异维A酸胶囊间歇疗法联合克林霉素甲硝唑治疗中重度痤疮的临床疗效

doi:10.3969/j.issn.1671-7171.2023.08.011

摘要
图/表
参考文献
相关文章 (10)

全文: PDF (1188 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要【目的】探讨异维A酸胶囊间歇疗法联合克林霉素甲硝唑治疗中重度痤疮的临床疗效。【方法】选择靖边县中医医院2019年1月至2022年1月收治的80例中重度痤疮患者,采用随机抽签法分为观察组和对照组,每组40例。观察组使用异维A酸胶囊间歇疗法联合克林霉素甲硝唑外用涂抹治疗,对照组使用单一的克林霉素甲硝唑外用涂抹治疗。比较两组临床疗效、治疗期间不良反应发生率及治疗前后皮损严重程度(压痛、潮红)和数量(脓疱、囊肿、结节、粉刺)评分、炎症因子[肿瘤坏死因子-α(TNF-α)、白介素-8(IL-8)、Toll样受体(TLR)]水平、性激素[睾酮(T)、孕酮(P)、雌二酮(E₂)]水平。【结果】观察组总有效率显著高于对照组(P<0.05);两组治疗后皮损严重程度以及数量评分均低于治疗前(P<0.05),且观察组皮损严重程度以及数量评分低于对照组(P<0.05);两组治疗后TNF-α、IL-8、TLR水平均低于治疗前(P<0.05),且观察组TNF-α、IL-8、TLR水平低于对照组(P<0.05);两组治疗后T、P水平均低于治疗前,E₂水平高于治疗前(P<0.05),且观察组T、P水平低于对照组,E₂水平高于对照组(P<0.05);两组用药不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】异维A酸胶囊间歇疗法联合克林霉素甲硝唑治疗中重度痤疮疗效显著,可有效减轻皮损程度,降低炎症因子,调节性激素水平,且未明显增加不良反应发生率,值得临床推荐应用。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	马晓红
	张亚勤

关键词 ：痤疮,寻常/药物疗法, 异维A酸/药理学, 克林霉素/药理学, 甲硝唑/药理学

Abstract：【Objective】To investigate the clinical efficacy of intermittent therapy with isotretinoin capsules combined with clindamycin metronidazole in treating moderate to severe acne. 【Methods】Eighty patients with moderate to severe acne admitted to our hospital from January 2019 to January 2022 were selected as research subjects. Patients were randomly divided into the observation group and control group,with 40 cases each. The observation group was treated with isotretinoin capsule intermittent therapy combined with clindamycin metronidazole topical treatment,while the control group was treated with clindamycin metronidazole topical treatment. The clinical efficacy,the severity (tenderness,flushing) and quantity (pustules,cysts,nodules,blackheads) scores of skin lesions before and after treatment,changes in inflammation factors [tumor necrosis factor-alpha (TNF-α),interleukin-8 (IL-8),Toll-like receptors (TLR)] levels before and after treatment,changes in hormone levels [testosterone (T),progesterone (P),estradiol (E₂)] before and after treatment,and the incidence of drug side effects were compared between the two groups. 【Results】The total effective rate of the observation group was significantly higher than that of the control group (P<0.05). The severity and quantity scores of skin lesions in both groups were lower after treatment than before (P<0.05),and the scores in the observation group were lower than those in the control group (P<0.05). After treatment,the levels of TNF-α,IL-8 and TLR in both groups were lower than those before treatment (P<0.05); And their levels in the observation group were lower than those in the control group (P<0.05). The levels of T and P in both groups after treatment were lower than those before treatment,and E₂ levels of posttreatment groups were higher than those of pretreatment groups (P<0.05); While posttreatment levels of T and P in the observation group were lower than those in the control group,and E₂ level in the observation group was higher than that in the control group (P<0.05). There was no significant difference in the incidence of drug side effects between the two groups (P>0.05). 【Conclusion】The combination of intermittent isotretinoin capsules with clindamycin metronidazole has a significant effect on the treatment of moderate to severe acne. It can effectively reduce the degree of skin lesions,decrease inflammation,adjust hormone levels,and does not significantly increase adverse reactions. Thus it is recommended for clinical application.

