摘要
目的 观察腔内激光联合泡沫硬化剂注射及多磺酸黏多糖乳膏治疗下肢淤积性皮炎的疗效.方法 2015年12月至2017年5月在四川省人民医院皮肤科收集下肢淤积性皮炎患者52例,共60条患肢,利用随机数字表及随机数余数分组法将患肢随机分为分为联合组、黏多糖组和对照组,每组20条患肢.3组均先接受大隐静脉主干腔内激光消融术,联合组肢体在激光术中同时注入泡沫硬化剂后,外用多磺酸黏多糖乳膏治疗4周;黏多糖组在激光术后仅外用多磺酸黏多糖乳膏治疗4周;对照组在激光术后仅外用糠酸莫米松乳膏治疗4周.记录3组治疗前、治疗4周后湿疹面积严重程度评分(EASI)、瘙痒视觉模拟评分(VAS).治疗前后组内比较采用配对t检验,3组间总体比较采用方差分析,两两比较采用LSD检验.结果 联合组、黏多糖组、对照组治疗前EASI(分别为9.64±4.58、9.94±4.18、9.50±4.41)、VAS(分别为7.25±1.29、7.50±1.19、7.45±1.32)差异均无统计学意义(F值分别为0.052、0.218,均P>0.05).治疗4周后EASI分别降至3.54±1.57、5.86±2.39、7.04±2.75,VAS分别降至2.35±0.67、3.85±0.67、4.65±1.23,与治疗前相比,差异均有统计学意义(t值为4.30~ 18.80,均P<0.05).治疗4周后,联合组EASI低于黏多糖组、对照组(均P<0.05),黏多糖组与对照组之间差异无统计学意义(P>0.05);联合组VAS低于黏多糖组、对照组(均P<0.05),黏多糖组低于对照组(P<0.05).结论 对于淤积性皮炎,腔内激光消融术联合泡沫硬化剂注射和多磺酸黏多糖乳膏外用短期疗效优于仅联合外用多磺酸黏多糖乳膏或糠酸莫米松乳膏,联用多磺酸黏多糖乳膏对瘙痒的改善优于联用糠酸莫米松乳膏,长期疗效尚需进一步观察.
Objective To evaluate the therapeutic effect of endovenous laser ablation (ELA) combined with foam sclerotherapy (FS) and mucopolysaccharide polysulfate (MP)cream on stasis dermatitis.Methods From December 2015 to May 2017,52 patients with 60 lesional limbs were enrolled from Department of Dermatology of Sichuan Provincial People's Hospital.The 60 lesional limbs were randomly and equally divided into 3 groups by a random number table and remainder grouping:combination group,MP group and control group.All the 3 groups were firstly treated with ELA in the main great saphenous vein.Then,the combination group was treated with FS followed by topical MP cream for 4 weeks.After the laser therapy,the MP group was treated with topical MP cream for 4 weeks,and the control group was treated with topical mometasone furoate cream alone for 4 weeks.The eczema area and severity index (EASI) and visual analogue scale (VAS) for itching scores in the above 3 group were recorded before treatment and 4 weeks after treatment.Statistical analysis was done by paired t-test for comparisons before and after treatment,one-way analysis of variance (ANOVA) for intergroup comparison,and least significant difference (LSD)-t test for multiple comparisons.Results No significant difference was observed before treatment among the combination group,MP group and control group in the EASI (9.64 ± 4.58,9.94 ± 4.18,9.50 ± 4.41 respectively,F =0.052,P > 0.05) or VAS scores (7.25 ± 1.29,7.50 ± 1.19,7.45 ± 1.32 respectively,F =0.218,P > 0.05).After 4-week treatment,the combination group,MP group and control group all showed significantly decreased EASI (3.54 ± 1.57,5.86 ± 2.39,7.04 ± 2.75 respectively) and VAS scores (2.35 ± 0.67,3.85 ± 0.67,4.65 ± 1.23 respectively) compared with those before treatment (t =4.30-18.80,all P < 0.05).After 4-week treatment,the EASI score was significantly lower in the combination group than in the MP group and control group (both P < 0.05),while there was no significant difference between the MP group and control group (P > 0.05).Additionally,the VAS score was significantly lower in the combination group than in the MP group and control group (both P < 0.05),as well as in the MP group than in the control group (P < 0.05).Conclusions ELA combined with FS and topical MP cream shows better short-term efficacy for the treatment of stasis dermatitis compared with ELA combined with topical MP cream or mometasone furoate cream.The combination with topical MP cream is superior to that with topical mometasone furoate cream in improving itching.The long-term efficacy needs to be observed further.
作者
陈明懿
应川蓬
罗东升
吴冬梅
杨镓宁
戴耕武
Chen Mingyi;Ying Chuanpeng;Luo Dongsheng;Wu Dongmei;Yang Jianing;Dai Gengwu(Department of Dermatology,Sichuan Academy of Medical Science and Sichuan Provincial People's Hospital,Chengdu 610072,China)
出处
《中华皮肤科杂志》
CAS
CSCD
北大核心
2018年第12期885-888,共4页
Chinese Journal of Dermatology
基金
四川省卫计委科研课题(130208).