复方甘草酸苷注射液对B16鼠黑素瘤细胞黑素生成的影响

目的：研究复方甘草酸苷注射液对B16鼠黑素瘤细胞黑素的影响及其机制。方法：通过CCK8、流式细胞术、NaOH裂解法、多巴氧化法和Western-blotting技术检测复方甘草酸苷对B16鼠黑素瘤细胞生长,黑素合成与转运及酪氨酸酶活性和蛋白含量的影响。结果：(1) 复方甘草酸苷注射液浓度低于30μl/ml,对B16鼠黑素瘤细胞生长无明显影响;浓度大于50μl/ml,细胞生长速率减慢;浓度达到500μl/ml,细胞生长明显受抑制。(2) 浓度在10μl/ml到200μl/ml之间,黑素的合成和酪氨酸酶的活性均增加。黑素的合成在复方甘草酸苷注射液浓度为50μl/ml时增加最明显;且酪氨酸酶活性呈浓度依赖性增加,在浓度为100μl/ml和150μl/ml时达到最高。结论：复方甘草酸苷注射液有促进黑素瘤细胞黑素的合成与转运及增加酪氨酸酶活性的作用。     

A randomized, single-blind comparison of topical clindamycin + benzoyl peroxide and adapalene in the treatment of mild to moderate facial acne vulgaris

BACKGROUND: Antibiotics are often combined with other agents to provide topical acne treatments that are effective against both inflammatory and noninflammatory lesions and minimize the development of antibiotic resistance. Retinoids and associated treatments also have anti-inflammatory activity and decrease microcomedo formation. To date, few direct comparisons of these different acne treatments have been conducted. OBJECTIVES: To compare the clinical effectiveness of two treatments for facial acne: a ready-mixed once-daily gel containing clindamycin phosphate 10 mg mL(-1) + benzoyl peroxide 50 mg mL(-1) (CDP + BPO; Duac; Stiefel, High Wycombe, U.K.) and a once-daily gel containing adapalene 0.1% (ADA; Differin; Galderma, Watford, U.K.). METHODS: In this assessor-blind, randomized study; 65 patients were treated with CDP + BPO once daily and 65 patients with ADA once daily. The treatment period was 12 weeks and lesion counts, acne grade and global improvement were assessed at weeks 1, 2, 4, 8 and 12. RESULTS: CDP + BPO showed an earlier onset of action with a faster significant reduction in inflammatory and total lesion counts than ADA. A between-group comparison of the percentage change from baseline showed that CDP + BPO was statistically significantly superior to ADA from week 1 onwards both for inflammatory lesions (P < or = 0.001) and for total lesions (P < or = 0.004). While 76% of inflammatory lesions remained at week 2 for patients using ADA, in contrast, only 55% of inflammatory lesions remained at week 2 in the CDP + BPO group, resulting in a treatment effect of 1.38. Thus CDP + BPO removed 38% more inflammatory lesions than ADA at this timepoint. The trend in favour of CDP + BPO, although less marked, continued to the end of the study. CDP + BPO was better tolerated than ADA, with a greater proportion of ADA-treated patients experiencing treatment-related adverse events. Adjunctive topical or oral agents and their impact on acne were not studied in this trial. Due to product differences, this study could not be double blinded but was only single (assessor) blinded. CONCLUSIONS: CDP + BPO and ADA are both effective treatments for acne, but CDP + BPO has a significantly earlier onset of action, is significantly more effective against inflamed and total lesions and is better tolerated, which should improve patient compliance.     

