克林霉素磷酸酯凝胶治疗痤疮

目的：观察克林霉素磷酸酯凝胶治疗痤疮的疗效。方法：痤疮１５４例随机分成３组,克林霉素磷酸酯凝胶１０４例,其中试验组５０例（男性１３例,女性 ３７例;年龄 ２３ ａ＋ ｓ ６ ａ）,开放组 ５４例（男性 １３例,女性 ４１例;年龄 ２４ ａ＋ ７ ａ）。磷酸克林霉素洗液５０例为对照组（男性 １８例,女性 ３２例;年龄２６ ａ±７ ａ）。上述药物每日早晚各 １次涂于患部,疗程均 ４ ｗｋ。结果： ３组治疗后炎性丘疹、脓疱改善较治疗前差异有显著意义（Ｐ＜０．０５或Ｐ＜０．０１）。试验组与对照组症状改善及疗效比较,差异无显著意义（Ｐ＞０．０５）。结论：克林霉素磷酸酯凝胶治疗痤疮疗效佳。     

Combination of azelaic acid 5% and clindamycin 2% for the treatment of acne vulgaris

Context and objective: Acne vulgaris, an inflammatory skin disease with different clinical appearances, is a common problem in most adolescents. It seems that using combinations of topical agents can decrease resistance to the treatment and improve the efficacy. Therefore, we evaluated the effects of azelaic acid (AA) 5% and clindamycin (Clin) 2% combination (AA-Clin) on mild-to-moderate acne vulgaris.

Materials and methods: The efficacy and safety of 12-week treatment with AA-Clin in patients with mild-to-moderate facial acne vulgaris were evaluated by a multicenter, randomized, and double-blind study. A total of 88 male and 62 female patients were randomly assigned to one of these treatments: AA 5%, Clin 2%, and combination of them. Every 4 weeks, total inflammatory and noninflammatory lesions were counted, acne severity index (ASI) was calculated, and patient satisfaction was recorded.

Results: Treatment for 12 weeks with combination gel significantly reduced the total lesion number compared with baseline (p?<?0.01), as well as Clin 2% or AA 5% treatment groups (p?<?0.05 or p?<?0.01). The percentage of reduction in ASI in combination treated group (64.16?±?6.01) was significantly more than those in the Clin 2% (47.73?±?6.62, p?<?0.05) and 5% AA (32.46?±?5.27, p?<?0.01) groups after 12 weeks. Among the patients in the AA-Clin group, 75.86% of males were satisfied or very satisfied and 85.71% of females were satisfied or very satisfied. This trend was significant in comparison to the number of patients who were satisfied with AA 5% or Clin 2% treatment (p?<?0.01). Seven patients in AA-Clin group (incidence?=?22%) showed adverse effects that were not statistically significant compared to treatment with individual active ingredients.

Discussion and conclusion: The profound reduction in lesion count and ASI by combination therapy with AA-Clin gel in comparison to individual treatment with 5% AA or Clin 2% suggested the combination formula as an effective alternative in treatment of acne vulgaris.     

复方克林霉素搽剂治疗寻常痤疮

目的 :观察复方克林霉素搽剂治疗寻常痤疮的疗效。方法 :采用开放、多中心临床试验方法以复方克林霉素搽剂治疗 153例寻常痤疮病人 (男性53例 ,女性 10 0例 ,年龄 2 2a±s 6a) ,每日 3次涂于面部 ,连续 4wk ,每 2wk随访。结果 :复方克林霉素搽剂治疗寻常痤疮 ,4wk总显效率达 83.0 % ,对脓疱和丘疹的总有效率分别为 96.1%和 80 .7% ,不良反应率为 1.9%。结论 :复方克林霉素搽剂治疗痤疮疗效显著 ,安全性高 ,使用方便     

Clindamycin phosphate/tretinoin gel formulation in the treatment of acne vulgaris

Clindamycin phosphate 1.2% together with tretinoin 0.025% as a gel (CTG) is a topical formulation of a fixed and stable combination approved by the FDA for the treatment of acne vulgaris in patients 12 years of age or older. The main indication of CTG is the management of moderate comedonal and mild-to-moderate papulopustular acne, an acne form which is present in more than 50% of acne patients. CTG can also be combined with systemic antiacne therapy, such as systemic isotretinoin, in nodulocystic acne. The product combines the anti-inflammatory and antibacterial properties of clindamycin with the well proven and beneficial comedolytic and anticomedogenic effects of tretinoin (all-trans retinoic acid). The addition of clindamycin to tretinoin enhances the comedolytic efficacy of tretinoin in moderate-to-severe acne of the face. The comedolytic activity of tretinoin and the anti-inflammatory efficacy of clindamycin accelerate resolution of all types of acne lesions without affecting the safety of both compounds. Discontinuation rates due to adverse events related to this formulation were found to be low (≤ 1%). Safety of CTG use in pregnancy has not been established. The combination formulation is mainly designed to enhance effectiveness and minimize irritation. The once daily use of CTG, its rapid and dual effect and good tolerability have a positive impact on the duration of disease, patients' compliance and overall costs of therapy.     

