果酸和胶原蛋白敷料联合五味消毒饮加减治疗颜面部痤疮的 临床疗效分析

目的 观察五味消毒饮加减配合果酸治疗痤疮的临床疗效及安全性。方法 将 64 例痤疮患者,随机分为治疗组（五 味消毒饮加减配合果酸治疗）和对照组（五味消毒饮加减治疗）。其中治疗组先以 20% 果酸治疗,间隔 2 周 1 次,共 4 次。在每次果酸治疗后胶原蛋白敷料第 1 周每日 1 次,第 2 周隔日 1 次;口服中药每日 2 剂,分 2 次服用,随症状加减, 2 个月为 1 个疗程。结果 治疗组和对照组总有效率分别为 84.38%、53.13%,治疗组明显优于对照组。结论 五味消毒饮 加减配合果酸治疗痤疮,疗效满意度高。     

医院门诊处方中痤疮药物治疗的适宜性分析

目的:为提高皮肤科门诊合理用药的水平,根据相关法规、技术规范,对门诊处方中有关痤疮药物治疗的适宜性进行评价.方法:选取我院皮肤科门诊近2年来的处方,对其中临床诊断为痤疮的处方共计192份进行分析.结果:我院皮肤科门诊近两年就诊的痤疮患者占到皮肤病患者的8%,其中以中、重度患者较多,痤疮药物治疗不适宜处方比例为8.85%,存在着一定的不合理用药现象.结论:开展对专病门诊用药适宜性的点评,是医院处方点评工作的延伸,也是将该病种治疗尽快纳入临床治疗路径的必要过程.根据痤疮药物分级治疗的原则,当前急需完善的是合理规范的使用抗菌药物,预防痤疮丙酸杆菌耐药性的发生.     

红蓝光照射联合西黄胶囊治疗面部中重度痤疮疗效及安全性评价

目的：采用红蓝光照射联合西黄胶囊治疗面部中重度痤疮,并评价其疗效及安全性。方法：80例中重度痤疮患者随机分为西黄胶囊组（对照组）和红蓝光照射联合西黄胶囊组（观察组）,每组40例。对照组患者口服西黄胶囊,每次1.5g,每日2次;观察组患者采用红蓝光照射治疗,每次20min,每周2次,同时口服西黄胶囊,每次1.5g,每日2次;治疗时间均为4周。治疗后2和4周各随访1次,观察患者皮损变化情况及不良反应发生情况,比较其疗效。结果：治疗2周后,观察组总有效率为67.5%,对照组为52.5%,2组总有效率比较差异无统计学意义（P > 0.05）,但观察组患者炎性皮损和非炎性皮损消退数目明显多于对照组（P=0.002和P=0.005）;治疗4周后,观察组总有效率为85.0%,对照组总有效率为65.0%,观察组疗效明显优于对照组（P < 0.05）,且观察组患者炎性皮损和非炎性皮损消退数目均明显多于对照组（P=0.01和 P=0.001）。治疗期间2组患者均未见严重不良反应,观察组仅有2例患者在红光照射治疗后有轻度头痛及恶心症状,下调照射剂量后症状消失。结论：红蓝光照射联合西黄胶囊治疗面部中重度痤疮具有见效快、疗效好、安全性高的优势,值得在临床上推广应用。     

多西环素胶囊联合安体舒通和甲氯酊治疗育龄女性中重度痤疮疗效观察

目的评价多西环素胶囊联合安体舒通和甲氯酊治疗育龄女性中重度痤疮的疗效。方法选择患有中重度痤疮的育龄女性80例,随机分为两组。治疗组服用多西环素胶囊100mg,一日两次,安体舒通片20mg,一日三次,外用甲氯酊,一日三次。对照组仅外擦甲氯酊,一日三次。两组均治疗6周。治疗前及治疗2、4、6周观察记录炎症性丘疹、脓疱、结节、囊肿症状及体征的改善程度,计算疗效指数。结果经过6周治疗,治疗组有效率90％,对照组30％。结论多西环素胶囊联合安体舒通和甲氯酊治疗育龄女性中重度痤疮疗效显著,值得推广。     

倒膜联合异维A酸治疗中重度痤疮临床效果分析

目的：探讨倒膜联合异维A酸治疗中重度痤疮的临床疗效。方法：将256例门诊中重度痤疮患者随机分为两组,治疗组138例采用中药倒膜联合异维A酸治疗8周,对照组118例口服异维A酸,两组均使用相同的外用药。结果：第8周进行随访,治疗组：痊愈97例（70．29％）,显效36例（26．09％）,有效5例（3．62％）,无效0例;对照组：痊愈46例（38．98％）,显效52例（44．07％）,有效20例（16．95％）,无效0例。结论：中药倒膜联合异维A酸治疗中重度痤疮较单纯口服异维A酸起效快,疗程缩短,效果显著,复发率低。     

In a study for acne vulgaris, sequence-based HLA typing showed a novel DPB1 allele, DPB1*2402

In this paper, we characterize the novel human leucocyte antigen (HLA)-DPB1*2402 allele that we found in a patient suffering from acne vulgaris. In comparison to the closest related allele DPB1*0401, HLA-DPB1*2402 has a single nucleotide exchange at position 115 (202), T replaces G. In consequence, codon 39 (68) TAC encodes for tyrosine in the novel allele instead of aspartic acid 39 (68) GAC in DPB1*0401. In November 2008, the DNA samples of a cohort of patients who were afflicted with acne vulgaris were sent to our laboratory for human leucocyte antigen (HLA) high-resolution typing. This happens in course of a study of HLA pattern in respect to the disease. In one of these samples, a male patient of German Caucasoid origin (laboratory code 191849), we showed a novel DPB1 allele.     

