糖皮质激素长疗程间歇疗法治疗神经性皮炎的临床疗效观察

目的探讨外用糖皮质激素长疗程间歇疗法治疗神经性皮炎的疗效、安全性及复发情况,为指导临床用药提供依据。方法采用随机对照开放试验,选取门诊神经性皮炎患者,外用复方氟米松软膏常规疗法短期治疗。将已短期治愈入选的120例患者随机分为2组,试验组外用复方氟米松软膏进行长疗程间歇治疗,2次/d;对照组外用尿素霜（成分：尿素,羊毛脂,白蜡,凡士林）进行治疗,2次/d。2组每周用药2 d,每次间隔3 d用药,疗程8周。在长疗程治疗4周、8周及停药12周时各随访1次,分别比较2组患者的复发率。结果长疗程治疗8周及停药12周时,试验组SCORAD评分均显著低于对照组（P均〈0.05）。长疗程治疗4周、8周及停药12周时,试验组复发率均显著低于对照组（P均〈0.05）。治疗期间不良反应发生率1.67%,无严重不良事件。结论外用糖皮质激素长疗程间歇治疗神经性皮炎,效果好,不良反应少,有预防症状加重、延缓复发的作用。

Observation of Clinical Efficacy of Long-Term Intermittent Rreatment with Topical Cortieosteroids in Neurodermatitis

Objective To investigate the efficacy and safety of long-term intermittent treatment with topical cortieosteroids in neurodermatitis,and to provide basis for clinical treatment. Methods An open-label randomized controlled trail was conducted. A certain number of patients with neurodermatitis were selected and treated with a short-term conventional therapy with compound flumetasone ointment. A total of 120 patients who have been cured by the short-term therapy will be enrolled in to the following long-term study,and were randomly divided into 2 groups. Patients in the experimental group will be intermittently treated with topical ointment compound flumetasone in a long course,applying the cream for 2times a day; patients in the control group will be treated with urea cream（ ingredients： urea,lanolin,wax,petrolatum）,applying the cream topically for 2 times a day. Patients were followed up on week 4 and 8 after the beginning of treatment and on week 12 after the discontinuation of treatment. The recurrence rates between the 2 groups were compared. Results The severity of neurodermatitis in patients was rated according to SCORAD（ scoring atopic dermatitis）. The SCORAD score was significantly lower in patients treated with compound flumetasone ointment than in those with urea cream on week 8 in the treatment and week l2 after the discontinuation（ both P〈0. 05）. A statistical decrease was also observed in the experimental group compared with the control group at the 3 follow-up time points（ all P〈0. 05）. The incidence of adverse reactions during treatment was 1. 67% in the experiment group,and no serious adverse events were observed.Conclusion Long-term intermittent treatment with topical corticosteroids is effective for the prevention of exacerbation and recurrence of neurodermatitis,and will cause fewer adverse reactions.