复方甘草酸苷注射液治疗黄褐斑疗效评估

目的 观察复方甘草酸苷注射液治疗黄褐斑的疗效。方法 2015年5月至2016年7月在杭州市第三人民医院皮肤科门诊收集皮肤镜血管评分为++或+++以及反射式共聚焦显微镜（RCM）黑素评分为++或+++的黄褐斑患者30例。所有患者按照抽签法随机分为两组：实验组静脉滴注复方甘草酸苷注射液40 ml/次,每3天1次,连续使用8次;同时口服维生素C片每日3次每次0.2 g;维生素E片每日1次,每次0.1 g;对照组仅口服维生素C片和维生素E片,剂量同试验组。治疗前及治疗开始3个月后使用黄褐斑面积和严重指数（MASI）评估疗效,同时用RCM、皮肤镜和VISIA皮肤检测仪评估皮损,计算黑素评分、血管评分以及棕色斑和红色区指数。结果 实验组治疗开始3个月后与治疗前相比,RCM黑素评分分布（z = 2.773,P = 0.006）、皮肤镜血管评分分布（z = 3.135,P = 0.002）差异有统计学意义, VISIA棕色斑指数下降（38.3 ± 3.1比43.9 ± 5.8,z = 3.091,P = 0.002）,VISIA红色区指数亦下降（26.5 ± 5.6比33.3 ± 7.7,t = 2.752,P = 0.010）。治疗开始3个月后,对照组RCM黑素评分较治疗前明显下降（P = 0.023）,而皮肤镜血管评分和VISIA指数与治疗前相比差异均无统计学意义（P＞0.05）。治疗开始3个月后,实验组显效9例,好转6例;对照组显效3例,好转11例,无效1例,实验组疗效显著优于对照组（z = 2.276,P = 0.029）。结论 复方甘草酸苷注射液治疗黄褐斑有效,RCM、皮肤镜和VISIA皮肤检测仪可辅助黄褐斑疗效评估。     

异维A酸联合水杨酸治疗中重度痤疮的疗效观察

目的:探讨口服异维A酸胶囊联合30％超分子水杨酸治疗中重度痤疮的临床疗效.方法:将80例中重度痤疮患者随机分为对照组(40例)和观察组(40例),对照组给予异维A酸胶囊10 mg口服,一天2次,连续8周;观察组给予异维A酸胶囊的同时联合30％超分子水杨酸治疗,每隔4周治疗一次,共3次.比较两组患者总积分、临床疗效、不良...     

复方木尼孜其颗粒治疗女性寻常痤疮临床疗效观察

[摘要]目的观察复方木尼孜其颗粒治疗女性寻常痤疮的临床疗效。方法78例女性寻常痤疮患者随机分为两组,试验组40例口服复方木尼孜其颗粒6g,每日3次;对照组38例口服维胺脂胶囊25mg,每日3次,两组均连续治疗12周。结果试验组有效率为87．50％,对照组为60．53％,两组有效率相比差异有统计学意义（P〈0．05）。结论复方木尼孜其颗粒治疗女性寻常痤疮有效。     

复方甘草酸苷片联合氯雷他定治疗儿童慢性荨麻疹的疗效观察

目的：探讨复方甘草酸苷片联合氯雷他定治疗儿童慢性荨麻疹的疗效及安全性。方法：将80例慢性荨麻疹患儿分为两组,治疗组40例口服复方甘草酸苷片75mg,3次/d,氯雷他定5mg,1次/d,对照组40例口服氯雷他定5mg,1次/d。两组疗程均为4周,治疗后第14,30天评价疗效。结果：治疗结束时症状/体征总评分,治疗组优于对照组（P〈0.01）;治疗组总有效率82.5%,明显优于对照组的57.5%（χ^2=5.952,P〈0.05）;且无明显副作用。结论：复方甘草酸苷片联合氯雷他定治疗儿童慢性特发性荨麻疹疗效满意,安全性好。     

Gut microbiota alterations in moderate to severe acne vulgaris patients

Acne vulgaris is a chronic inflammatory dermatosis affecting approximately 85% of adolescents. There are many factors contributing to the development of this ailment. A recent study indicated that gut microbiota takes part in the pathogenesis of acne. We aimed to investigate the link between acne vulgaris and gut microbiota. A total of 31 moderate to severe acne vulgaris patients and 31 healthy controls were enrolled. We collected their feces, and gut microbiota was evaluated by the hypervariable regions of 16S rRNA genes through high‐throughput sequencing. We identified links between acne vulgaris and changes of gut microbiota. At the phylum level, Actinobacteria (0.89% in acne patients and 2.84% in normal controls, P = 0.004) was decreased and Proteobacteria (8.35% in acne patients and 7.01% in normal controls, P = 0.031) was increased. At the genus level, Bifidobacterium, Butyricicoccus, Coprobacillus, Lactobacillus and Allobaculum were all decreased. The observed difference in genera between acne patients and healthy controls provides a new insight into the link between gut microbiota changes and acne vulgaris risk.     