蓝光对痤疮患者的疗效及对糠秕马拉色菌的影响

目的 观察波长407～420 nm蓝光对痤疮患者的疗效,对面部皮肤皮脂溢出率及糠秕马拉色菌的影响.方法 对20例痤疮患者蓝光治疗前后行电子显微成像观察,评价靶疹的表皮层及真皮浅层变化;应用Looking bill及Cunliffe改良测定法进行皮脂溢出率测定;应用蓝光对培养的糠秕马拉色菌进行照射,观察照光前后菌落的数量及形态变化.结果 20例痤疮患者蓝光治疗后靶疹明显消退,其表皮层及真皮浅层损伤减轻;皮脂溢出率较治疗前显著减少(P<0.01);在0.5 ml细胞数为5×10~6/ml的糠秕马拉色菌菌液中,菌落数量、直径与光照时间成反比,蓝光光照时间大于3 min 30 s时,平吼内无菌落生长.结论 蓝光对痤疮有很好的治疗效果:能修复深至真皮层的皮肤损伤,抑制皮脂分泌,对糠秕马拉色菌有杀菌作用.     

环酯红霉素胶囊联合维胺酯维E乳膏治疗中度痤疮的疗效观察

目的探讨环酯红霉素胶囊联合维胺酯维E乳膏治疗中度痤疮的疗效。方法将68例患者随机分为治疗组39例,对照组29例,治疗组口服环酯红霉素胶囊0.25 g,2次/d,2周后改为1次/d,再服2周,同时外用维胺酯维E乳膏。对照组口服四环素片,0.25 g/次,3次/d,2周后改为1次/d,再服2周,同时外用维胺脂维E乳膏。两组疗程均为4周,比较停药时的临床疗效。结果治疗组和对照组有效率分别为87.18%和58.62%,两组比较差异有统计学意义(P0.05);两组痊愈率分别为48.72%和27.59%,两组比较差异有统计学意义(P0.01)。结论环酯红霉素胶囊联合维胺酯维E乳膏治疗中度痤疮的疗效肯定。     

Short‐term isotretinoin treatment decreases insulin‐like growth factor‐1 and insulin‐like growth factor binding protein‐3 levels: does isotretinoin affect growth hormone physiology?

Summary Background Isotretinoin is an effective treatment for acne vulgaris. However, it has numerous side‐effects. It was previously reported that serum growth hormone (GH) levels decreased with isotretinoin treament. Objectives To analyse whether isotretinoin has any effects on insulin‐like growth factor‐1 (IGF‐1), insulin‐like growth factor binding protein‐3 (IGFBP3) and GH levels. Methods Forty‐seven patients aged 21·5 ± 5·1 years (mean ± SD) with acne vulgaris were included in this study. Isotretinoin therapy was initiated at a dose of 0·5–0·75 mg kg^?1 daily and then adjusted to 0·88 mg kg^?1 daily as maintenance dosage after 1 month. Screening for biochemical and hormonal parameters was performed just before initiation and after 3 months of isotretinoin treatment. Results IGF‐1 and IGFBP3 levels decreased significantly after treatment (P < 0·01), while GH levels did not change. Post‐treatment, significant increases were seen in aspartate aminotransferase, total cholesterol, low‐density lipoprotein cholesterol, triglycerides and low‐density lipoprotein cholesterol/high‐density lipoprotein cholesterol ratio (P < 0·0001) while high‐density lipoprotein cholesterol levels were significantly decreased (P < 0·0001). Conclusions Isotretinoin therapy may have an effect on GH physiology, and further studies are needed to understand this association.     

祛痰化瘀汤联合火针治疗女性青春期后痤疮39例

[目的]观察自拟祛痰化瘀汤联合火针治疗女性青春期后痤疮的临床疗效及对情志改变的影响。[方法]将78例女性痰湿体质青春期后痤疮门诊患者随机分成两组,对照组与治疗组每组各39例,治疗组予以祛痰化瘀汤联合火针治疗,对照组予以口服安体舒通、美满霉素。治疗4周后评估其疗效。[结果]对照组总有效率为76.9%,明显低于治疗组94.8%。两组对情志指标改变有明显差异,且治疗组改善较对照组显著,具有统计学意义(P0.05)。两组患者治疗期间及治疗后,不良反应均未发现。[结论]祛痰化瘀汤联合火针可有效改善女性青春期后痤疮患者临床症状,疗效显著,无明显不良反应。