口服伊曲康唑治疗及预防中重度脂溢性皮炎复发作用的临床疗效分析

Clinical Efficacy of Oral Itraconazole in the Treatment and Relapse Prevention of Moderate to Severe Seborrheic Dermatitis

目的研究口服伊曲康唑治疗和预防中重度脂溢性皮炎复发作用的临床疗效。方法选取2013年11月—2014年10月于我院诊断为中重度脂溢性皮炎患者70例为本试验的研究对象,随机分为A、B 2组,每组各35例。A组患者给予伊曲康唑药物治疗,B组患者给予安慰剂治疗。患者口服伊曲康唑200 mg/d或安慰剂连续治疗1周,随后3个月每个月的前2天重复给药1次。记录患者的脂溢性皮炎皮损面积及严重度指数(SDASI)评分、疾病持续时间、复发人数,瘙痒感/灼烧感评分及临床改善率/治愈率等信息。结果 A、B 2组患者接受治疗后SDASI评分均有显著改善,但前者使用伊曲康唑后的SDASI评分明显低于后者([1.82±0.55)vs.(5.47±2.17),P<0.05]。A、B组在治疗2周和16周后的临床改善率分别为(88.6%,80%)vs.(77.1%,54.3%)。另外,A组患者的疾病复发率也显著低于B组。结论口服伊曲康唑不仅能够有效、安全地控制脂溢性皮炎患者的恶化,还可作为维持治疗方案防止该病的再次复发。

Objective In order to study the clinical efficacy of oral itraconazole in the treatment and relapse prevention of moderate to severe seborrheic dermatitis. Methods Seventy patients diagnosed as moderate to severe seborrheic dermatitis in our hospital from November 2013 to October 2014 were chosen in this study, and they were randomly divided into groups A and B with each group 35 patients. Patients in group A and B were given itraconazole and placebo, respectively. Itraconazole200 mg/d or placebo was taken orally for 1 week and then for the first 2 days of every month for the following 3 months. The Seborrheic Dermatitis Area Severity Index（SDASI） score, disease duration, recurrence rate, itching/burning sensation scores and clinical improvement/cure were recorded. Results After receiving the treatment, the SDASI score in both two groups had the obvious improvement, but SDASI score of the former treating with itraconazole was notably lower than the latter（1.82±0.55 vs. 5.47 ±2.17,P〈 0.05）. The clinical improvements at the end of 2 and 16 weeks in group A and B were 88.6%,80% vs.77.1%,54.3%, respectively. Furthermore, recurrence rate in group A was also lower than group B. Conclusion Itraconazole is not only an effective and safe therapy for controlling exacerbations of seborrheic dermatitis, but also may be used as maintenance therapy to prevent disease recurrence.