Oral R115866 in the treatment of moderate to severe facial acne vulgaris: an exploratory study

BACKGROUND: R115866 (Rambazole; Barrier Therapeutics NV, Geel, Belgium), a new-generation retinoic acid metabolism-blocking agent, is a nonretinoid compound enhancing intracellularly the endogenous levels of all-trans-retinoic acid by blocking its catabolism. By virtue of this property, and the proven positive effects of retinoids in the treatment of acne, R115866 could potentially be a useful drug for acne. OBJECTIVES: To explore the efficacy, safety and tolerability of systemic R115866 in male patients with moderate to severe facial acne vulgaris (at least 15 papules and/or pustules and at least two nodulocystic lesions). METHODS: In this exploratory trial, 17 patients were treated with oral R115866 1 mg once daily for 12 weeks, followed by a 4-week treatment-free period. RESULTS: At the end of treatment (week 12, n = 16) a mean reduction in inflammatory lesion count of 77.4% (P < 0.001), in noninflammatory lesion count of 58.3% (P < 0.001) and in total lesion count of 76.0% (P < 0.001) was observed as compared with baseline. All lesion counts were significantly reduced from week 4 onwards. Mild side-effects were reported occasionally. CONCLUSIONS: The current data indicate that treatment with oral R115866 1 mg once daily for 12 weeks in patients with moderate to severe facial acne vulgaris is efficacious and well tolerated and merits further investigation.     

Clinical evaluation of the efficacy and safety of fractional bipolar radiofrequency for the treatment of moderate to severe acne scars

Several treatment modalities are used for the treatment of acne scars with variable results. Recent studies showed that fractional radiofrequency may be an effective treatment modality for acne scars. The objective of this study was to assess the efficacy, safety, tolerability and patient satisfaction of fractional bipolar radiofrequency (RF), the eTwo? system (Syneron Candela Ltd., Yokneam, Israel) for treating acne scars. Twelve patients with moderate to severe acne scars received 3–5 treatments with the Sublative fractionated bipolar RF applicator of the eTwo device at 1‐month intervals. Patients were evaluated clinically and photographically at each visit and 3 months after the final treatment. Very good improvement (at least one scale) was seen after completing the five treatments. The patient satisfaction survey (Global Aesthetic Improvement Scale scores) revealed that half (6 out of 12) of the patients reported to be satisfied with treatment results, while the other half reported to be very satisfied. Beyond the expected erythema and minimal scab formation in the treated areas, which was mild and transient, none of the participants reported any adverse events. The data presented here support the high efficacy and safety of fractionated bipolar RF for the aesthetic improvement of moderate to severe acne scars.     

红蓝光动力联合复方木尼孜其颗粒及阿达帕林凝胶治疗重度痤疮疗效评价

目的:评价红蓝光动力联合复方木尼孜其颗粒及阿达帕林凝胶治疗重度痤疮的疗效。方法:实验组和对照组均口服复方木尼孜其颗粒和外搽阿达帕林凝胶,实验组加用红蓝光照射。结果:治疗6周后实验组和对照组总有效率分别为92.6%和72.5%,差异有显著性(P0.01)。结论:红蓝光动力联合复方木尼孜其颗粒及阿达帕林凝胶治疗重度痤疮有效。     

5-氨基酮戊二酸光动力疗法治疗重症痤疮疗效评价

目的:评价5-氨基酮戊二酸光动力疗法(ALA-PDT)治疗重度痤疮的临床疗效。方法:36例重度痤疮患者随机分为治疗组和对照组(各18例)。治疗组给予ALA-PDT治疗,10天1次,共3次。对照组给予维胺酯50 mg口服,日3次和过氧苯甲酰凝胶外涂,每晚1次,共4周。结果:治疗组在第4、8和12周的有效率分别为50%、66.6%和83.3%;对照组有效率分别为22.2%、33.3%和27.8%,两组差异均有统计学意义(均P0.05)。结论:ALA-PDT是治疗重度痤疮的有效方法。     

Efficacy of fixed low-dose isotretinoin (20 mg, alternate days) with topical clindamycin gel in moderately severe acne vulgaris

