3012例重型痤疮治疗现状分析

The Analysis of Therapy in 3 012 Severe Acne Patients

目的分析重型痤疮治疗现状,为提高重型痤疮疗效提供依据。方法采用抽样调查法,对首次就诊于全国35家医院皮肤科的3 012例重型痤疮患者进行问卷调查,内容包括患者对痤疮的认知情况、既往干预措施及接受药物治疗情况等。结果 3 012例重型痤疮患者中,76.6%认为痤疮是一种疾病,但仅35.2%早期到医院就诊,其他干预措施包括自行挤压皮损、外涂药物/化妆品、钦凉茶/使用民间秘方、美容院治疗、使用遮盖性化妆品。2 388例(79.3%)患者接受过口服药物治疗,包括1 161例(48.6%)口服过抗生素,其中罗红霉素占33.9%,其他抗生素占14.9%,55.5%的患者连续口服药物时间≤4周。2 081例(69.1%)患者用过外用药物,其中糖皮质激素占4.3%,其他外用制剂占21.0%;外用药物常导致不良反应如红斑512例(24.6%),脱屑683例(32.8%),结痂73例(3.5%),敏感性皮肤281例(13.5%)。结论重型痤疮是一种需要系统治疗的疾病,但早期就诊率较低;治疗存在药物选择缺乏靶点、外用药物不良反应明显、疗程不足的问题,应提高早期就诊率,为患者提供安全、有针对性、足够疗程的综合治疗。

Objective To analyze the current clinic application of severe acne treatment, and to provide evidences to improve its treatment. Methods Using sampling survey, a total of 3 012 severe acne patients who visited the dermato-logical department of 35 hospitals over the country for the first time were selected for this study. Each patient filled a ques-tionnaire about their acknowledgement, history of medical intervention and drug therapy of severe acne. Results Among all 3 012 patients with severe acne, 76.6%believed acne is a kind of skin disease, but only 35.2%of the patients went to see doctors at early stage of disease, while others choose interventions such as self-extrudation , topical medication or skin care products, herbal tea/folk recipes, beauty salons and application of coverture cosmetics. Among all severe acne patients, 2 388 cases （79.3%）had taken oral medications, which included 1 161（48.6%） patients who took anti-biotics. 394 cases （33.9%） took roxithromycine and 173 cases（14.9%） took other kinds of anti-biotics. 55.5%of all these patients who took oral medication less than 4 weeks in duration. 2 081 cases （69.1%） applied external drugs, in which includes 90 cases （4.3%） of using glucocorticoid, and 437 cases （21.0%） of using other kinds of external products. The adverse effects of topical treat-ments were commonly observed, such as erythema （512 cases, 24.6%）, desquamation （683 cases, 32.8%）, scab （73 cases, 3.5%） and hypersensitive （281 cases, 13.5%）. Conclusion Severe acne is a disease need systematic treatment. but only mi-nority of the patients went to see doctors at early stage of disease. The current problems in treatment of severe acne include lack of target in choosing drugs, not long enough treatment course, and adverse effects of cutaneous administration.Early , safe and targeted medical attention with sufficient treatment course is encouraged.