0.1％他克莫司软膏与1％氢化可的松软膏治疗面部脂溢性皮炎的对比观察

Contrastive observation on the efficacy of facial seborrheic dermatitis treated with 0.1% tacrolimus ointment and 1% hydrocortisone ointment

目的对比观察0．1％他克莫司软膏与1％氢化可的松软膏治疗面部脂溢性皮炎的疗效和安全性。方法选取70例面部脂溢性皮炎患者进行12周的研究。将患者按随机数字表法分为他克莫司组34例和氢化可的松组36例，分别使用0．1％他克莫司软膏和1％氢化可的松软膏涂抹患处皮肤，每日2次。于治疗后4、8、12周进行随访，记录皮损积分、药物剩余量，患者满意度，评价疗效并记录不良反应。结果治疗后4、8、12周两组患者皮损积分与治疗前比较均明显下降[他克莫司组：（1．81±1．77）、（0．81±0．35）、（0．07±0．26）分比（14．81±2．52）分，氢化可的松组：（2．01±1.58）、（0．91±0．46）、（0．08±0．28）分比（16．42±2．15）分，P〈0．05]，但同一时间点两组比较差异无统计学意义（P〉0．05）；他克莫司组有效率和氢化可的松组比较差异无统计学意义（P〉0．05）；他克莫司组治疗后4、8、12周药物剩余量均明显多于氢化可的松组，差异有统计学意义（P〈0．05）；两组患者均未出现严重不良反应，他克莫司组治疗后4、8、12周患者满意度均明显高于氢化可的松组[88．2％（30／34）比69.4％（25，36）、91．2％（31／34）比83.3％（30／36）、97．1％（33，34）比80．6％（29／36），P〈0．05]。结论与l％氢化可的松软膏比较，0．1％他克莫司软膏只需更少用量即可获得同样的疗效，0．1％他克莫司软膏治疗面部脂溢性皮炎更有优势。

Objective To compare the efficacy and safety of facial seborrheic dermatitis treated with 0.1% tacrolimus ointment and 1% hydrocortisone ointment. Methods Seventy patients with facial seborrheic dermatitis were enrolled in a 12-week study. The patients were divided into tacrolimus group （34 cases） and hydrocortisone group （36 cases） by table of random digit method,the 2 groups were treated with 0.1% tacrolimus ointment or 1% hydrocortisone ointment applied twice daily to symptomatic regions of the face. The skin injury score,drug residue,patient satisfaction,efficacy and adverse event were followed up after treatment of 4,8,12 weeks. Results The skin injury score in 2 groups after treatment of 4,8,12 weeks was significant lower than that before treatment [tacrolimus group： （ 1.81± 1.77）, （0.81 ± 0.35）, （0.07 ±0.26） scores vs. （14.81± 2.52） scores,and hydrocortisone group： （2.01 ± 1.58）, （0.91 ± 0.46）, （0.08 ± 0.28） scores vs. （ 16.42 ± 2.15） scores, P 〈 0.05 ],but there was no significant difference between 2 groups （ P 〉 0.05 ）. There was no significant difference in effective rate between 2 groups （P 〉 0.05 ）. The drug residue of tacrolimus group was significantly more than that of hydroeortisone group （P 〈 0.05 ）. There was no severe adverse event in 2 groups. The patient satisfaction in tacrolimus group after treatment of 4,8,12 weeks was significantly higher than that in hydrocortisone group [ 88.2% （ 30/34 ） vs. 69.4% （25/36）, 91.2% （ 31/34 ） vs. 83.3% （30/36）,97.1% （33/34） vs. 80.6% （29/36）,P 〈0.05]. Conehtsion The 0.1% tacrolimus ointment requires significantly fewer applications compared with 1% hydrocortisone ointment to achieve a comparable clinical response with facial seborrheie dermatitis.