复方多黏菌素B软膏治疗细菌性皮肤病临床实验研究

目的评价复方多黏菌素B软膏与环丙沙星软膏治疗细菌性皮肤病1周的疗效和安全性。方法入组包括脓疱疮、毛囊炎、甲沟炎、伤口感染等细菌性皮肤病48例,采用随机、双盲、平行组对比研究。受试者3次/d外用患处,疗程1周。结果治疗1周,试验组靶皮损总积分(TSS)由治疗前15.67±2.28降至3.25±3.90,症状体征改善率为(79.90±24.21)%;对照组总积分由治疗前14.71±2.90降至3.38±2.62,改善率为(76.44±19.40)%。临床有效率试验组和对照组分别为83.33%和75.00%。细菌学清除率试验组为83.33%,对照组为91.67%。临床和细菌学综合疗效评价显示,试验组总有效率为75.00%,对照组为70.83%。两组在临床疗效、细菌学疗效和总体疗效的比较差异均无统计学意义。结论复方多黏菌素B软膏与环丙沙星软膏相似,治疗细菌性皮肤病安全有效。     

口服特比萘芬治疗成人脂溢性皮炎疗效观察

目的　探讨口服特比萘芬治疗中、重度成人脂溢性皮炎的疗效。方法　治疗组口服特比萘芬 2 5 0mg 1次 /d ,外涂 0 .1%地塞米松霜及 2 %酮康唑霜 1次 /d ,共 4周 ;对照组仅外涂前两药 4周。结果　第 4周时人均病情总积分治疗组由 9.3± 1.8降为 1.9± 1.1(t =2 0 .73 ,P <0 .0 0 1) ,对照组由 9.5± 1.9降为 2 .9± 1.4(t =16.5 5 ,P <0 .0 0 1) ,两组间比较差异有显著性 (t=3 .3 2 ,P <0 .0 1) ;第 8周时人均总积分治疗组为 2 .3± 1.4,对照组为 8.9± 1.7,两组比较差异显著性 (t =8.89,P <0 .0 0 1)。结论　特比萘芬治疗成人中、重度脂溢性皮炎有较好疗效 ,并能延缓复发。     

喜树碱软膏联合派瑞松霜治疗慢性湿疹或神经性皮炎疗效观察

目的　观察喜树碱软膏与派瑞松霜联合应用治疗慢性湿疹和神经性皮炎的疗效。方法　 160例慢性湿疹或神经性皮炎的患者 ,随机分为两组。治疗组皮损先用 0 .0 3 %喜树碱软膏 ,后用派瑞松霜涂抹 ,均 1次 /d。对照组皮损应用派瑞松霜涂抹 ,2次 /d。用药 4周后判断疗效 ,随访半年观察其复发率。结果　治疗组治愈率为 5 8.5 4% ,有效率为85 .3 7% ,复发率为 18.75 %。对照组分别为 42 .3 1% ,69.2 3 % ,3 9.3 9%。两组间三者比较P均 <0 .0 5 ,差异有显著性。结论　喜树碱软膏联合派瑞松霜外用治疗慢性湿疹与神经性皮炎疗效显著 ,复发率低 ,可供临床选用     

丙酸氟体卡松乳膏治疗局限性湿疹和神经性皮炎的多中心临床研究

目的评价丙酸氟体卡松乳膏治疗局限性湿疹和神经性皮炎的临床疗效及安全性。方法采用多中心、开放性试验,局限性湿疹42例,神经性皮炎18例。外用0.05%丙酸氟体卡松乳膏1次/d,疗程为2周。结果治疗前皮损面积为19.59±18.61 cm2,治疗后皮损面积为4.11±9.13。治愈率43.33%,有效率88.33%,无不良反应发生。结论外用0.05%丙酸氟体卡松乳膏治疗局限性湿疹和神经性皮炎起效快、疗效高、安全性好且有较好,的依从性。     

