自制中药暗疮灵联合阿奇霉素对炎症性痤疮的临床效果及其对细胞因子IL-8、TNF-α的影响

Clinical Efficacy of Homemade TCM Acne Remover Combined with Azithromycin for Inflammatory Acne and Its Impact on the Cytokine IL-8,TNF-α

目的探讨自制中药暗疮灵联合阿奇霉素对炎症性痤疮的临床效果及其对细胞因子白细胞介素(IL)8、肿瘤坏死因子α(TNF-α)的影响。方法选择2013年9月至2014年7月来凤县中心医院收治的100例炎症性痤疮患者为研究对象,按照随机数字表法分为对照组和观察组,各50例。对照组仅采用阿奇霉素0.5 g/d进行治疗,于餐前1 h顿服,每周服药3 d,停药4 d。观察组在上述治疗的基础上,口服自行研制的中药方暗疮灵加减,结合外用自创方暗疮散进行药物倒模治疗。比较两组患者的临床疗效,治疗前后皮损严重程度及数量评分、健康状况调查问卷量表各维度评分、血清IL-8及TNF-α水平变化及不良反应发生情况。结果观察组临床总有效率显著高于对照组[92.0%(46/50)比74.0%(37/50)],差异有统计学意义(P<0.05)。治疗后,观察组皮损严重程度及数量评分(潮红、压痛、炎性丘疹、脓肿、脓疱、粉刺及瘢痕)均低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组SF-36量表评分(情感、一般感情指数、健康指数及生活满意度)均高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组血清IL-8及TNF-α水平均低于对照组[(20±4)ng/L比(26±5)ng/L,(40±7)ng/L比(55±7)ng/L],差异有统计学意义(P<0.05)。观察组不良反应发生率低于对照组[4.0%(2/50)比14.0%(7/50)],差异有统计学意义(P<0.05)。结论自制中药暗疮灵联合阿奇霉素对炎症性痤疮的临床效果显著,可有效降低细胞因子IL-8、TNF-α的水平,应加以推广应用。

Objective To investigate the clinical efficacy of homemade TCM acne remover combined with azithromycin for inflammatory acne and its impact on the cytokine interleukin（ IL）-8,tumor necrosis factor α（ TNF-α）. Methods From Sep. 2013 to Jul. 2014 in Laifeng County Central Hospital 100 patients with inflammatory acne were included as the research objects,according to random number table method they were divided into a control group and an observation group,50 cases each. The control group was treated with azithromycin only,0. 5 g / d,1 h before meal,weekly dose of 3 d,4 d discontinuation; on the basis of the above treatment,the observation group was added oral TCM acne remover added / subtracted,combined with external use of acne power for reverse mould treatment. The clinical efficacy,skin lesion severity and quantity score before and after the treatment,health questionnaire scale-dimension score,serum levels of IL-8 and TNF-α changes and adverse reactions of the two groups were compared. Results Total effective rate of the observation group was significantly higher than the control group[92. 0%（ 46 /50） vs 74. 0%（ 37 /50） ],the difference was statistically significant（ P〈0. 05）. After treatment,the number of lesions and severity score（ flushing,tenderness,inflammatory papules,abscesses,pustules,acne and scars） of the observation group were lower than the control group,the differences were statistically significant（ P〈0. 05）. After treatment,SF-36 scores（ emotional,general feeling index,health index and life satisfaction） of the observation group were higher than the control group（ P〈0. 05）. After treatment,serum IL-8 and TNF-α levels of the observation group were lower than the control group [（ 20 ± 4） ng / L vs（ 26 ± 5） ng / L,（ 40 ± 7） ng / L vs（ 55 ±7） ng / L],the differences were statistically significant（ P〈0. 05）. The incidence of adverse reactions of the observation group was lower than the control group [4. 0%（ 2 /50） vs 14. 0%（ 7 /50） ],the difference was statistically significant（ P〈0. 05）. Conclusion Homemade TCM acne remover combined with azithromycin for inflammatory acne has a significant clinical effect,which can effectively reduce the level of the cytokine IL-8,TNF-α,thus should be promoted and applied.