曲安奈德益康唑乳膏联合氯雷他定治疗外耳湿疹的疗效观察

目的：探讨曲安奈德益康唑乳膏联合氯雷他定治疗外耳湿疹的疗效。方法选取2012年3月—2014年3月韶关市第一人民医院收治的外耳湿疹患者108例,随机分为对照组与试验组,各54例。对照组患者给予曲安奈德益康唑乳膏治疗,试验组患者在对照组基础上加用氯雷他定治疗。观察两组患者临床疗效及不良反应发生情况。结果试验组患者总有效率为94.5%,高于对照组的81.5%,差异有统计学意义（ P<0.05）;两组患者不良反应发生率比较,差异无统计学意义（ P>0.05）。结论曲安奈德益康唑乳膏联合氯雷他定治疗外耳湿疹的疗效显著,且不良反应少,安全性高。     

Decreased recurrence of symptoms in oral lichen planus with intralesional injection of hyaluronic acid and triamcinolone

Oral lichen planus (OLP) is a chronic non-infectious, inflammatory, immunological disease. In contrast to skin lesions, which are often self-limiting, oral lesions rarely heal on their own and can be resistant to local and systemic treatments. In this clinical trial, hyaluronic acid (HA) was mixed with triamcinolone for intralesional injection to reduce side effects in the treatment of OLP. This randomized clinical trial with a split-mouth design was performed on 28 patients with OLP. The mouth was divided randomly into two sides: a test side, which received HA combined with triamcinolone, and a control side, which received triamcinolone alone. The rate of symptom recurrence was 74.1% on the control side and 11.1% on the test side (significant difference, P < 0.01). Pain scores did not differ between the two groups when assessed after 2 weeks. The group treated with a combination of HA and triamcinolone experienced a significantly better resolution of lesions and symptoms. Considering the role of HA in tissue healing and in regulating inflammatory responses, as well as its antioxidant and hydration properties, it appears that HA could be effective in improving of OLP and decreasing the rate of symptom recurrence.     

循证护理对浅表性血管瘤患儿不良反应及不良情绪的影响

目的探究循证护理对浅表性血管瘤患儿不良反应及不良情绪的影响。方法采用信封密封法将2019年4月~2020年2月期间我院收治的浅表性血管瘤婴幼儿66例分为两组,分别为对照组(n=33,常规护理干预)及观察组(n=33,循证护理),比较两组疗效、护理满意度、不良情绪及不良反应发生率。结果观察组总有效率高于对照组(90.91%vs 78.79%)(P<0.05);观察组不良反应发生率低于对照组(6.06%vs 24.24%)(P<0.05);观察组满意度高于对照组(93.94%vs 81.82%)(P<0.05)。干预后,两组SAS、SDS评分均较干预前降低,且观察组均较对照组低(P<0.05)。结论循证护理应用曲安奈德治疗婴幼儿浅表性血管瘤中,能够针对循证护理问题进行针对性护理,显著缓解不良情绪,降低不良反应发生率,值得推广。     

改装滚轮微针促进人增生性瘢痕皮肤对醋酸曲安奈德的吸收

目的考察改装滚轮微针在人增生性瘢痕皮肤中对醋酸曲安奈德的促透作用。方法采用亚甲蓝和H-E染色法观察不同针长的微针刺入人增生性瘢痕皮肤的形态;建立高效液相色谱法测定醋酸曲安奈德含量;采用洗脱法、匀浆法分别考察给药1、12h时增生性瘢痕皮肤醋酸曲安奈德在体吸收特性;采用经皮水分流失(TEWL)测量法、激光多普勒血流量法考察其皮肤刺激性。结果所优选的针长500μm滚轮微针能有效穿透角质层,形成的微孔分布相对均匀;微针处理1、12h后,分别有27.42%、60.64%药物吸收进入皮肤。给药12h,皮内注射醋酸曲安奈德皮肤中滞留药量较给药1h下降至45.98%,而微针、直接涂布醋酸曲安奈德乳膏分别增加到2.73、4.18倍,微针组皮肤中滞留药量是直接涂布乳膏组的3.56倍(P<0.05)。皮内注射12h皮肤药量分布并不均匀,均值为(4.83±5.51)μg,微针组均值为(0.93±0.14)μg,分布相对均匀。TEWL法显示微针处理与皮内注射的皮肤刺激性差异无统计学意义,但激光多普勒血流量法显示皮内注射的皮肤刺激性是微针处理的8.40倍。结论改装滚轮微针处理后涂布醋酸曲安奈德乳膏较皮内注射醋酸曲安奈德在人增生性瘢痕中吸收均匀、皮肤刺激性较小,但其瘢痕治疗效果尚有待进一步验证。     