湿疹及皮炎

20 0 3 1 3 46　长沙地区 1 88例湿疹及接触性皮炎患者斑贴试验结果分析 /张桂英 (中南大学湘雅二院皮肤科 )…∥临床皮肤科杂志 . 2 0 0 2 ,3 1 ( 6) . 3 5 7斑试总阳性 1 0 3例 ( 5 4.78% ) ,镍、汞、钴、铬 4种金属和芳香化合物是引起长沙地区湿疹、接触性皮炎的常见致敏因素 ,常存在于日常用品中 ,接触机会多 ,手部皮损为本组高发。参 2　 (刘斌 )2 0 0 3 1 3 47　湿疹的病机及防治探析 /毕艳武 (沈阳市沈河区中医院 )…∥辽宁中医杂志 . 2 0 0 3 ,3 0( 2 ) . 1 2 92 0 0 3 1 3 48　硝酸益康唑 /曲安奈德霜治疗湿疹临床观察 /路雪艳 (北…     

地奈德乳膏联合薇诺娜柔润保湿霜治疗婴幼儿湿疹疗效观察

目的评价0.05%地奈德乳膏联合薇诺娜柔润保湿霜治疗婴幼儿湿疹的有效性及安全性。方法将门诊2014年1月—2014年12月诊治的婴幼儿湿疹100例随机分成试验组和对照组。试验组先给予薇诺娜柔润保湿霜外用,5 min后再外用地奈德乳膏;对照组仅外用地奈德乳膏,每日2次,7 d为1个疗程。在第1个疗程和第2个疗程后判定疗效。8周后随访,观察预后及复发情况。结果第1个疗程试验组有效率为70.2%,对照组为64%,两组有效率比较差异无统计学意义。第2个疗程试验组有效率为94%,对照组为82%,两组相比差异有统计学意义。8周后随访,试验组有效率为84%,对照组为60%,两组相比差异有统计学意义。结论地奈德乳膏联合薇诺娜柔润保湿霜治疗婴幼儿湿疹疗效好,并能减少皮损的反复。     

穴位注射治疗发廊工作人员手部湿疹疗效观察

目的　观察醋酸曲安奈德两侧曲池穴位注射合用火把花根片治疗发廊及美容工作人员手部湿疹的疗效。方法　治疗组 5 5例用醋酸曲安奈德注射液进行两侧曲池穴位注射合用火把花根片口服 ;对照组 44例用醋酸曲安奈德注射液进行臀部肌肉注射合用刻免胶囊口服。结果　治疗组的痊愈率为 5 6.4% ,有效率为 90 .9% ,明显优于对照组的2 2 .7%、5 9.1% (P均 <0 .0 1)。治疗组的复发率为 6.5 % ,明显低于对照组的 3 0 .0 %。结论　曲安奈德注射液曲池穴位注射合用火把花根片治疗发廊及美容工作人员手部湿疹疗效确切。     

复方多粘菌素B软膏联合地奈德乳膏治疗亚急性/慢性湿疹的多中心、随机、双盲、平行对照临床研究

目的探讨复方多粘菌素B软膏联合地奈德乳膏治疗亚急性/慢性湿疹的临床疗效和安全性。方法采用多中心、随机、双盲、平行对照临床研究，入选亚急性湿疹患者144例（试验组72例，对照组72例），慢性湿疹患者144例（试验组72例，对照组72例）。试验组与对照组分别外用复方多粘菌素B软膏和复方多粘菌素B软膏基质，隔3h后两组均使用地奈德乳膏，每日交替使用各2次。记录患者的症状/体征（包括瘙痒程度、炎症程度、糜烂/渗出程度、浸润/肥厚程度及靶皮损面积）和时间指标（瘙痒减轻起效时间、瘙痒减轻缓解时间）。分析两组的疗效，评估安全性。结果试验组和对照组的症状/体征总分在用药7d（亚急性湿疹：试验组6.09±2.78，对照组8.26±3.17；慢性湿疹：试验组6.56±2.68，对照组8.84±2.90）和14 d（亚急性湿疹：试验组3.68±3.18，对照组5.28±4.05；慢性湿疹：试验组4.38±3.27，对照组6.25±3.78）均较基线水平（亚急性湿疹：试验组13.44±1.66，对照组13.60±1.75；慢性湿疹：试验组12.96±1.16，对照组12.64±1.18）有不同程度的下降。试验组亚急性、慢性湿疹患者在用药7、14 d后的症状/体征均较相应的对照组低，差异有统计学意义（均P<0.05）。亚急性湿疹患者中，试验组瘙痒和浸润肥厚评分的下降幅度均显著高于对照组（均P<0.01）；慢性湿疹患者中，试验组瘙痒、浸润肥厚和靶皮损面积评分的下降幅度均显著高于对照组（均P<0.05）。亚急性湿疹患者试验组瘙痒减轻起效时间短于对照组，但瘙痒减轻缓解时间长于对照组（均P<0.05）；慢性湿疹患者试验组瘙痒减轻起效时间短于对照组（P<0.0001），但瘙痒减轻缓解时间与对照组差异无统计学意义。试验组医生和患者对治疗效果的满意度均高于对照组（均P<0.05）。结论外用复方多粘菌素B软膏可增强外用地奈德乳膏治疗亚急性和慢性湿疹的疗效，且对亚急性湿疹的效果更为显著。复方多粘菌素B软膏还能较好地控制湿疹患者的瘙痒症状和浸润肥厚。     

