不同剂量和不同剂型甘草酸苷制剂对甲醛和硫酸镍皮肤斑贴试验的影响

Effect of different doses and different formulations of glycyrrhizin preparations on skin patch test results of formaldehyde and nickel sulfate

目的研究复方甘草酸制剂对甲醛和硫酸镍皮肤斑贴试验的影响。方法选择甲醛和硫酸镍皮肤斑贴试验阳性的患者96例,首次斑贴试验结束后先后给予不同剂量及不同剂型甘草酸苷制剂进行干预。中剂量复方甘草酸苷片50 mg,每日3次口服,连续治疗2周;2个月后给予高剂量复方甘草酸苷片75 mg,每日3次口服,连续治疗2周,均在治疗干预后2周进行斑贴重复试验;2个月后给予静脉干预(复方甘草酸苷注射液60 ml/d),于治疗干预后1周进行斑贴重复试验,并分析不同剂量及剂型复方甘草酸苷制剂对甲醛和硫酸镍皮肤斑贴试验的影响。结果中剂量干预后92例斑贴试验阳性,其中15例为弱阳性(+),75例为强阳性(++),2例为极强阳性(+++),无阴性检查结果,反应程度Z=-3.367,P=0.001。高剂量干预后79例阳性,其中40例为弱阳性(+),39例为强阳性(++),10例为阴性(-),反应性质Z=-5.792,P=0.000;反应程度Z=-8.774,P=0.000。静脉干预后23例阳性,其中11例为弱阳性(+),12例为强阳性(++),36例为阴性(-),反应性质Z=-8.024,P=0.000;反应程度Z=-9.683,P=0.000。结论复方甘草酸苷高剂量和采用静脉注射可对甲醛和硫酸镍皮肤斑贴试验产生明显抑制作用,并对诱发的变应性接触性皮炎有一定的临床疗效。

Objective To evaluate the effect of compound glycyrrhizin on skin patch test results of formaldehyde and nickel sulfate. Methods A total of 96 patients who showed moderate positive patch test reactions to nickel sulfate or formaldehyde were enrolled into this study. After the first patch test, the patients were treated with different doses and different dosage forms of glycyrrhizin in succession. Firstly, the patients were treated by middle-dose medicine for 2 weeks（compound glycyrrhizin glucoside piece, 50 mg, tid, orally）, then, the patients were treated by high dose the same medicine（compound glycyrrhizin glucoside piece, 75 mg, tid, orally） for another 2 weeks, finally the patients were treated by the intravenous dosage form（glycosides compound glycyrrhizin injection, 60 ml, qd, intravenous drip） for 1 week. The interval between every two courses was two months, and the patch test was repeated after every course, then the effect of the different doses and formulations of compound glycyrrhizin preparations on the patch test results of formaldehyde and nickel sulfate was analyzed. Results Totally, 92 patients completed the middle-dose compound glycyrrhizin intervention trial, repeated patch test results were as follow： 15 cases of weakly positive（＋）, 75 cases of strong positive（＋＋）, 2 cases of strong positive（＋＋＋） and no patient was negative. Significant differences were observed in the degree of reactivity（Z=-3.367, P=0.001）. For the patch test results of the 89 patients who completed high dose intervention trial, 40 cases was weakly positive（＋）, 39 cases was strong positive（＋＋）, 10 cases was negative（-）, reaction properties of qualitative results： Z=-5.792（P=0.000） and degree of reactivity： Z=-8.774（P=0.000）. For the 59 patients who completed the intravenous injection intervention, repeated patch test results were as follow： 11 cases of weakly positive（＋）, 12 cases of strong positive（＋＋）, 36 cases were negative, reaction properties of qualitative results： Z=-8.024（P=0.000） and degree of reactivity： Z=-9.689（P=0.000）. Conclusion Both high-dose oral compound glycyrrhizin and intravenous compound glycyrrhizin could evidently suppress skin patch test reactions of formaldehyde and nickel sulfate, and exert a certain clinical curative effect on the allergic contact dermatitis induced by the same substance.