特应性皮炎皮损微生物与外用药对比治疗研究

目的 研究特应性皮炎(AD)皮损微生物感染、金黄色葡萄球菌(金葡菌)耐药与外用药的疗效.方法 2001年11月至2002年3月在北京中日友好医院及北京市儿童医院皮肤科门诊,按照Hanifin-Rajka诊断标准,共诊断AD患者71例.治疗前后于皮损处取材进行真菌直接镜检、真菌培养、细菌培养及药敏试验,以SCORAD方法计分,将其中66例患者随机分成两组,分别采用1%硝酸益康唑+0.1%曲安奈德霜与0.1%丁酸氢化可的松软膏外用对比治疗AD患者.结果 AD患者以婴幼儿、儿童为主(≤12岁者占73.24%);皮损细菌培养阳性率为53.51%(金葡菌阳性率为35.21%),真菌阳性率为1.41%;药敏结果显示金葡菌对利福平、万古霉素、丁胺卡那霉素、环丙沙星、头孢唑啉、头孢呋辛等敏感性好;1%硝酸益康唑+0.1%曲安奈德霜与0.1%丁酸氢化可的松软膏外用治疗AD4周时,前者疗效优于后者(P<0.05),细菌阴转率前者高于后者(P<0.01).两组外用药治疗的患者均未见不良反应.结论 具有抗感染与抗炎双重作用的1%硝酸益康唑+0.1%曲安奈德霜治疗AD的疗效优于0.1%丁酸氢化可的松软膏.

Study on Microbes on Skin Lesions and a Controlled Topical Treatment Trial in Atopic Dermatitis

Objective To study microbial flora on skin lesions and their antim icrobial susceptibilities and to conduct a topical treatment trial in atopicder matitis (AD). Methods Seventy one patients with AD were diagnosed according to the criteria of Hanifin-Rajka's in departments of dermatology in China-Japan Friendship Hospital and Beijing Children Hospital during November,2001 to March, 2002. Bacteria and fungi were examined by culture and microscopy. Among 71 cases, 66 were divided into two groups randomly with one group receiving 1% econazole +0.1% triamcinolone acetonide cream topically twice daily for 4 weeks, and the control group receiving 0.1% hydrocortisone butyrate ointment. Severity of AD was measured by SCORAD index. Results It was shown that AD mainly affected infants and children with a prevalence of 73.24% in patients less than 12 years old. The rates of bacterial and fungal colonization were 53.51%, 1.41%, respectively on skin lesions. S.aureus was detected in 35.21%of patients with AD. Antimicro bial susceptibility test indicated that S.aureus was sensitive to rifampin, vanc omycin, amikacin, ciprofloxacin, cefazolin, cefuroxime, etc. It was found that 1% econazole +0.1% triamcinolone acetonide cream had significantly more advantage over hydrocortisone butyrate ointment in the therapeutical effects (P<0.05) and clearance of bacteria (P<0.01). There were no side effects in the two groups. Conclusions The therapeutic effect of 1% econazole +0.1% triamcinolone acetonide cream is better than that of hydrocortisone butyrate ointment because of the c learance of bacterial colonization of the former.