自制保湿剂对银屑病复发的预防作用

The Preventive Effect of Skin Barrier Function on Psoriasis

目的探讨增强表皮屏障功能制剂能否预防或延缓银屑病的复发。方法选取40例银屑病治愈后患者,过去几年中均在冬季发病,每次发病都累及双上肢。其中左侧上肢涂擦自制保湿剂(主要成分为凡士林、葵花籽油、维生素E、尿囊素等),2次/d,共20d;没经任何处理的另一侧上肢作为对照。分别于涂药前和涂药20d检测患者的皮肤屏障功能指标及血液中银屑病相关免疫学指标。结果最终完成研究者32例。处理前,双前臂的角质层含水量和透皮失水率差异无统计学意义。经处理20d后,涂擦保湿剂的前臂其角质层含水量明显升高(P=0.000 2),透皮失水率则显著降低(P=0.007 1);未涂擦保湿剂一侧的角质层含水量和透皮失水率无明显改变。统计皮损出现的时间指标中,有22例是有效指标,其中6例双侧皮损同时出现;5例在保湿剂处理的前臂先出现皮损;11例保湿剂处理的前臂与自身另一侧对照手臂相比,延缓或无皮损出现(占到有效样本量的50%)。处理前后患者血液TNF-α和IL-17无明显改变,而处理后血液IL-23的值上升明显(31.70%,P<0.000 1)。结论涂擦保湿剂能降低银屑病复发的风险。

Objective To explore whether the enhanced epidermal barrier function can prevent or delay the recurrence of psoriasis.Methods Forty cases patients with psoriasis were selected in the rest of the peri- od, in the past few years in the winter onset, the incidence of skin lesions involving bilateral upper limbs. The left arm rubbed homemade moisturizer（ Self-made moisturizing agent for the main components of Vaseline, sunflower oil, vitamin E, allantoin and so on） ,2 times a day, a total of 20 days, the other side limb without any treatment as control. The function of skin barrier function and immune indexes of psoriasis in patients were detected before and after 20 days.Results the sample number of the final study was 32 cases. Before treatment, there was no significant difference in the water content and the water loss rate between the two forearms. But after 20 days of treatment, skin moisturizing agent forearm horny layer water content was significantly increased （ P = O. 000 2 ）, transdermal water loss rate decreased signifi- cantly （P = 0. 007 1 ） ; no rubbed moisturizing agent on one side of the water content of stratum corneum and transdermal water loss rate did not change significantly. There were 22 cases of effective indicators, of which 6 cases of bilateral skin lesions occurred at the same time;5 cases in the moisturizer treated forearm first lesions. 11 cases of moisturizer treated forearm compared with the other side of the control arm, delayed or no skin lesions （accounting for 50% of the effective sample size）. Before and after treatment,the blood TNF-α and IL-17 were not significantly changed, but the value of IL-23 after treatment increased significantly （31.70% ,P 〈0. 000 1 ）.Conclusion Applying moisturizing agent can reduce the risk of recurrence of psoriasis.