曲安奈德与雷公藤多甙联合治疗OLP的疗效评价

目的：评价曲安奈德与雷公藤多甙联合应用治疗口腔扁平苔藓（OLP）的疗效。方法：将76例OLP患者随机分为3组,分别采用“局部注射曲安奈德＋口服雷公藤多甙片”、“单纯局部注射曲安奈德”、“单纯口服雷公藤多甙片”的方法治疗4周,分别在治疗结束后即刻和半年后复查,比较各种治疗方法的疗效。结果：统计学分析显示,联合应用曲安奈德和雷公藤多甙组的疗效最佳。结论：曲安奈德与雷公藤多甙联合治疗OLP具有较好的短期疗效和长期临床疗效。     

Platelet‐rich plasma protects rotator cuff‐derived cells from the deleterious effects of triamcinolone acetonide

Triamcinolone acetonide (TA) injections are widely used to treat enthesopathy, but they may induce adverse effects such as tendon impairment and rupture. Platelet‐rich plasma (PRP) is a blood fraction containing high platelet concentrations and various growth factors that play a role in tissue repair processes. The purpose of this study is to investigate whether TA has deleterious effects on human rotator cuff‐derived cells, and if PRP can protect these cells from the effects of TA. Human rotator cuff‐derived cells were cultured with and without TA and PRP, and the culture without any additive served as the control. Cell morphology was assessed at days 7 and 21. Cell viability was evaluated at days 1, 7, 14, and 21 by a water‐soluble tetrazolium salt assay. Induction of apoptosis was measured by immunofluorescence staining and flow cytometry at day 7. Induction of cleaved caspase‐3 was measured by immunofluorescence staining at day 7. The cells cultured with TA had a flattened and polygonal shape at day 7. The cells cultured with both TA and PRP were similar in appearance to control cells. Exposure to TA also significantly decreased cell viability, but cell viability did not decrease when PRP was added along with TA. The number of apoptotic cells increased with TA exposure, while addition of PRP prevented cell apoptosis. In conclusion, the deleterious effect of TA was prevented by PRP, which can be used as a protective agent for patients receiving local TA injections. © 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 31: 976–982, 2013     

兔膝骨性关节炎治疗中透明质酸钠与曲安奈德对滑膜和软骨的影响

目的：评估透明质酸钠与曲安奈德对兔膝骨性关节炎中关节滑膜及软骨的影响。方法24只新西兰兔制造骨关节炎模型后按数表法随机分为对照组、透明质酸钠(SH)组、曲安奈德(TA)组,每组各8只,分别进行关节腔注射生理盐水0.4 mL、SH 0.4 mL、TA 0.4 mL,每周一次,每组6次。6周后观察每组兔膝关节滑膜组织病理切片、血管滑膜SP法染色、软骨AB-PAS染色及MMP-1免疫组化。结果滑膜病理切片显示,SH组滑膜增生最少, TA组滑膜增生较少,对照组滑膜增生明显;滑膜SP法染色显示SH组、TA组VEGF阳性细胞百分数较对照组减少[(42.50±5.29)%、(50.80±5.24)%vs (53.38±4.75)%,P<0.05],SH组、TA组平均光密度值较对照组减少[(0.32±0.02)、(0.43±0.04) vs (0.48±0.05),P<0.05],TA组较SH组和对照组内软骨细胞减少,软骨基质成分减少,SH组、TA组较对照组软骨表层破坏减少。SH组、TA组软骨MMP-1细胞百分数评分优于对照组[(61.25±4.06)%、(76.27±4.68)%vs (87.13±3.64)%,P<0.05];SH组、TA组软骨Mankins评分优于对照组[(6.88±1.25)分、(7.27±0.68)分vs (8.13±0.83)分, P<0.05]。结论透明质酸钠和曲安奈德均能抑制滑膜炎增生,减少兔膝关节腔内的炎性细胞因子,减少了软骨基质的破坏,且透明质酸钠要优于曲安奈德。     

Microemulsion-based delivery of triamcinolone acetonide to posterior segment of eye using chitosan and butter oil as permeation enhancer: an in vitro and in vivo investigation