派瑞松霜治疗新生儿尿布皮炎32例疗效观察

采取随机分组、对照试验 ,观察两组临床疗效、皮损痊愈时间及不良反应。结果治疗组痊愈率、总有效率分别为 87.5 %、96.9% ,明显高于对照组的 5 3 .6%、71.5 % (P <0 .0 5 ,0 .0 1)。治疗组痊愈时间平均为 3 .0± 1.2天 ,对照组为 6.0± 1.5天 ,两组比较差异有显著性 (t =2 .3 5 ,P <0 .0 5 )。派瑞松霜治疗新生儿尿布皮炎疗效显著而且安全。     

0.05％地奈德乳膏治疗湿疹的多中心随机双盲、对照研究

目的 了解0．05％地奈德乳膏治疗湿疹的临床疗效及安全性。方法 采用多中心、随机双盲、安慰剂对照法，试验组及对照组患者分别外用0．05％地奈德乳膏及地奈德基质，每日2次，共治疗3周。对红斑、糜烂、浸润、丘疹、渗出／结痂、瘙痒及皮损面积的总积分进行评价。结果 治疗结束时，试验组的临床总有效率为80．8％，对照组为41．1％。两组间的疗效差异有统计学意义（P〈0，0001）；试验组未见与用药相关的不良反应。结论 0．05％的地奈德乳膏治疗湿疹临床疗效可靠，安全性高。     

Efficacy and tolerability of pale sulfonated shale oil cream 4% in the treatment of mild to moderate atopic eczema in children: a multicentre,randomized vehicle‐controlled trial

Background Reports on controlled trials on the efficacy and tolerability of sulfonated shale oils in atopic eczema are not available so far. The aim of this study was to investigate whether topically applied, specially prepared pale sulfonated shale oil (PSSO) cream is capable of improving symptoms/signs of mild to moderate atopic eczema in children more efficaciously than a corresponding vehicle cream. Patients and methods A total of 99 children suffering from mild to moderate atopic eczema were enrolled in this multicentre, randomized, vehicle‐controlled study. Verum or vehicle cream was applied to the affected skin area three times a day over 4 weeks. As the primary outcome parameter served the reduction of the total score after 4 weeks of treatment, compared with the initial examination. Secondary outcome parameters were addressed as well. Tolerability was judged by investigators and patients/parents, and adverse events were documented. Results After 4 weeks of treatment, the total score declined from 13.4 ± 3.7 to 4.5 ± 7.4 score points in the verum group and from 13.0 ± 3.1 to 11.7 ± 8.6 score points in the vehicle group (P < 0.0001). The superiority of verum regarding total score was already apparent after a treatment period of 1 week (reduction by 5.6 ± 4.3 vs. 1.3 ± 5.9 score points; P < 0.0001). Tolerability was found superior at the end of the treatment in the verum when compared with the control group – both by investigators (P < 0.0001) and patients/parents (P = 0.0051). Conclusion Pale sulfonated shale oil cream 4% is capable to treat mild to moderate atopic eczema in children more efficaciously than vehicle and is well tolerated. PSSO thus represents a valuable addition to our therapeutic armamentarium. PSSO should be considered in particular when valid alternatives for topical glucocorticoids are sought for.     