Key words： Acne Vulgaris (TCM)/DT Isotretinoin/PD Clindamycin/PD Metronidazole/PD

收稿日期: 2022-09-14

中图分类号:

R7587.33

通讯作者: ^*E-mail:1142115132@qq.com

引用本文:

马晓红, 张亚勤. 异维A酸胶囊间歇疗法联合克林霉素甲硝唑治疗中重度痤疮的临床疗效[J]. 医学临床研究, 2023, 40(8): 1157-1160.
MA Xiao-hong, ZHANG Ya-qin. Clinical Efficacy of Intermittent Isotretinoin Capsules Combined with Clindamycin Metronidazole in Treatment of Moderate to Severe Acne. JOURNAL OF CLINICAL RESEARCH, 2023, 40(8): 1157-1160.

链接本文:

http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.08.011 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I8/1157

[1] GUO K,ZHU D,LU Z,et al. Effect of minocycline hydrochloride combined with photodynamic therapy on skin barrier function of patients with acne[J].Am J Transl Res,2021,13(7):8427-8432.
[2] 马英,刘晔,蒋敏,等. 痤疮丙酸杆菌生物膜形成与抗菌药物耐药的相关性分析[J].中国感染与化疗杂志,2021,21(6):703-707.
[3] 周静芳,张维娜,张云淑,等. 不同严重程度的寻常性痤疮患者心理及与外周血BDNF/TrKB表达的关系[J].中国皮肤性病学杂志,2019,33(4):383-389.
[4] 卢改会,李涛,朱克彬,等. 畅枢汤对异维A酸治疗中重度痤疮的“减毒增效”作用[J].中国皮肤性病学杂志,2021,35(11):1289-1294.
[5] 谭小琦,熊皓君,李旭林,等. 异维A酸联合omega-3脂肪酸辅助治疗中重度寻常痤疮的临床疗效及不良反应评价[J].中国皮肤性病学杂志,2021,35(5):576-581.
[6] 哈比夫. 临床皮肤病学[M]. 北京:北京大学医学出版社,2014:36-39.
[7] 郭娴菲,尹兴平,黄海峰,等. 寻常痤疮患者痤疮丙酸杆菌耐药性及其分子机制[J].临床皮肤科杂志,2020,49(12):717-722.
[8] 唐慧菁,孙菲,邓向军,等. 痤疮患者痤疮丙酸杆菌对克林霉素和甲硝唑的敏感性分析[J].中国皮肤性病学杂志,2018,32(1):26-28.
[9] BETTOLI V,GUERRA T A,HERANE M I,et al. Challenges and solutions in oral isotretinoin in acne: reflections on 35 years of experience[J].Clin Cosmet Investig Dermatol,2019,30(12):943-951.
[10] ZOUBOULIS C C . Endocrinology and immunology of acne: Two sides of the same coin[J].Exp Dermatol,2020,29(9):840-859.
[11] PHAM C T,HOSKING A M,COX S,et al. Therapeutic response of facial papules and inflammation in frontal fibrosing alopecia to low-dose oral isotretinoin[J].JAAD Case Reports,2020,6(5):453-456.
[12] 丁娟,张建青,陈宏. 清热散结片联合异维A酸软胶囊、克拉霉素缓释片治疗寻常型痤疮的临床效果及对血清IL-17的影响[J].中华中医药学刊,2021,39(5):67-69.
[13] 王钦,金智华,范义凤. 复方甲硝唑克林霉素乳膏的皮肤刺激性、致敏试验及离体透皮释药特性[J].中国医院药学杂志,2018,38(11):1153-1157.
[14] 袁智娟,王璐,钱齐宏. 克林霉素磷酸脂凝胶联合波长1565 nm掺铒光纤点阵激光治疗轻中度寻常痤疮的疗效观察[J].应用激光,2018,38(2):315-319.