复方利多卡因乳膏治疗激素依赖性皮炎的疗效及对Th1/Th2水平的影响

Clinical Efficacy and Effection on Th1 /Th2 of Compound Lidocaine Cream in the Treatment of Hormone-dependent Dermatitis

目的探讨复方利多卡因乳膏治疗激素依赖性皮炎的临床疗效及对外周血Th1,Th2分泌的相关细胞因子的调节作用与临床意义。方法 64例激素依赖性皮炎患者随机分为治疗组和对照组,治疗组外涂复方利多卡因乳膏,前4周2次/d,后2周1次/d,最后2周隔日1次,共治疗8周;对照组外涂肝素钠软膏,用药方法与疗程同治疗组。另选志愿者32例作为健康对照组,分别于治疗前和治疗后第1,2,4,8周及治疗后2周记录病情积分;于疗程结束后评价临床疗效;检测健康对照组以及患者治疗前后及治疗后2周血中IFN-γ,IL-2,IL-4,IL-12,IL-18含量。结果治疗组治疗2,4,8周及治疗后2周病情积分下降明显优于肝素钠对照组(P<0.05);治疗组有效率90.63%,明显优于肝素钠对照组59.38%(P<0.01);治疗后及治疗后2周,治疗组IFN-γ,IL-2,IL-4,IL-12,IL-18和肝素钠对照组IFN-γ,IL-4,IL-18与治疗前比较,差异均有统计学意义(P<0.05);治疗组上述各指标与肝素钠对照组比较,差异均有统计学意义(P<0.01);治疗组和肝素钠对照组IFN-γ与病情积分呈负相关性,IL-4,IL-18与病情积分呈正相关性。结论复方利多卡因乳膏治疗激素依赖性皮炎疗效显著,可能是通过纠正体内Th1/Th2细胞因子的失衡状态而发挥其治疗激素依赖性皮炎的作用。

Objective To investigate the clinical efficacy of compound lidocaine cream in the treatment of hormone-dependent dermatitis, and its regulation on Thl ,Th2 cytokines secretion in peripheral blood. Methods Sixtyfour cases of patients with hormone-dependent dermatitis were randomly divided equally into treatment group and control group. The treatment group were treated with compound lidocaine cream, twice a day in the first four weeks, and then once a day in the following 2 weeks, at last once every other day in the last two weeks. The whole treatment course is 8 weeks. The control group was treated with heparin sodium ointment, and the medication methods and treatment course were the same with treatment group. In additon, 32 volunteers were chosen as a healthy control group. The illness integrals were recorded respectively before treatment, at 1^ st, 2^nd,4^th, 8^th weeks of treatment, and 2 weeks after the treatment. The clinical efficacy and IFN-γ, IL-2, IL-4, IL-12, IL-18 in blood of healthy control group and hormone-dependent dermatitis patients was evaluated after the treatment. Results In treatment group, at 2^nd ,4^th ,8^th weeks and 2 weeks after treatment, illness integrals descending was much better than that of heparin sodium control group （ P 〈 0.05 ） ; The effective rate of treatment group was 90. 63%, significantly better than the heparin sodium control group 59. 38% （ P 〈 0.01 ） ; After treatment and 2 weeks after treatment, IFN-γ, IL-2, IL-4, IL-12, IL-18 of treatment group and IFN-γ, IL-4,IL-18 of heparin sodium control group, comparing with that before the treatment, showed the difference had statistical significance （P 〈 0. 05） ; Comparing the above indices of treatment group with that of heparin sodium control group, the differences were statistically significant（P 〈 0. 01 ） ;IFN-γ, IL-2, IL-12 of treatment group and IFN-γ of heparin sodium control group were negatively related to the illness integrals ; IL-4,IL-18 of treatment group and heparin sodium control group were positively related to the illness integrals. Conclusion Compound lidocaine cream has significant efficacy in the treatment of hormone-dependent dermatitis, possibly by correcting the imbalance of Thl/Th2 cytokines in vivo.