Background  In view of the potentially serious side-effects of standard isotretinoin (0.5–1.0 mg/kg per day) therapy for acne, we studied the safety and efficacy of low-fixed dose isotretinoin plus topical 1%clindamycin gel in the treatment of moderate grade of acne.
Methods  In this prospective, non-comparative study, 320 adult patients, with moderately severe acne were enrolled and treated with fixed-dose isotretinoin at 20 mg every alternate day (approximately 0.15 mg/kg/day to 0.28 mg/kg/day) for 6 months along with topical clindamycin gel. All female patients were assessed for polycystic ovarian disease. Patients were followed up for 6 months.
Results  A total of 305 patients completed the study. Overall, patients received a mean of 38.4 mg/kg cumulative dose of isotretinoin, and very good results were observed in 208 (68.20%), while good response was seen in 59 (19.34%) of patients. Failure of the treatment occurred in 38 (12.46%), while relapses occurred in 50 (16.39%) of patients. Relapses were commoner in females, and 37 of 43 (86.04%) patients had polycystic ovarian disease. Though mild chelitis (91%) and xerosis (43%) were common, laboratory abnormalities in the form of elevated hepatic enzymes (5%) and elevated serum lipids (6%) were rare.
Conclusion  Six months of treatment with fixed-dose, alternate-day isotretinoin (20 mg) plus topical 1%clindamycin gel was found to be effective in the treatment of moderate acne in adult patients, with a low incidence of side-effects.

Conflicts of interest

None declared     

光电协同与420nm宽谱强光治疗中重度痤疮的临床研究

目的:比较400 nm强光联合双极射频(electro-optical synergy,Elos)与420 nm宽谱强光(broadband light,BBL)治疗中、重度痤疮的临床疗效和安全性。方法:纳入20例中重度痤疮患者,采用两侧面颊自身对照方法,左侧脸行Elos治疗,右侧脸行BBL治疗,每例患者治疗3次,治疗间隔3周,分别于治疗后2周和4周进行疗效和安全性评价,比较治疗前后痤疮严重程度评分及皮脂分泌量,评估临床疗效和不良反应,同时统计患者主观评价。结果:Elos治疗组和BBL治疗组有效率分别为55.9%和52.9%,两组差异无统计学意义;而Elos治疗组皮脂分泌量低于BBL治疗组,且两组均无严重不良反应发生。结论:Elos和BBL均能有效地治疗中重度痤疮,且Elos具有更强的油脂分泌抑制作用。     

Comparison of tretinoin 0.05% cream and 3% alcohol‐based salicylic acid preparation in the treatment of acne vulgaris

Background  No single effective topical treatment is available for treating all pathogenic factors causing acne vulgaris (AV). Salicylic acid (SA), tretinoin (all‐TRA) and clindamycin phosphate (CDP) are known to to be effective agents depending on their comedolytic and anti‐inflammatory properties. Objective  To compare the efficacy and tolerability of SA and CDP combination (SA + CDP) with all‐TRA and CDP (all‐TRA + CDP) in patients with mild to moderate facial AV. Methods  Forty‐six patients aged between 18 and 35 years were enrolled in a 12‐week prospective, single‐blind, randomized and comparative clinical study. Efficacy was assessed by lesion counts, global improvement, quality of life index and measurement of skin barrier functions. Local side effects were also evaluated. Results  Both combinations were effective in reducing total lesion (TL), inflammatory lesion (IL) and non‐inflammatory lesion (NIL) counts and showed significant global improvement as evaluated by the investigator. At the end of the study, there was no significant difference between the two groups in terms of all lesion counts. In addition, TL counts decreased faster in the all‐TRA + CDP group compared with those in the SA + CDP group, with a significant difference between the two groups occurring as early as 2 weeks. Safety evaluations demonstrated that the incidence of mild to moderate side effects generally peaked at week 2 and declined gradually thereafter. Both combinations did not have an effect on stratum corneum hydration, although skin sebum values decreased with SA + CDP treatment. Conclusions  Combination of SA + CDP and all‐TRA + CDP was effective in decreasing lesion counts and well tolerated with minimal local cutaneous reactions in patients with mild to moderate AV.     

