特应性皮炎患者变应原检测及卡介菌多糖核酸联合曲安奈德益康唑乳膏的疗效

Detection of allergen and treatment of atopic dermatitis by polysaccharide nucleic acid fraction of bacillus calmette guerin combined with triamcinolone acetonide and econazole nitrate cream

目的检测特应性皮炎(AD)的变应原及观察卡介菌多糖核酸联合曲安奈德益康唑乳膏治疗AD的临床疗效。方法利用德国“敏筛”定量过敏原检测系统检测68例AD患者的变应原。患者均分为试验组(卡介菌多糖核酸联合曲安奈德益康唑乳膏治疗)和对照组(仅予曲安奈德益康唑乳膏治疗)观察临床疗效。结果AD患者的变应原检测阳性率为91．2％,以吸入性变应原为主(74．2％),明显高于食入性变应原(25．8％, P<0．05);吸入性变应原中尘螨所占比例最高,其次是毛皮屑、蟑螂等。试验组患者的治疗有效率为88．2％,明显高于对照组的58．8％(P<0．05),且治疗3周后皮损湿疹面积和严重度指数(EASI)评分和搔痒视觉模拟尺度评分法积分均明显优于对照组(P值均<0．01)。结论尘螨是AD的主要变应原,卡介菌多糖核酸联合曲安奈德益康唑乳膏治疗AD的疗效优于单用曲安奈德益康唑乳膏。

Objective To detect the allergens and assess the treatment of atopic dermatitis（AD） by polysaccharide nucleic acid fraction of bacillus calmette（BCG-PSN） combined with triamcinolone acetonide and econazole nitrate cream. Methods In vitro allergy screening test（IVT） was used to detect allergens in 68 cases of AD. The patients were divided into two groups, the treatment group received BCG-PSN combined with triamcinolone acetonide and econazole nitrate cream, whereas the control group received triamcinolone acetonide and econazole nitrate cream only. Results The positive rate of AD allergen was 91.2%, higher in the inhalant（74. 2%） than that of food allergen（28.5%, P 〈 0.05）. Among the inhalant allergens, dust mite was the highest, and next followed by dog-cat skin or hair piecemeal, cockroach excreta etc. The effective rate was significantly higher in the treatment group（88.2 % ） than that of the control group（58.8 %, P〈 0.05）. The eczema area and severity index（EASI） and visual analogue scale（VAS） scores were also significantly higher in the treatment group than those in the control group after 3 weeks（P 〈 0.01）. Conclusions Dust mites are the most common allergens in AD. Combined BCGPSN and triamcinolone acetonide and econazole nitrate cream therapy is superior to triamcinolone acetonide and econazole nitrate cream only.