复方甘草酸苷湿敷治疗面部糖皮质激素依赖性皮炎90例临床观察

Clinical Observation on Wet Compress of Compound Glycyrrhizin Solution for 90 Cases of Facial Corticosteroid Addictive Dermatitis

目的观察复方甘草酸苷湿敷治疗面部糖皮质激素依赖性皮炎的临床疗效和对皮肤屏障功能及角质层的修复作用。方法将150例患者随机分为治疗组90例和对照组60例。治疗组给予复方甘草酸苷溶液湿敷(无纺布面膜纸)每天2次,每次20min,对照组给予他克莫司乳膏,每天2次外用。治疗前后记录临床症状评分、皮肤多功能生理功能测试仪测定患者皮肤经皮水分丢失(TEWL)、共聚焦激光显微镜测定患者角质层厚度。结果两组临床症状评分、TWEL及角质层厚度在治疗后4周、8周、停药4周时分别与治疗前比较差异均有统计学意义(P<0.01)。治疗后4周、8周时对照组临床症状评分较治疗组下降更快(P<0.01);停药4周后,治疗组临床症状评分明显低于对照组(P<0.01)。治疗后4周治疗组TEWL下降程度优于对照组(P<0.01),停药4周治疗组下降程度优于对照组(P<0.01)。停药后4周,治疗组角质层增厚程度优于对照组(P<0.01)。治疗4周、8周时对照组总有效率高于同期治疗组(P<0.05);停药后4周治疗组总有效率高于同期对照组(P<0.05)。结论复方甘草酸苷湿敷治疗面部糖皮质激素性皮炎具有很好的临床疗效,具有修复皮肤屏障功能的作用,并能促进角质层厚度的恢复。

Objective To observe the therapeutic effect of wet compress of Compound Glycyrrhizin Solution for facial corticosteroid addictive dermatitis （FCAD） and its repairing effect on the barrier function of skin and stratum corneum. Methods Totally 150 cases of FCAD were randomized into the treatment group and control group, with 90 and 60 in each. The treatment group was given wet compress of Compound Glycyrrhizin Solution with Non-woven mask paper 20 min each time and twice daily. The control group was given tacrolimus ointment twice daily. The symptom scores were observed and recorded. The transepidermal water loss （TEWL） was detected by multi-function skin physiology analyzer. The thickness of stratum corneum was detected by confocal laser scanning microscopy before and after treatment. Results The symptom scores, TEWL and thickness of stratum corneum were significantly improved after 4-week and 8-week treatment and 4-week drug withdrawal in both groups （P〈0.01）. Comparing with the treatment group, the symptom scores in the control group were significantly decreased after 4-week and 8-week treatment （P〈0.01）. The symptom scores in the treatment group were significantly lower than those in the control group after 4-week drug withdrawal （P〈0.01）. The TEWL was significantly decreased in both groups after 4-week and 8-week treatment, especially in the treatment group after 4-week treatment （P〈0.01） and after 4- week drug withdrawal （P〈0.01）. Comparing with the control group, the stratum corneum was significantly thicker in the treatment group after 4-week drug withdrawal （P〈0.01）. The total effective rate of the control group was significantly higher than that of the treatment group after 4-week and 8-week treatment （P〈0.05）. The total effective rate of the treatment group was significantly higher than that of the control group after 4-week drug withdrawal （P〈0.05）. Conclusion The wet compress of Compound Glycyrrhizin Solution is effective for FCAD. It can repair the skin barrier function and recover the stratum corneum.