克林霉素磷酸酯外用溶液剂联合重组人表皮生长因子凝胶外用治疗轻中度痤疮疗效观察

目的：探讨克林霉素磷酸酯外用溶液剂联合重组人表皮生长因子凝胶外用治疗轻中度痤疮疗效.方法：将80例患者随机分为两组,治疗组40例采用克林霉素磷酸酯外用溶液剂涂擦皮损处,早晚各1次,重组人表皮生长因子凝胶外用皮损处,每日中午1次;对照组40例采用克林霉素磷酸酯外用溶液剂外涂皮损处,早晚各1次.8周后进行疗效判断.结果：治疗组和对照组总有效率分别为92.5％和82.5％,痊愈率分别为45％和30％,差异均有统计学意义（P＜0.05）.结论：克林霉素磷酸酯外用溶液剂联合重组人表皮生长因子凝胶治疗轻中度痤疮疗效优于单用克林霉素磷酸酯外用溶液剂.     

Topical clindamycin in the management of acne vulgaris

A small cadre of antimicrobials are commonly used and regarded as effective and safe, as systemic and topical treatments of acne vulgaris. These include oral tetracycline, doxycycline, minocycline and topical clindamycin and erythromycin. Topical antimicrobials work via both antimicrobial and non-antimicrobial mechanisms: the former due to suppression of the growth of propionibacterial species (especially Propionibacterium acnes and P. granulosum). Clindamycin appears to be superior in efficacy compared with erythromycin and tetracycline. However, the emergence and spread of resistance among propionibacteria to both erythromycin and clindamycin calls into question their long-term viability as topical anti-acne therapies. Only through judicious use of combination topical therapies (e.g., topical retinoid, benzoyl peroxide or azelaic acid plus clindamycin or erythromycin) and the practice of effective infection control (i.e., handwashing between seeing patients in the clinic) can both clindamycin's and erythromycin's widespread utility be preserved in this disorder.     

五味消毒饮内服外敷治疗寻常性痤疮35例临床观察

目的:观察五味消毒饮加减内服外敷治疗寻常性痤疮临床疗效。方法:60例痤疮患者随机分为两组,治疗组35例,采用五味消毒饮加减内服外敷联合治疗方法。对照组25例,口服甲硝唑片,睡前外用维A酸乳膏。结果:治疗组痊愈率51.4%,总有效率97.1%;对照组痊愈率24.0%,总有效率80.0%。两组痊愈率与总有效率比较,差异均有显著性(P<0.05)。结论:五味消毒饮加减内服外敷法治疗寻常性痤疮有显著疗效,安全性好。     

复合维生素E,C,B组合物面膜治疗寻常痤疮117例的疗效和安全性(英文)

目的:了解维生素E,C,B组合物面膜治疗寻常痤疮的疗效及安全性。方法:117例13a以上、痤疮严重程度分级在2级以上且主要表现于脸部的病人,予维生素E,C,B组合物面膜治疗,每日1次,共8wk。观察治疗前后痤疮数量及性质,包括粉刺、丘疹、脓疱及囊肿之数目,并评估整体疗效。结果:治疗后,粉刺、丘疹、脓疱及囊肿数目下降了13±s13,10±12,5±7及3±3,均P<0.01。7例(6.0%)病人症状完全改善,44例(37.6%)中度改善,56例(47.9%)轻度改善,10例(8.6%)无改善。59例(50.4%)病人无红肿、搔痒、灼热及脱皮等现象发生。结论:维生素E,C,B组合物面膜治疗痤疮有效,超过半数的受试者无不良反应发生,可作为传统治疗寻常痤疮药物的替代。     

An evaluation of dapsone gel 5% in the treatment of acne vulgaris

Background: Oral dapsone has been available for over 60 years. Its first clinical use was discovered in 1945, when it was found to be efficacious in inhibiting the progression of leprosy. The combined antibacterial and anti-inflammatory pharmacologic activities of dapsone have made it a widely investigated drug, particularly for use in refractory and unusual dermatologic conditions. However, the possibility of significant hematological side effects, even at low doses, has limited its use. Currently, oral dapsone has FDA approval for the treatment of leprosy and dermatitis herpetiformis. The potential of oral dapsone to treat acne vulgaris is well established, but the risks of serious side effects have made it an undesirable drug for use in the relatively healthy acne population. Recently, a topical formulation of dapsone (Aczone^?, Allergan, Inc., Irvine, CA, USA) has been approved by the FDA for the treatment of acne vulgaris. Objective/methods: The aims of this study were to review the published literature on dapsone pharmacology and pharmacokinetics, and to evaluate the gel's efficacy and safety in treating acne vulgaris, and finally to provide personal insight into its future as a topical agent for acne vulgaris. Results/conclusions: Clinical studies indicate dapsone gel 5% is effective in treating mild to moderately severe acne. It is well tolerated, with pharmacokinetic evidence indicating topical dosing in comparison to oral administration significantly reduces systemic concentrations of the drug, and therefore risk of serious side effects. Data suggests that dapsone gel 5% has the potential to become an established topical drug for the treatment of acne vulgaris. However, studies comparing the clinical effectiveness of the dapsone gel 5% to other available topical antiacne drugs are needed as are studies accessing its usefulness and safety when combined with other acne pharmaceuticals.     

