寻常性痤疮与功能性消化不良的关系初探

目的：观察痤疮患者伴随的消化不良症状及药理剂量的烟酸、锌及其他维生素对轻、中、重度（pillsbury分级法）寻常性痤疮的治疗效果。方法：将176例轻、中、重度寻常性痤疮患者随机分为两组：治疗组,口服烟酸、锌、VitB12、VitB6、VitE、叶酸等,不能耐受皮肤发红者用烟酰胺替代;对照组,口服乙酰螺旋霉素片、VitB12、VitB6、VitE、叶酸、锌口服,抗菌素用3天。门诊记录患者伴随症状,两组疗程均为4周。治疗结束后观察治疗组中继续烟酸治疗的患者与停药患者的复发情况。结果：93.2%以上的痤疮患者伴有不同程度的消化道症状,68.5%的患者伴有明显的功能性消化不良。治疗组和对照组有效率分别为93.26%和36.36%,治疗组有效人数明显高于对照组,P〈0.01。随访停药2周后的患者复发率明显高于继续用药的患者,P〈0.05。结论：烟酸治疗寻常性痤疮具有良好疗效,长期大剂量使用的目的不仅在于治疗和预防痤疮,还在于治疗痤疮伴随的抑郁症、消化不良等并发症。观察结果提示痤疮患者存在烟酸缺乏,特别是女性患者。痤疮患者伴随的各种消化道症状应该考虑到很可能是由于烟酸缺乏导致的能量代谢障碍,并由此造成胃肠蠕动及吸收功能障碍,而非仅仅由于食物造成的功能性消化不良,这有待于进一步研究。

Preliminary investigation of acne vulgaris associated with dyspepsia

Objective To observe the dyspepsia symptom associated with acne,as well as an open-label to assess the clinical utility of oral pharmacologic doses of Niacin,Zinc and other Vitamin in patients with Pillsbury grade 1 to grade 3 acne vulgaris.Methods 176 Acne patients were allocated to two groups and all the patients fill in simple questionnaires before treatment.The experimental group was treated with Nicotinic Acid Tablets,zinc and Vitamin E,Vitamin B12,Vitamin B6,Folic acid.Those who can not tolerate flushing,stomach-ache substituted with nicotinamide.While the control group was treated with Acetylspiramycin tablets,Vitamin B6,Vitamin B12 and Vitamin E,Folic acid.The accompany symptom before treatment of all acne patients were recorded.The therapeutic efficacy of both groups was the evaluation of percentage of reduction in inflammatory lesions after 4 weeks of treatment.Acetylspiramycin tablets were used only 3 days.The recurrence rate of continued drug user and withdrawal were assessed.Results There are about 93.2% acne patients accompany a variety of gastrointestinal symptoms,68.5% of patients with obvious symptoms of functional dyspepsia.The total effective rate in the experimental group and control group were 93.26% and 36.36% respectively.The effective case number in the experimental group is more than control group significantly （P0.01） and relapse rate of niacin continued user is less than who withdrawal niacin treatment for 2 weeks remarkably.Conclusion Acne patients accompanying gastrointestinal symptoms should be considered that it is probably the deficiency of niacin,not just a variety of food induced indigestion.