The aim of the study was to formulate a microemulsion (ME) using chitosan (CH) and the butter oil (BO) as a permeation enhancer for targeting drug to the posterior segment of the eye, via topical route. Triamcinolone acetonide (TA) was selected as the model drug since it undergoes extensive first-pass metabolism, leading to poor oral bioavailability of 23%. For optimisation of BO concentration, different ratios of TA:BO were prepared by simple physical mixing in the ratio of 1:9 to 9:1 and diffusion study was performed. MEs containing TA, TA:BO and TA CH ME were formulated by water titration method. Globule sizes of TA ME, TA:BO ME and TA CH ME were found to be 66.06?±?0.32?nm, 78.52?±?1.50?nm and 97.30?±?2.50?nm, respectively. In ex vivo diffusion studies using goats eye, TA:BO ME (31.33?±?0.46 and 33.98?±?0.23) and TA CH ME (24.10?±?0.41 and 27.00?±?0.18) showed higher percentage of drug diffusion in comparison to TA ME (13.29?±?0.41and 15.56?±?0.34) and TA solution (8.20?±?1.04 and 10.39?±?0.22) in presence and in absence of vitreous humour. Fluorescence intensity of coumarin-6 (as a marker) loaded ME with BO and CH was found to be higher, confirming their role in altering membrane permeability and facilitating coumarin-6 diffusion to the posterior chamber. Overall, it was concluded that BO enhances the bioavailability of TA across the retina, thereby proving its potential as permeation enhancer in facilitating drug delivery to the posterior segment of the eye.     

多磺酸黏多糖乳膏联合曲安奈德益康唑乳膏治疗成人慢性湿疹45例

目的 观察多磺酸黏多糖乳膏与曲安奈德益康唑乳膏联合应用治疗成人慢性湿疹的临床效果.方法 选取90例成人慢性湿疹患者作为研究对象,采用随机数字表法分为两组,每组45例,其中对照组采用曲安奈德益康唑乳膏治疗,观察组在对照组治疗的基础上,联合多磺酸黏多糖乳膏治疗,观察并比较两组患者经过用药后的临床效果及随访恢复情况.结果 观察组总有效率(91.11%)明显高于对照组(60.00%),差异有统计学意义(P<0.05);观察组患者临床各指标积分(4.81 ±1.01)分明显优于对照组(10.61 ±2.60)分,差异有统计学意义(P <0.05);观察组患者透明质酸酶合成的增长率(639.15 ± 140.43)%明显高于对照组(48.98 ±14.26)%,差异有统计学意义(P<0.05);治疗后,观察组患者皮肤水份情况(46.15 ± 14.32)%明显优于对照组(40.02 ±11.56)%,差异有统计学意义(P<0.05).结论 在曲安奈德益康唑乳膏治疗的基础上,联合多磺酸黏多糖乳膏对成人慢性湿疹的治疗具有积极作用,提高临床总有效率,有效改善自觉瘙痒程度、皮损厚度和皮肤软硬度及颜色恢复等方面的临床状况,患者皮肤水份得以维持,为受损皮肤的组织再生提供了保障,值得临床广泛应用.     

Nd:YAG激光联合曲安奈德治疗口腔黏膜下纤维化的临床研究

  目的  采用Nd:YAG激光联合曲安奈德治疗口腔黏膜下纤维化患者,观察治疗后纤维化组织的修复、愈合及病情进展情况。  方法  选取2018年6月—2019年10月于杭州师范大学附属医院口腔科就诊的80例口腔黏膜下纤维化患者,采用随机数字表法分为观察组与对照组,每组40例。对照组患者使用曲安奈德注射液治疗,观察组在此基础上使用Nd:YAG激光治疗,2组均持续治疗9周。2组患者治疗前后采用视觉模拟评分法(VAS)评分进行评价,并测量张口程度和口腔黏膜病损面积;采用酶联免疫吸附法(ELISA)测定血清血管内皮生长因子(VEGF)、血小板反应蛋白(TSP)、基质金属蛋白酶-2(MMP-2)水平及血清IL-6、TNF-α水平。  结果  治疗后,对照组口腔黏膜病损面积为(1.47±0.62)cm2,观察组为(0.86±0.23)cm2,观察组口腔黏膜病损面积小于对照组(P < 0.05);2组患者血清VEGF均升高,观察组高于对照组[(0.75±0.19)pg/mL vs.(0.61±0.23)pg/mL, P < 0.05],而血清TSP、MMP-2、IL-6和TNF-α水平均降低,观察组低于对照组(均P < 0.05)。  结论  Nd: YAG激光联合曲安奈德可有效缓解口腔黏膜下纤维化患者口腔灼痛,抑制纤维化发展,并促进纤维化组织的修复与愈合,控制病情进一步发展。