异维A酸治疗寻常痤疮疗效观察

寻常痤疮４４例，随机双盲分为Ａ和Ｂ２组。Ａ组１９例：男性１１例，女性８例，年龄２２±ｓ４ａ，服精制豆油胶丸，１０ｍｇ／丸，２－３丸／ｄ×１２ｗｋ。Ｂ组２５例；男性２０例，女性５例，年龄２４±４ａ，服异维Ａ酸胶丸，１０ｍｇ／丸，２－３丸／ｄ×１２ｗｋ。结果：总有效率Ａ组为５％，Ｂ组为９２％，经Ｒｉｄｉｔ分析ｐ＜０．０５。异维Ａ酸主要不良反应为口干。     

Evaluating FMX-101 as a promising therapeutic for the treatment of acne

ABSTRACT

Introduction

Oral minocycline is a mainstay of therapy for moderate-to-severe acne; however, systemic side effects which include hepatotoxicity, lupus-like syndrome, drug hypersensitivity syndrome, autoimmune hepatitis, polyarteritis nodosa, gastrointestinal side effects and skin hyperpigmentation are of concern. Topical antibiotics commonly used in acne, such as erythromycin and clindamycin, present high P. acnes resistance rates which has opened the market for new topical antibiotics. FMX-101 is a novel topical minocycline foam that has shown promising results in phase I, II and III trials for the treatment of moderate-to-severe acne with a better safety profile than oral minocycline.     

阿达帕林凝胶治疗寻常痤疮临床观察

目的 :观察 0 1%阿达帕林凝胶治疗寻常痤疮的临床疗效和安全性。方法 :16 0例寻常痤疮患者 ,分别给予外涂 0 1%阿达帕林凝胶 (80例 )及 0 0 2 5 %全反维A酸凝胶 (80例 )。根据治疗前后炎性损害和非炎性损害总数减少的百分率评价疗效。结果 :两组痊愈率、显效率、有效率均无统计学差异 ,阿达帕林组不良反应率明显低于全反维A酸组。结论 :0 1%阿达帕林是一种局部治疗寻常痤疮的有效的安全的药物     

阿达帕林凝胶治疗寻常性痤疮疗效及安全性研究

目的:通过阿达帕林凝胶与5%过氧苯甲酰霜对寻常性痤疮治疗的对照观察,评价阿达帕林凝胶治疗寻常性痤疮的疗效和安全性.方法:采用开放对照临床实验,分别应用阿达帕林凝胶与5%过氧苯甲酰霜对寻常性痤疮病人进行治疗,疗程12周,在治疗的2、4、8和12周进行随访.结果:阿达帕林凝胶治疗寻常性痤疮疗效和安全性均高于5%过氧苯甲酰霜剂.结论:阿达帕林凝胶是治疗寻常性痤疮安全和有效的药物.     

维胺酯2种给药方案治疗寻常痤疮44例

目的 :观察维胺酯不同剂量治疗痤疮的疗效和安全性 ,探索有效治疗方案。方法 :将 4 4例中、重度寻常痤疮病人分为 2组 ,A组 2 4例 ,总疗程 6mo ,分别在mo 1～ 2按 1mg·kg- 1·d- 1;在mo 3～ 4按 2 5mg ,qd ;在mo 5～ 6按 2 5mg ,qod的剂量口服。B组 2 0例 ,5 0mg ,tid ,总疗程 6wk。结果 :2组总累积量A组为 (6 14 3±s 5 71)mg ,B组为 6 30 0mg ;治疗后临床评分分别为 (7.7± 1.7)分vs(7.7±1.6 )分 ;基本痊愈率分别为 5 4%vs 5 0 % ,差异均无显著意义 (P >0 .0 5 )。日剂量分别为 (0 .5 3±0 .0 3)mg·kg- 1·d- 1vs (2 .4± 0 .3)mg·kg- 1·d- 1、不良反应率为 8%vs 4 0 % ;复发率 12 %vs4 5 % ,差异均有显著意义 (P <0 .0 5或P <0 .0 1)。结论 :应用维胺酯低剂量长疗程治疗寻常痤疮 ,疗效好 ,安全性高 ,复发率低。     

