老鹳草软膏联合丁酸氢化可的松乳膏序贯疗法治疗儿童期特应性皮炎临床观察

目的 观察老鹳草软膏联合丁酸氢化可的松乳膏序贯疗法治疗儿童期特应性皮炎的临床疗效。方法 选取96例儿童期特应性皮炎患儿作为研究对象，用随机数字表法将患儿分为治疗组、对照A组和对照B组，每组32例。因无法复诊脱落3例，外用老鹳草软膏局部皮肤过敏脱落2例，因发生其他疾病中止治疗1例，最终完成研究并纳入分析90例，每组30例。3组患儿均给予地氯雷他定糖浆口服，其中治疗组序贯外用老鹳草软膏联合丁酸氢化可的松乳膏；对照A组外涂丁酸氢化可的松乳膏，每日2次；对照B组每日外涂1次老鹳草软膏。采用特应性皮炎评分（scoring atopic dermatitis，SCORAD）评估皮损严重程度、瘙痒程度和影响睡眠指数，8周后随访复发率情况，并记录患者不良反应发生情况。结果 治疗2、4周后，3组SCORAD逐渐降低，后一治疗时点SCORAD均显著低于前一时点（P＜0.05）。治疗2周后，治疗组SCORAD显著低于对照B组（P＜0.05）。治疗4周后，治疗组SCORAD显著低于对照A组和对照B组（P＜0.05）。治疗组基于SCORAD的临床疗效显著优于对照A组和对照B组（P<0.05）。3组患者不良反应发生率和复发率比较，差异均无统计学意义（P＞0.05）。结论 老鹳草软膏联合丁酸氢化可的松乳膏序贯疗法治疗儿童期特应性皮炎可降低患者的皮损程度，改善症状，安全性较好。

Clinical Effect of Sequential Therapy with Geranium wilfordii Ointment and Hydrocortisone Butyrate Cream in Treatment of Childhood Atopic Dermatitis

Objective To investigate the clinical effect of sequential therapy with Geranium wilfordii ointment and hydrocortisone butyrate cream in the treatment of childhood atopic dermatitis. Methods A total of 96 children with childhood atopic dermatitis were enrolled as subjects and were divided into treatment group, control group A, and control group B using a random number table, with 32 children in each group. Three children were lost to follow-up since they were unable to attend the hospital for further consultation, two children were lost to follow-up due to local skin allergy following external application of Geranium wilfordii ointment, and 1 withdrew from treatment due to other diseases; at last, 90 children completed the study and were included in analysis, with 30 children in each group. All children were given oral administration of desloratadine syrup; in addition, the children in the treatment group were given sequential therapy with Geranium wilfordii ointment and hydrocortisone butyrate cream, those in the control group A were given external application of hydrocortisone butyrate cream twice a day, and those in the control group B were given external application of Geranium wilfordii ointment once a day. Scoring Atopic Dermatitis (SCORAD) score was used to evaluate the severity of skin lesion, the degree of pruritus, and the influence on sleep index. The children were followed up after 8 weeks to observe recurrence rate, and the incidence rates of adverse reactions were recorded. Results The three groups had a gradual reduction in SCORAD score after 2 and 4 weeks of treatment, and SCORAD score at the later time point was significantly lower than that at the earlier time point(P<0.05).After 2 weeks of treatment,the treatment group had a significantly lower SCORAD score than the control group B (P<0.05), and after 4 weeks of treatment, the treatment group had a significantly lower SCORAD score than the control groups A and B (P<0.05). The treatment group had a significantly better clinical outcome based on SCORAD score than the control groups A and B (P<0.05). There were no significant differences in the incidence rate of adverse reactions and recurrence rate between the three groups (P>0.05). Conclusion In the treatment of childhood atopic dermatitis, sequential therapy with Geranium wilfordii ointment and hydrocortisone butyrate cream can reduce the degree of skin lesion and improve clinical symptoms with good safety.