剂量龙血竭凝胶可不同程度改善大鼠耳廓痤疮模表皮角化、减轻炎性细胞浸润及脓性丘疹。阳性对照组和龙血竭凝胶高剂量组兔耳厚度与模型相比均有降低(P<0.05),兔血清中TNF-α、IL-6水平与模型组相比均有降低(P<0.01),空白组、阳性对照组和高剂量组耳片组织中MFGE8表达高于模型组(P<0.01)。结论外用涂擦龙血竭125 mg/mL、62.5 mg/mL凝胶对兔耳痤疮有改善作用,这可能与其能够降低其血清中TNF-α、IL-6水平,恢复痤疮模型兔耳组织中MFGE8的表达有关。     

茶多酚乳膏对痤疮动物模型的实验研究

目的：研究茶多酚（tea polyphenols，TP）乳膏外用对实验性痤疮动物模型的治疗效果。方法：采用煤焦油外涂致兔耳实验性角化和金黄地鼠皮脂腺斑增生模型，于动物模型的病变部位外搽一定剂量的12％、6％和3％TP乳膏，结合组织病理学检查和其他量化指标观察TP乳膏的抗痤疮作用。结果：家兔耳郭涂煤焦油2周后，肉眼可见兔耳皮肤粗糙、增厚、有粉刺样皮损，组织病理检查示其病变与人类粉刺相似。TP乳膏涂搽后可明显减少毛囊角化物，减轻皮肤增厚；金黄地鼠皮脂腺斑涂搽TP乳膏后，能明显减轻皮脂腺斑增厚，并使其变得柔软，表明TP乳膏对皮脂腺增生有抑制作用。结论：TP乳膏可抑制实验性毛囊上皮角化过度和皮脂腺增生，表明该制剂具有抗实验性痤疮的作用。     

加味黑布膏对大鼠耳廓复合痤疮模型局部组织IL-2及EGF的影响

目的通过观察加味黑布膏对大鼠耳廓复合痤疮模型IL-2及EGF的影响,研究加味黑布膏对大鼠痤疮的干预机制。方法按随机数字表法将72只雌雄各半的Wistar大鼠平均分为6组,分别是:空白组、模型组、加味黑布膏高、中、低剂量组以及阳性对照组。除空白组外用Kligman法对大鼠耳廓进行造模,21 d后,随机抽取4只进行病理切片观察,提示造模成功后开始外用药物,空白组和模型组不给予药物治疗,黑布膏低、中、高剂量组分别给予不同剂量的加味黑布膏,外用1次/d,阳性对照组给予0.025%的维A酸乳膏,给药1次/d,连续用药4周,4周后对大鼠进行局部组织采样,并采用ELISA法检测样品中IL-2以及EGF的含量。结果经4周治疗后各组局部组织中IL-2以及EGF较模型组均有所下降(P<0.05),加味黑布膏中、低剂量组中所测因子与阳性对照组比较差异无统计意义(P>0.05),高剂量组与阳性对照组比较差异有统计学意义(P<0.01)。结论加味黑布膏治疗痤疮疗效明确,可能与加味黑布膏降低局部组织中IL-2及EGF有关。     

Randomised,controlled trial of the efficacy and safety of adapalene gel 0.1% and tretinoin cream 0.05% in patients with acne vulgaris

BACKGROUND: Previous clinical trials have shown that adapalene gel produces less irritation than tretinoin gels and tretinoin 0.025% cream. Short term results have shown that adapalene is less irritating than tretinoin gels and creams. This study is the first to compare the 0.1% formulation of adapalene gel with the 0.05% strength of tretinoin cream in a formal clinical trial. OBJECTIVE: To investigate the efficacy and tolerability of adapalene gel 0.1% compared with tretinoin cream 0.05% in patients with mild-to-moderate acne vulgaris. METHODS: Ten-week, multicentre, randomised, investigator-masked, active-controlled, parallel group study in 409 patients with acne vulgaris. RESULTS: Adapalene gel 0.1% demonstrated equivalent efficacy in reduction of acne lesion counts and global improvement of acne severity over 10 weeks' treatment and was significantly better tolerated than tretinoin cream 0.05% in terms of erythema, dryness, desquamation and stinging/burning. CONCLUSION: Adapalene gel 0.1% showed equivalent efficacy and was significantly better tolerated than tretinoin cream 0.05% in patients with mild-to-moderate acne vulgaris.     