他扎罗汀乳膏与阿达帕林凝胶随机对照治疗寻常型痤疮多中心临床试验

目的 评价国产0．1％他扎罗汀乳膏治疗面部轻中度寻常型痤疮的疗效及安全性。方法 用多中心、随机单盲对照试验方法，0．1％他扎罗汀乳膏或0．1％阿达帕林凝胶局部外用每日1次，疗程8周。在治疗前、治疗2，4和8周进行观察。入选病例142例，其中0．1％他扎罗汀乳膏组71例，完成8周观察64例。0．1％阿达帕林凝胶组71例，完成8周观察67例。结果他扎罗汀乳膏组有效率72．3％，阿达帕林凝胶组有效率62．7％。两组之间无显著统计学差异。两组的不良反应均表现为轻度到中度的局部刺激，发生率分别为28．70％和23．50％。结论 他扎罗汀乳膏治疗寻常型痤疮安全有效。     

Benzoyl peroxide: a review of its current use in the treatment of acne vulgaris

Background: Owing to the use of topical and systemic antibiotics for acne vulgaris, the incidence of antibiotic-resistant Propionibacterium acnes is increasing worldwide. Topical benzoyl peroxide (BPO) is an alternative to antibiotics in the treatment of acne vulgaris. Objective: This review describes and evaluates recent clinical literature regarding the efficacy and tolerability of BPO. Methods: A PubMed literature search was conducted using the keywords benzoyl peroxide, acne, and combination therapy. Results: BPO is equally effective at concentrations of 2.5, 5.0 and 10%. However, a concentration-dependent irritant dermatitis can occur with higher concentrations. The efficacy of BPO can be enhanced when used in combination with topical retinoids, antibiotics and tertiary amines. BPO-containing combinations do not induce bacterial resistance and are important first-line treatments for mild to moderate acne vulgaris.     

异维A酸凝胶治疗寻常痤疮多中心随机双盲安慰剂对照临床研究

目的 评价0.05%异维A酸凝胶（抗面部痤疮药）治疗寻常痤疮的疗效及安全性.方法 用多中心随机双盲安慰剂对照试验设计,以凝胶基质为对照,2药分别外用患处,每日2次,疗程12周.结果 0.05%异维A酸凝胶与凝胶基质比较,治疗寻常痤疮的有效率分别为78.5%和23.3%;2药的药物不良反应发生率分别为23.2%和15.6%（P＞0.05）.结论 0.05%异维A酸凝胶治疗寻常痤疮是安全有效的外用药物.     

5-氨基乙酰丙酸光动力疗法治疗痤疮的作用机理

用5-氨基乙酰丙酸诱导产生原卟啉IX的光动力疗法(ALA-PDT)已经发展成为非常有用的治疗方法。近年来,有些作者报导该法对痤疮有效。这种方法基于一个事实,即5-氨基乙酰丙酸诱导产生的原卟啉IX对皮脂腺有很强的选择性。局部用5-氨基乙酰丙酸在人体毛囊和皮脂腺中转变成有效的光敏剂(原卟啉IX);在细菌中转变成光敏剂(粪卟啉或尿卟啉),经光激发,引起光动力反应,继而抑制皮脂分泌,灭活皮肤角化细胞并杀灭毛囊中的致病菌。这可能是ALA-PDT治疗寻常痤疮的作用机理。     

龙珠软膏联合一清胶囊治疗寻常型痤疮的临床研究

目的探究龙珠软膏联合一清胶囊治疗寻常型痤疮的临床疗效。方法选取2016年2月—2017年5月于广州中医药大学第一附属医院皮肤科就诊的72例寻常型痤疮患者,随机分为对照组和治疗组,每组各36例。对照组患者口服一清胶囊,2粒/次,3次/d。治疗组在对照组治疗基础上应用龙珠软膏,2次/d。两组均连续治疗8周。观察两组的临床疗效,比较两组治疗前后白介素-1(IL-1β)、白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、γ-干扰素(IFN-γ)、皮损积分的变化情况。结果治疗后,对照组和治疗组患者的总有效率分别为77.78%、97.22%,两组比较差异具有统计学意义(P0.05)。治疗后,两组血清IL-1β、IL-6、IL-8、TNF-α、IFN-γ、皮损积分均明显下降,同组治疗前后比较差异有统计学意义(P0.05);治疗后,治疗组IL-1β、IL-6、IL-8、TNF-α、IFN-γ、皮损积分显著低于对照组,两组比较差异具有统计学意义(P0.05)。结论龙珠软膏联合一清胶囊治疗寻常型痤疮具有较好的临床疗效,可较好地抑制炎症反应,降低皮损积分,具有一定的临床推广应用价值。