龙牡汤治疗特应性皮炎的临床疗效评价

目的 观察龙牡汤治疗血虚风燥型特应性皮炎的临床疗效、安全性及对患者生活质量的改善情况、复发情况.方法 采用随机对照方法将64例患者随机分配到试验组(龙牡汤内服加外洗组)和对照组(氯雷他定片和丁酸氢化可的松乳膏组),疗程8周.于治疗前、治疗第2周、第4周、第8周记录皮肤病变面积、皮损严重程度、瘙痒及患者的生活质量、用药情况、不良反应等,并在疗程结束后第3、6个月记录复发情况.结果 试验组治疗前后症状体征积分比较有显著性差异,与对照组疗效相当;两组治疗前后生活质量评分比较无显著性差异;两组复发情况比较差异有显著性,对照组6个月的复发风险是试验组的3.14倍.结论 龙牡汤内外合治特应性皮炎,有一定临床疗效.     

镇心安神方对特应性皮炎样动物模型维生素D及丝聚蛋白表达的影响

目的 探讨镇心安神方(ZXASF)对特应性皮炎(AD)样小鼠模型血清及皮肤组织1,25(OH)2-D3、维生素D受体及Filaggrin表达的影响.方法 采用1-氯-2,4-二硝基苯(DNCB)反复刺激BALB/c小鼠背部皮肤,建立AD样动物模型.54只小鼠随机分为6组(正常对照组、模型组、维生素D组、ZXASF低、中...     

特应性皮炎的治疗

<正>特应性皮炎(atopic dermatitis,AD)又名异位性湿疹,是一种较常见的慢性、复发性、炎症性皮肤病,主要表现为剧痒、湿疹样皮损和干皮病样症状等,常在婴幼儿期或青少年期起病,可伴有血清IgE水平升高及过敏性鼻炎或哮     

特应性皮炎的治疗

特应性皮炎（atopic dermatitis,AD）又名异位性湿疹,是一种较常见的慢性、复发性、炎症性皮肤病,主要表现为剧痒、湿疹样皮损和干皮病样症状等,常在婴幼儿期或青少年期起病,可伴有血清IgE水平升高及过敏性鼻炎或哮喘的个人史或家族史。流行病学调查显示,近年来AD的发病率逐渐上升,严重影响患者的生活质量,故正确治疗AD应是皮肤科医师熟知的内容。     

龙牡汤治疗青年及成人期特应性皮炎的疗效观察及生活质量评价

目的 评价中药龙牡汤治疗青年及成人期特应性皮炎的临床疗效、安全性及患者生活质量的改善情况.方法 采用随机、西药平行对照的方法对122例青年及成人期特应性皮炎患者给予中药龙牡汤或氯雷他定片联合0.1%丁酸氢化可的松乳膏,治疗前及治疗后第1、2、4、8周记录皮肤病变面积、皮损严重程度、瘙痒程度,计算SCORAD分值、生活质量分值(DLQI量表)及不良反应等.结果 中药组与西药组有效率分别为83.87%和78.33%,两组治疗前后疗效比较差异无统计学意义(P>0.05);风湿蕴肤证组与血虚风燥证组有效率分别为93.33%和75%,两者比较差异有统计学意义(P<0.05);中药组与西药组患者、风湿蕴肤证与血虚风燥证患者各自治疗前后生活质量改善均有显著性差异,具体表现在自觉症状、休闲活动、人际交往、工作学习、日常生活、治疗的影响等方面,两组治疗后比较均无显著性差异(P>0.05).结论 龙牡汤治疗青年及成人期特应性皮炎可以显著改善患者各项症状及生活质量,且安佥性高.     

曲尼司特治疗特应性皮炎临床疗效观察

目的：观察曲尼司特治疗特应性皮炎的疗效与安全性。方法：采用随机双盲、安慰剂平行对照的方法，将入选患者随机分为试验组与对照组，分别接受曲尼司特和安慰剂的治疗，同时两组患者均外用丝塔芙保湿润肤霜。对皮肤病变范围、皮损严重程度、瘙痒和睡眠影响程度进行临床观察，用SCORAD评分系统进行评估。结果：治疗组23例基本痊愈6例，显效9例，有效4例，无效4例，总有效率为65．22％，对照组总有效率为22．73％，两组有显著性差异（P=0．0216）；治疗组患者治疗前后SCORAD评分有统计学差异（P〈0．05）。治疗过程中治疗组不良反应仅为4．35％，且症状轻。结论：曲尼司特治疗特应性皮炎安全、有效。     

