中药接触性皮炎临床及斑贴试验分析

Clinical Study and Patch Testing of Contact Dermatitis Caused by Traditional Chinese Medicinal Materials

为了探讨中药接触性皮炎的致病药物、临床表现、检测方法等因素，对１４例中药接触性皮炎患者及３５１例非中药致湿疹皮炎类皮肤病患者（其中包括８０例诊断明确的非中药引起的接触性皮炎患者）进行了临床及斑贴试验分析。结果发现中药接触性皮炎的致病药物多为外用消炎止痛类中药；中药接触性皮炎组对香料及松香斑贴试验的阳性率均高达５５．６％（５／９），明显高于非中药所致的可疑接触性皮炎组及诊断明确的非中药引起的接触性皮炎患者组中香料及松香的阳性率（２×Ｋ表Ｘ２检验，香料及松香的Ｘ２分别为９．２３及３５．６，Ｐ值均＜０．０１）；对另外二种常见接触变应原橡胶促进剂及白降汞三组间无统计学差异，提示芳香类中药可能容易致敏。中药接触性皮炎临床表现包括刺激性接触性皮炎、变应性接触性皮炎、速发型接触性反应及系统性接触性反应等，使用原药作斑贴试验多可获阳性结果。

The putative allergens,clinical manilestations and patch tests of traditional Chinese medicinal materials (CMM) which cause contact dermatitis (CD) are studied in this paper. 14 patients with CMM CD and 351 controls were patch tested with the standard series of allergen produced by the Beijing Medical University and the suspected drugs been tised. It was found that most CMM CD were caused by the CMM frequently used topically for 'analgesic and antiphlogistic'. All the patients patch tested with suspected drugs gave positive results. Some patients also reacted to fragrance mix, colophony, rubber mix and ammoniated mercury. The positive rates of fragrance mix and colophony in CMM CD patients were significantly higher than controls while rubber mix and ammoniated mercury were not. The results indicated that the topical analgesic and antiphlogistic CMM especially those containing fragrance may be liable to cause sensitization. CMM CD can be diagnosed by patch testing the putative drugs.