0.1%阿达帕林凝胶和1%克林霉素溶液联合外用治疗寻常痤疮临床观察

目的:比较0.1%阿达帕林凝胶(达芙文)与1%克林霉素磷酸酯溶液(特丽仙)联合外用与特丽仙单用治疗寻常痤疮的疗效和安全性。方法:将300例中至重度寻常痤疮患者分为两组,试验组联合外用达芙文和特丽仙,对照组单用特丽仙,两组共治疗12周。结果:274例患者完成治疗,治疗4周后试验组皮损总数改善显著优于对照组(P<0.05),并维持至12周;治疗8周后试验组炎性皮损和非炎性皮损改善优于对照组(P<0.01),并维持至12周。治疗结束后试验组和对照组的有效率分别为84.40%和72.93%(P<0.05)。试验组局部刺激反应发生率为4.0%,对照组为8.7%。结论:达芙文联合特丽仙治疗中至重度寻常痤疮的疗效比单用特丽仙的效果好。     

Metformin as an adjunct therapy for the treatment of moderate to severe acne vulgaris: A randomized open‐labeled study

Insulin, insulin‐like growth factor‐1 (IGF‐1) and essential amino acids activate the mechanistic target of rapamycin complex 1 (mTORC1), the main nutrient‐sensitive kinase. Metformin, through inhibition of mTORC1 may improve acne. A 12‐week, randomized, open‐labeled study evaluated the efficacy and safety of metformin as an adjunct for moderate to severe facial acne. In total, 84 patients received either oral tetracycline 250 mg bd and topical benzoyl peroxide 2.5% with or without metformin 850 mg daily. Evaluations constituted lesion counts, the Cardiff Acne Disability Index (CADI), metabolic parameters and treatment success rate (Investigators Global Assessment score of 0 or 1 or improvement of two grades). Treatment success rates were higher in the metformin group (66.7% vs. 43.2%; p = .04). The mean percentage reduction from baseline in total lesion counts at Week 12 was greater in the metformin group (71.4% vs. 65.3%; p = .278). The CADI scores showed a greater mean reduction in the metformin group (4.82 vs. 4.22; p = .451). Metformin was equally efficacious in improving acne in lean and overweight subjects. Gastrointestinal symptoms were noted in 31.7% of subjects on metformin. This study presents favorable data for metformin as an adjunct for acne treatment. Further randomized placebo‐controlled studies are required.     

A randomized, single-blind comparison of topical clindamycin + benzoyl peroxide (Duac®) and erythromycin + zinc acetate (Zineryt®) in the treatment of mild to moderate facial acne vulgaris

BACKGROUND: Antibiotics are often combined with other agents to provide topical acne treatments that are effective against both inflammatory and non-inflammatory lesions and minimize the development of antibiotic resistance. OBJECTIVES: To compare the clinical effectiveness of two combination treatments for facial acne: a ready mixed, once daily gel containing clindamycin phosphate (1%) plus benzoyl peroxide (5%) (CDP + BPO) and a twice daily solution of erythromycin (4%) plus zinc acetate (1.2%) (ERY + Zn). METHODS/PATIENTS: In this assessor-blind, randomized study, 73 patients were treated with CDP + BPO once daily and 75 patients with ERY + Zn twice daily. The treatment period was 12 weeks and lesion counts and global improvement were assessed at weeks 1, 2, 4, 8 and 12. RESULTS: CDP + BPO showed an earlier onset of action with a faster significant reduction in total lesion counts than ERY + Zn. The proportion of patients with at least a 30% improvement in non-inflammatory lesions at week 1 was 31.5% for CDP + BPO and 17.3% for ERY + Zn; the corresponding percentages for inflammatory lesions were 39.7% and 29.3%. A difference was also observed at week 2 (53.4% vs. 36.0% for non-inflammatory lesions and 72.6% vs. 53.3% for inflammatory lesions). The trend in favour of CDP + BPO, although less marked, continued to the end of the study, with reductions in the total lesion count at endpoint of 69.8% for CDP + BPO group and 64.5% for ERY + Zn group. Both treatments were well tolerated. CONCLUSIONS: CDP + BPO and ERY + Zn are effective treatments for acne but CDP + BPO has an earlier onset of action that should improve patient compliance.     