特应性皮炎的免疫疗法

特应性皮炎的发病与多种因子有关,但免疫异常可解释其有关发病机制,因此,免疫疗法是近年治疗特应性皮炎,特别是严重特应性皮炎较为有效的方法之一。重点介绍了干扰素、环孢素A、他克莫司(FK506)、白介素及其受体等药物的作用机制、临床疗效和副作用,并对部分新药(如SDZ ASM981)和新疗法进行了讨论。     

微生物与特应性皮炎

特应性皮炎病因复杂 ,发病机制尚未完全明了 ,研究显示某些微生物的感染或过敏与特应性皮炎的发生或加重有关。本文就特应性皮炎患者对某些微生物的携带情况、可能的免疫学方面的致病机理及相关的治疗进行了综述。     

213例儿童特应性皮炎临床及病理特点分析

本研究对213例AD儿童患者临床及组织病理学特点进行分析,患儿平均发病年龄为0.88±1.73岁,约85.9%的患者表现为慢性皮炎;约78.9%的患者有个人或家族遗传过敏史。组织病理学示角化过度、微水疱形成、棘层肥厚、海绵水肿、浅层血管周围炎症及嗜酸性粒细胞浸润。     

神经生长因子在特应性皮炎患者血清中的检测

目的 检测特应性皮炎(AD)患者血清中神经生长因子(NGF)水平,并观察其与病情严重程度之间的关系以及探讨NGF在AD发病中的作用.方法 采用双抗体夹心ELISA法检测80例AD(其中轻度25例、中度30例和重度25例)和60例正常对照者血清中NGF水平.结果 患者组与正常对照组相比,血清中NGF水平明显增高,差异有统计学意义(P<0.01).重度组与中度和轻度组相比较,及中度与轻度相比,血清中NGF水平均增高,差异均有统计学意义(P均<0.01).内源性和外源性AD患者血清中NGF水平均较正常对照组明显增高,差异有统计学意义(P<0.01).NGF水平与AD患者病情严重程度呈正相关(P<0.01).结论 NGF可能是表明AD患者病情严重程度的一个指标.     

The Influence of Pregnancy and Menstruation on the Deterioration of Atopic Dermatitis Symptoms

Background

Female patients with atopic dermatitis (AD) often experience cutaneous deterioration associated with their pregnancy or menstrual cycle.

Objective

We wanted to determine the prevalence of symptom aggravation as related to pregnancy and the menstrual cycle in female patients with AD.

Methods

One hundred female patients with AD were included in the study and interviews were performed. The total IgE level and the Eczema Area and Severity Index score of the patients were retrospectively reviewed.

Results

Ninety seven patients replied the questionnaire, and among them, 23 patients had completed at least 1 pregnancy. Among the 23 women who experienced pregnancy, 14 (61%) had noticed deterioration of their clinical symptoms during pregnancy. Of the 97 females, 31 (32%) patients had noticed deterioration of their AD as related to their menstrual cycle. For the patients who were sub-grouped as the intrinsic type of AD, the prevalence of symptom aggravation as related to pregnancy was significantly higher as compared to that of the extrinsic type of AD patients (p=0.048).

Conclusion

Of the 97 patients, 45 (46%) females answered that they have experienced deterioration of AD during pregnancy or in relation to their menstrual cycle, and this suggests the relation of a hormonal influence on the clinical manifestations of AD.     

特应性皮炎与行为异常

特应性皮炎作为一种慢性炎症性皮肤病严重影响患者的身心健康,行为学方面的异常也影响着患者的生活质量,其严重时可表现为注意缺陷多动症。睡眠紊乱及感觉调制障碍是行为异常可能的原因,特应性皮炎、注意缺陷多动症以及伴随的睡眠紊乱的因果关系需要进一步研究,特应性皮炎仍然需要完整的医学诊断、预防及治疗的联合策略。     

Atopic Dermatitis

Atopic dermatitis (AD) is a chronic and relapsing disease affecting an increasing number of patients. Usually starting in early childhood, AD can be the initial step of the so-called atopic march, i.e. followed by allergic rhinitis and allergic asthma. AD is a paradigmatic genetically complex disease involving gene-gene and gene-environment interactions. Genetic linkage analysis as well as association studies have identified several candidate genes linked to either the epidermal barrier function or to the immune system. Stress, bacterial or viral infections, the exposure to aero- or food-allergens as well as hygienic factors are discussed to aggravate symptoms of AD. Athough generalized Th2-deviated immune response is closely linked to the condition of AD, the skin disease itself is a biphasic inflammation with an initial Th2 phase and while chronic lesions harbour Th0/Th1 cells. Regulatory T cells have been shown to be altered in AD as well as the innate immune system in the skin. The main treatment-goals include the elimination of inflammation and infection, preserving and restoring the barrier function and controlling exacerbating factors. The overall future strategy in AD will be aimed to control skin inflammation by a more proactive management in order to potentially prevent the emergence of sensitization as well as to design customized management based on genetic and pathophysiologic information.     

