糖皮质激素和抗菌药物联合外用治疗湿疹的疗效观察

Efficacy of topical glucocorticoid-antibiofic combination in the treatment of localized eczema

目的探讨糖皮质激素和抗菌药物联合外用与单方激素外用治疗湿疹的疗效及预后。方法急性及亚急性湿疹患者217例，随机分为试验组及对照组，试验组外用糖皮质激素加莫匹罗星软膏联合治疗，对照组单独外用激素。治疗2周，达到临床治愈者随访13周，观察复发情况。结果治疗2周后，试验组总痊愈率80．6％，明显高于对照组（64．8％，x^2检验，P=0．01）。急性、亚急性患者治疗2周后，试验组的痊愈率均分别高于对照组，差异有统计学意义（x^2检验，P〈0．05）。随访期末，试验组复发率（15．6％）明显低于对照组（33．8％，x^2检验，P〈0．05）。痊愈患者中，复发患者中手湿疹所占比例高于未复发者（29．4％1：L13．0％，x^2检验，P〈0．05）。试验组不良反应发生率（5．71％）与对照组（4．46％）相比无差异（x^2=0．176，P〉0．05），不良反应轻微。结论在急性及亚急性湿疹治疗中，加用局部抗菌药物可以提高疗效并可能减少复发。

Objective To observe the response of and recurrence in patients with localized eczema after treatment with topical glucoeortieoid alone or in combination with topical antibaeterials. Methods Totally, 217 outpatients with acute or subacute localized eczema were enrolled and randomly classified into two groups to be treated with topical corticosteroids combined with mupirocin cream （experiment group, n =191） or topical corticosteroids alone （control group, n = 190） for two weeks. The patients who were cured at the end of the 2-week treatment were followed for 13 weeks for the observation of recurrence. Chi-square test and Student＇s t test were conducted to compare the cure and recurrence rates between different groups of patients. Results After two weeks of treatment, the cure rate in the experiment group was significantly higher than that in the control group （80.6% vs. 64.8%, X2 = 6.576, P = 0.01）. Increased cure rate was also observed in patients with acute and subacute eczema receiving glucocortieoidCaspasel4antibiotic combination therapy compared with those receiving eorticosteroids alone. During the 13Caspasel4week follow up, a lower recurrence rate was noted in the experiment group compared with the control group （15.6% vs. 33.8%, X2 = 6.455, P 〈 0.05）. Further more, the patients experiencing relapse of eczema showed a higher proportion of hand eczema cases （29.4% vs. 13.0%, 22 = 4.982, P 〈 0.05） compared with those without relapse. Adverse reaction was mild in these patients, and no statistical difference was observed between the experiment group and control group （5.71% vs. 4.46%, 22 = 0.176, P 〉 0.05）. Conclusion The combination with topical antibacterials may enhance the therapeutic effect of topical glueoeortieoids on and reduce the recurrence of localized eczema.