复方甘草酸苷对皮肤斑贴试验的影响

目的 探讨复方甘草酸苷制剂对皮肤斑贴试验的影响.方法 选取皮肤斑贴试验镍阳性(++)或甲醛阳性(++)患者84例,分别给予复方甘草酸苷制剂中剂量干预(复方甘草酸苷片50 mg每天3次)和高剂量干预(复方甘草酸苷片75 mg每天3次)均2周后重复皮肤斑贴试验以及静脉途径干预(复方甘草酸苷注射液,60 ml/d)1周后重复皮肤斑贴试验.应用SPSS 19.0版软件进行秩和检验,从斑贴试验定性和反应程度两个角度分别进行统计学分析.结果 中剂量干预完成研究81例患者,第2次斑贴试验时,66例++,13例+,2例+++,无阴性结果者.两次斑贴试验结果定性无变化;反应程度Z=-2.84,P=0.005,差异有统计学意义.高剂量干预完成研究82例患者,第2次斑贴试验时,37例++,36例+,9例阴性.两次斑贴试验结果:定性Z=-3.000,P=0.003;反应程度Z=-6.247,P=0.000,差异均有统计学意义.静脉途径干预完成研究58例患者,第2次斑贴试验时,12例++,10例+,36例阴性.两次斑贴试验结果:定性Z=-6.000,P=0.000;反应程度Z=-6.289,P=0.000,差异均有统计学意义.结论 复方甘草酸苷制剂口服高剂量和静脉途径应用时,对皮肤斑贴试验反应有明显抑制作用.建议做斑贴试验前应停此药2周.     

The effectiveness of intermittent isotretinoin treatment in mild or moderate acne

BACKGROUND: Isotretinoin is the only drug that affects almost all factors in acne pathogenesis. Recently, its use for the treatment of chronic mild or moderate acne unresponsive to long-term antibiotic therapy, and with a tendency to cause scarring and leading to negative psychological effects, has became popular. The aim of the study was to investigate the effectiveness of intermittent isotretinoin treatment in mild or moderate acne. METHODS: Sixty patients with mild or moderate acne localized to the face were enrolled in the study. The treatment regimen consisted of isotretinoin, 0.5-0.75 mg/kg per day, applied for 1 week every 4 weeks for a total period of 6 months, according to the degree of acne and number of inflammatory lesions. RESULTS: Forty-one (68.3%) of the 60 patients completed the 6-month therapy. At the end of the treatment complete improvement was observed in 34 patients (82.9%) out of 41. All adverse effects were mild and discontinuation of the treatment was not necessary. CONCLUSION: Intermittent isotretinoin treatment was found to be a safe and effective choice for patients with mild or moderate acne.     

Efficacy of the addition of salicylic acid to clindamycin and benzoyl peroxide combination for acne vulgaris

Clindamycin phosphate (CDP), benzoyl peroxide (BPO) and salicylic acid (SA) are known to be effective acne therapy agents depending on their anti-inflammatory and comedolytic properties. The purpose of this study was to investigate the efficacy and tolerability of the addition of SA treatment to CDP and BPO (SA and CDP + BPO) and compare it with CDP + BPO in patients with mild to moderate facial acne vulgaris. Forty-nine patients were enrolled in a 12 week prospective, single-blind, randomized, comparative clinical study. Efficacy was assessed by lesion counts, global improvement, quality of life index and measurements of skin barrier functions. Local side effects were also evaluated. Both combinations were effective in reducing total lesion (TL), inflammatory lesion (IL) and non-inflammatory lesion (NIL) counts. There were statistically significant differences between treatment groups for reductions in NIL counts beyond 2 weeks, IL counts and TL counts throughout the all study weeks, and global improvement scores evaluated by patients and investigator at the end of the study in favor of SA and CDP + BPO treatment when compared to CDP + BPO treatment. Both combinations significantly decreased stratum corneum hydration, although skin sebum values decreased with SA and CDP + BPO treatment. These combinations were also well tolerated except significantly higher frequency of mild to moderate transient dryness in patients applied SA and CDP + BPO. The addition of SA to CDP + BPO treatment demonstrated significantly better and faster results in terms of reductions in acne lesion counts and well tolerated except for higher frequency of mild to moderate transient dryness.