糠酸莫米松乳膏治疗湿疹皮炎类皮肤病多中心临床研究

目的 评价0.1%糠酸莫米松乳膏治疗湿疹皮炎类皮肤病疗效和安全性。方法 本研究采用随机、双盲、平行对照的临床研究方法。受试者分别接受国产糠酸莫米松乳膏和艾洛松治疗。患者每日局部涂药1次,连续用药4周。在治疗始及治疗后第1～4周对各观察指标进行评估记录。结果 本研究共入选受试者284例(试验组和对照组各142例)中湿疹143例,神经性皮炎141例。治疗后1～4周,两组患者各项症状/体征指标计分及总计分均有明显下降。试验组和对照组组间比较差异无统计学意义。治疗结束时,湿疹患者试验组基愈率和总有效率分别为78.87%、97.18%;对照组基愈率和总有效率分别为84.51%、92.96%。神经性皮炎患者试验组基愈率和有效率分别为75.71%、100%;对照组基愈率和总有效率分别为80.28%、94.37%。两组患者总体评价试验组基愈率77.30%,有效率98.58%。对照组基愈率82.39%,有效率93.64%。两组间疗效比较差异无统计学意义。研究中两组均未发生不良反应。试验组发生接触性皮炎1例。结论 0.1%糠酸莫米松乳膏治疗湿疹、神经性皮炎使用方便,安全性好。     

Pimecrolimus cream (1%) efficacy in perioral dermatitis – results of a randomized, double-blind, vehicle-controlled study in 40 patients

BACKGROUND: Perioral dermatitis (POD) is a common skin disease and difficult to treat. Pimecrolimus cream (1%) successfully controls atopic eczema. OBJECTIVE: Our aim was to investigate its efficacy in POD. STUDY DESIGN: Single-centre, randomized, double-blind, vehicle-controlled study including 40 POD patients with a 4-week treatment and a 4-week follow-up. Efficacy was assessed by a novel Perioral Dermatitis Severity Index (PODSI) and Finlay's Dermatology Life Quality Index (DLQI). SETTING: Outpatient clinics of a large dermatological hospital in Munich, Germany. RESULTS: During treatment, the PODSI was significantly lower in the pimecrolimus group compared with vehicle (P = 0.005-0.02) whereas at follow-up, no significant differences were observed. At week 2, the responder rates (> or = 50% PODSI improvement) were 50% with pimecrolimus cream (1%) and 25% with vehicle (P = 0.095). DLQI was improved in pimecrolimus group compared with vehicle. CONCLUSION: Results suggest that pimecrolimus cream (1%) effectively treats acute-stage POD.     

Influence of pimecrolimus cream 1% on different morphological signs of eczema in infants with atopic dermatitis

BACKGROUND: In the published studies on the efficacy of the topical immunomodulator pimecrolimus, different eczema scores were used, and the impact on morphological key signs of eczema was not analysed. OBJECTIVE: To compare the influence of pimecrolimus cream 1% on different standard eczema scores in infants with atopic dermatitis and to analyse the impact of treatment on the individual morphological key signs of eczema. METHODS: Pimecrolimus cream 1% (n = 129) or double-blind vehicle control (n = 66) was administered for 4 weeks. The Eczema Area and Severity Index (EASI), Investigators' Global Assessment (IGA) and Scoring Atopic Dermatitis Index (SCORAD) were determined and were correlated with each other. RESULTS: Following treatment with pimecrolimus, the EASI, IGA and SCORAD were significantly reduced on day 29 as compared with the vehicle group (p < 0.001, p < 0.001, p = 0.002, respectively). There was a close correlation between EASI, IGA and SCORAD. The single parameters of the EASI were already significantly decreased by day 4 in the pimecrolimus group as compared to vehicle (each p < 0.001). CONCLUSION: Treatment with pimecrolimus 1% cream leads to a rapid improvement of all morphological signs of eczema. The close correlation of different scores was shown for the first time.     

