他克莫司软膏联合氯雷他定片治疗特应性皮炎的临床疗效及机制研究

Clinical Effects of Tacrolimus Ointment combined with Loratadine on Patients with Atopic Dermatitis and its Mechanisms

目的:研究他克莫司软膏联合氯雷他定片治疗特应性皮炎患者的临床疗效及可能机制。方法:选取2014年9月至2016年7月于我院就诊的特应性皮炎患者共计82例纳入研究,所有患者随机分成观察组(n=41)和对照组(n=41)。对照组患者采取氯雷他定片治疗,观察组患者在此基础上应用他克莫司软膏治疗。观察并比较两组患者的临床治疗效果、SCORAD评分情况、复发情况以及血清白细胞介素-4(IL-4)、白细胞介素-3(IL-13)、干扰素(IFN-γ)及白细胞介素-7(IL-17)水平的变化和不良反应的发生情况。结果:观察组患者治疗后的临床总有效率明显高于对照组(P<0.05)。两组患者皮损严重程度、皮肤病变范围、瘙痒和睡眠程度的评分以及总积分较治疗前明显下降,且观察组低于对照组,差异有统计学意义(P<0.05)。两组患者治疗后血清IL-4、IL-13以及IL-17水平均较治疗前显著下降,且观察组低于对照组,差异具有统计学意义(P<0.05);两组患者治疗后血清IFN-γ较治疗前明显升高,且观察组高于对照组,差异具有统计学意义(P<0.05)。观察组复发率显著低于对照组,差异具有统计学意义(P<0.05)。结论:他克莫司软膏联合氯雷他定片治疗特应性皮炎能够有效提高其临床疗效,可能与其降低血清IL-4、IL-13、IL-17水平及提高IFN-γ水平,进而改善患者的免疫功能有。

Objective： To study the effects of tacrolimus ointment and loratadine on serum levels of IL-4, IL-13, IFN--γand IL-17 in patients with atopic dermatitis. Methods： 82 cases with atopic dermatitis who were treated in our hospital from September 2014 to July 2016 were selected and randomly divided into the observation group （n=41） and the control group （n=41）. The patients in the control group were treated with loratadine, while the patients in the observation group were treated with tacrolimus ointment combined with lo- ratadine. Then the serum levels of IL-4, IL-13, IFN-γ and IL-17, and the clinical effect, SCORAD score and adverse reactions in the two groups were observed and compared. Results： The effective rate in the observation group was significantly higher than that of the control group, and the difference was statistically significant （P〈0.05）. The scores of skin lesions, the range of skin lesions, the degree of itching and sleep in the two groups were significantly lower than before treatment, and, the observation group was lower than that of the control group, and the differences were statistically significant （P〈0.05）. The serum levels of IL-4, IL-13 and IL-17 in the two groups were sig- nificantly lower than before treatment, and the observation group was lower than that of the control group, and the differences were statis- tically significant （P〈0.05）; The serum levels of IFN--γ was significantly higher than before treatment, and the observation group was higher than that of the control group, and the differences were statistically significant （P〈0.05）. The recurrence rate and relapse rate in the observation group were significantly lower than those of the control group （P〈0.05）. Conclusion： Tacrolimus ointment combined with lo- ratadine can effectively improve the clinical efficacy of patients with atopic dermatitis, which can reduce the atopic dermatitis SCORAD score, improve sleep and itching and other related clinical symptoms, and it is suggested that the mechanism may be the regulation of serum levels oflL-4, IL-13, IFN-γ and IL-17.