Low dose isotretinoin combined with tretinoin is effective to correct abnormalities of acne

Background: Isotretinoin is well known in the therapy of acne papulopustulosa and acne conglobata. No study has investigated the pathophysiological changes of the skin of acne patients, especially when low dose oral isotretinoin is given in combination with topical tretinoin. Patients and methods: 28 patients were treated for 6 months with oral isotretinoin. In the acne conglobata group (A – C) patients were treated with 10 mg (Group A) or 20 mg isotretinoin (Groups B, C) in combination with topical 0.05 % tretinoin cream. Group C was treated the first 2 weeks with 0.05 % betamethasone valerate cream instead of tretinoin cream. In the acne papulopustulosa group, the patients received 0.5 mg isotretinoin/kg bodyweight and 0.05 % tretinoin cream, either alone (Group E), or with oral methylprednisolone during induction (Group D). Results: Acne conglobata – A reduction of inflammatory lesion by 87 – 94 % and of non‐inflammatory lesions by 81 – 88 % was achieved (Groups A – C). A reduction of sebaceous gland size by 35 – 58 %, sebum production by 90 – 95 %, follicular keratinization by 55 – 70 % and Propionibacteria by 33 – 73 % was seen (Groups B and C better than Group A). In Group A the amount of lipids was only reduced by 6 %, in Group B by 35 % and in Group C by 40 %. Acne papulopustulosa – Sebum excretion rate and follicular keratinization were reduced in Group D by 89 % and 50 % respectively, with isotretinoin alone by 94 % and 53 %. The amount of lipids was reduced in Group D by 40 % and in Group E by 21 %. Conclusions: Because of the efficacy and cost‐benefit relationship of isotretinoin in the treatment of acne compared to other therapeutic approaches, further use low dose isotretinoin in the described settings seems to justified.     

维胺酯胶囊和全反式维A酸霜治疗寻常痤疮临床疗效观察

目的:观察维胺酯胶囊和全反式维A酸霜(商品名:迪维霜)治疗寻常痤疮的疗效。方法:将寻常痤疮患者随机分成3组,A组口服维胺酯胶囊,外用0.025%迪维霜;B组外用0.025%迪维霜;C组口服多西环素(商品名:强力霉素),外用硫磺炉甘石洗剂。均各治疗6周。结果:A组对丘疹和脂溢的疗效优于B组和C组(P<0.05),对粉刺的疗效优于C组(P<0.001),对脓疱的疗效优于B组(P<0.05),对结节囊肿的疗效3组差异无显著性;综合疗效A组优于B组和C组(P<0.05);A组中中度痤疮患者的效果优于B组和C组(P<0.05),但对轻度痤疮3组差异无显著性。结论:口服维胺酯胶囊联合外用迪维霜治疗轻、中度痤疮疗效较好。     

Topical retinoids in acne – an evidence‐based overview

Topical retinoids are important tools in the management of acne because they act against comedones and microcomedones and have direct anti‐inflammatory effects. The substances approved for acne treatment comprise tretinoin (all‐trans‐retinoic acid),isotretinoin (13‐cis retinoic acid) as well as the synthetic third‐generation polyaromatic retinoids adapalene and tazarotene,the latter being approved for acne treatment in the US only.Retinaldehyde is used in cosmetic preparations against acne. All topical retinoids are effective as single agents in mild to moderate acne but differ in efficacy and tolerability. Tazarotene 0.1% is more effective than tretinoin 0.025% or 0.1% microsphere gel or adapalene 0.1% gel or cream (EBM‐level 2c). Adapalene 0.1% is equally effective to tretinoin 0.025% or tretinoin microsphere 0.1% gel or tretinoin 0.05% cream or isotretinoin 0.05% gel (EBM‐level 2c). Adapalene 0.1% gel is significantly better tolerated than tazarotene 0.1% gel, tretinoin 0.025% and tretinoin 0.05% gel, tretinoin 0.05% cream,tretinoin microsphere 0.1% gel or isotretinoin 0.05% gel (EBM‐level 2c).The safety profile of topical retinoids differs from their systemic counterparts and is related mainly to local adverse effects, such as erythema, dry‐ness,itching and stinging.The currently available evidence justifies the use of topical retinoids in most types of acne and during maintenance treatment.     

当归苦参丸联合红蓝光和维A酸乳膏治疗中度痤疮疗效评价

目的:评价当归苦参丸联合红蓝光、维A酸乳膏治疗中度痤疮的临床疗效和安全性。方法:将入选的118例中度痤疮患者随机分成2组,治疗组(60例)给予当归苦参丸联合红蓝光、维A酸乳膏治疗,对照组(58例)给予红蓝光联合维A酸乳膏治疗,2组患者疗程均为4周。治疗结束时评价两组患者的临床疗效。结果:治疗组与对照组有效率分别为81.60%和55.17%,差异有统计学意义(P0.05)。结论:当归苦参丸联合红蓝光及维A酸乳膏治疗中度痤疮安全有效。