The Clinical Efficacy, Safety and Functionality of Anion Textile in the Treatment of Atopic Dermatitis

Background

Several previous studies have suggested the improvement of atopic dermatitis (AD) in response to special fabrics. In particular, beneficial effects have been reported, following the use of anion textiles.

Objective

The purpose of this study is to evaluate the effectiveness and safety of an anion textile in patients suffering from AD.

Methods

We compared an anion textile with a pure cotton textile. Fifty-two atopic patients (n=52) were enrolled and divided into two groups. The patients in the test (n=25) and control (n=19) groups wore undergarments made of an anion textile or pure cotton over a period of 4 weeks. The overall severity of disease was evaluated using the SCORing atopic dermatitis (SCORAD) index, whereas, the treatment efficacy was measured using a Tewameter® (Courage & Khazaka, Cologne, Germany), Mexameter® (Courage & Khazaka) and Corneo meter® (Courage & Khazaka).

Results

At the end of the study, a significant decrease in the SCORAD index was observed among the patients with AD in the test group (mean SCORAD decreased from 47.2 to 36.1). Similarly, improvements in the mean transepidermal water loss, skin erythema and stratum corneum hydration were significantly greater among the patients with AD in the test group than in the control group.

Conclusion

Anion textiles may be used to significantly improve the objective and subjective symptoms of AD, and are similar in terms of comfort to cotton textiles. The use of anion textiles may be beneficial in the management of patients with AD.     

他克莫司软膏治疗成人中重度特应性皮炎的疗效和安全性观察

目的观察0.1%和0.03%他克莫司软膏治疗成人中重度特应性皮炎的疗效和安全性。方法采用随机双盲、赋形剂平行对照的临床试验,共入组54例成人中重度特应性皮炎患者,年龄18~65岁,共用药3周,其中49例患者完成本试验。结果治疗结束时0.1%和0.03%他克莫司软膏痊愈率分别为46.7%(7/15)和23.5%(4/17),显效率分别为46.7%(7/15)和47.1%(8/17),与赋形剂组的痊愈率17.7%(3/17)和显效率11.8%(2/17)相比,差异有统计学意义;0.1%和0.03%他克莫司软膏治疗有效率分别为93.3%(14/15)和70.6%(12/17),均明显高于赋形剂对照组的29.4%(5/17),差异具有高度统计学意义。在0.1%和0.03%他克莫司软膏中,主要不良反应表现为用药部位出现瘙痒(38.9%和27.8%)、灼热感(33.3%和16.7%)、刺痛(16.7%和22.2%)等,严重程度多为轻到中度,并且均为一过性。治疗前后实验室检查也无明显异常改变。结论0.1%和0.03%他克莫司软膏是一种安全、有效的治疗成人中、重度特应性皮炎的药膏。     

儿童特应性皮炎153例变应原皮试分析

目的探讨儿童特应性皮炎(AD)的病因。方法对153例AD患儿进行了变应原皮试。结果阳性率83.01%,其中吸入组阳性率80.1%,食物组74.6%,二组阳性率差异无显著性。常见的阳性变应原为室内尘土(73.5%)、粉尘螨(70.9%)、多价昆虫(56.9%)、虾(46.4%)、芝麻(40.0%)。年龄3岁以内组、3～7岁组和7岁以上组的吸入组皮试阳性率分别为46.7%,82.9%和85.0%,其差异有显著性(P<0.005)。结论吸入性和食物变应原是儿童特应性皮炎的主要病因之一,吸入性变应原过敏多发生在3岁以上。     

Recalcitrant Atopic Dermatitis Treated with Omalizumab

Atopic dermatitis (AD) is a chronic cutaneous inflammatory disease. Various categories of therapeutic medications are used for treating AD. Omalizumab is a monoclonal anti-IgE antibody that binds to IgE molecules at the high-affinity receptor (FcεRI) binding site. Therefore, omalizumab can be used as a potential new systemic treatment agent for recalcitrant AD patients with elevated IgE levels. A 34-year-old man had been treated for AD with several topical and oral agents. However, he was refractory to these therapies and his serum IgE levels were very high. We treated him with omalizumab. After 8 months of the treatment, his symptoms were notably improved and the SCORAD index was decreased. Thus, we report on the first case of recalcitrant AD that was successfully treated with omalizumab in Korea.