Efficacy of pimecrolimus 1% cream in the long term management of atopic hand dermatitis. A double-blind RCT

Background: Efficacy and steroid sparing effects of pimecrolimus 1 % cream in atopic dermatitis have been shown recently, but there is no data on efficacy in long term management of atopic hand dermatitis. This study aims to investigate the efficacy of pimecrolimus 1 % cream as maintenance therapy in patients suffering from atopic hand dermatitis. Patients and Methods: A double‐blind vehicle controlled study in 40 adult patients with atopic hand dermatitis (IGA < 3) comparing the efficacy of twice daily application of pimecrolimus 1 % cream given as maintenance treatment versus vehicle over a 8 week period after clinical response (IGA < 2) to a 1–3 week pre‐treatment with mometasone fuorate 0.1 % was performed. Primary endpoint was the time to relapse (IGA > 3). Results: Thirty‐six out of 40 patients were randomised to receive either pimecrolimus 1 % (P) or vehicle cream (V). The number of patients with stable remission in patients randomised to pimecrolimus (53.8 %) and vehicle (43.8 %) did not achieve statistical significance between the groups (p = 0.41). Subgroup analysis of patients with initially moderate dermatitis (IGA = 3, n = 20) showed a trend towards a better outcome for the pimecrolimus group (stable remission P = 81.8 % versus V = 55.6 %) (p = 0.244). Conclusions: Pimecrolimus 1 % cream twice daily was not superior to vehicle in the sequential maintenance therapy of atopic hand dermatitis, but efficacy in moderate forms should be investigated in further studies.     

Improvement in treatment adherence with a 3-day course of fluocinonide cream 0.1% for atopic dermatitis

Variations in adherence may cause variations in treatment outcomes with topical corticosteroid therapy for atopic dermatitis. An intensive short course of outpatient treatment may promote good adherence and provide a high level of efficacy. The purpose of this study was to assess the efficacy, tolerability, and adherence to short-term treatment with fluocinonide cream 0.1% in the treatment of atopic dermatitis. Twenty participants with mild to severe atopic dermatitis were instructed to use fluocinonide cream 0.1% twice daily for 3 consecutive days for a total of 6 doses. Disease severity was assessed at baseline, day 3, day 7, and day 14. Electronic monitoring was used to measure adherence to treatment. Median adherence to treatment over the 3-day period was 100%. By day 14, the median visual analog scale (VAS) of pruritus and eczema area and severity index (EASI) scores improved from baseline by 79% and 76%, respectively. By the end of the study period, 11 participants had investigator global assessment (IGA) scores of clear or almost clear. The absolute degree of improvement was proportional to baseline disease severity. Short-term treatment with fluocinonide cream 0.1% for atopic dermatitis was well-tolerated and resulted in significant disease improvement (P < .001). Participants were highly adherent to the 3-day treatment regimen. Efforts to improve adherence may be valuable approaches for treating recalcitrant atopic dermatitis.     

Pimecrolimus cream 1% is effective in asteatotic eczema: results of a randomized, double-blind, vehicle-controlled study in 40 patients

BACKGROUND AND OBJECTIVE: Pimecrolimus cream 1% is an effective treatment for atopic eczema. The aim was to investigate its efficacy in asteatotic eczema, a skin disease similar to atopic eczema and its associated dry skin and itching. METHODS: Single-centre, randomized, double-blind, vehicle controlled study in 40 patients with asteatotic eczema. Efficacy was assessed by eczema area and severity index (EASI), investigators global assessment (IGA), patient's self-assessment, and pruritus severity. RESULTS: After 4 weeks of treatment, EASI, the primary efficacy variable, was reduced by 62+/-7% from baseline in patients on pimecrolimus, compared to 21+/-14% in patients on vehicle (P=0.013). With pimecrolimus there was also a better control of pruritus (P=0.042) at week 4 whereas a better control of disease according to self-assessment could only be observed at weeks 2 (P=0.01) and week 3 (P=0.08). CONCLUSION: Pimecrolimus cream 1% is effective in patients with asteatotic eczema.     

保湿剂并用糖皮质激素治疗异位性皮炎的疗效观察

目的：研究保湿剂对外用糖皮质激素治疗异位性皮炎疗效的影响。方法：通过随机对照临床研究，采用湿疹面积及严重度指数评分法，对外用糖皮质激素和保湿剂治疗45例轻中度异位性皮炎患者的临床疗效进行评估。结果：与单独外用糖皮质激素或保湿剂相比，联合外用糖皮质激素加保湿剂治疗轻、中度异位性皮炎，较单用糖皮质激素疗效显著，单独外用保湿剂可明显减轻轻中度异位性皮炎患者的临床症状。结论：外用保湿剂能增强局部糖皮质激素的疗效，单独外用保湿剂治疗异位性皮炎可获得与糖皮质激素相近的疗效。