薇诺娜保湿霜治疗特应性皮炎疗效及对皮肤屏障功能的影响研究

Therapeutic Effect of Winona Moisturizer on Atopic Dermatitis and its Effect on Skin Barrier Function

目的:观察薇诺娜保湿霜治疗特应性皮炎(atopicdermatitis,AD)疗效及对皮肤屏障功能的影响。方法:选取笔者医院2016年3月-2018年3月收治的82例特应性皮炎患者,按随机数字表法分为观察组与对照组,每组各41例。对照组外用丙酸氟替卡松乳膏,观察组外用丙酸氟替卡松乳膏联合薇诺娜保湿霜,两组患者均治疗2个月。比较两组总有效率、治疗前后表皮组织的丝聚蛋白(filaggrin,Flg)、兜甲蛋白(loricrin,Lor)、细胞角蛋白14(cytokeratin14,K14)、细胞角蛋白17(eytokeratin17,K17)、客观体征(红斑、表皮剥脱、苔癣样变)评分、皮肤美观度评分及不良反应发生率。结果:观察组治疗总有效率95.12%,显著高于对照组的80.49%,差异有统计学意义(P<0.05)。两组治疗前表皮组织中Flg、Lor、K14、K17表达差异无统计学意义(P>0.05)。治疗后,两组患者表皮组织中Flg、Lor表达均上调,K14、K17均下调,差异有统计学意义(P<0.05)。观察组治疗后的表皮组织中Flg、Lor表达高于同期对照组,K14、K17表达低于同期对照组(P<0.05)。两组治疗前的红斑评分、表皮剥脱评分、苔癣样变评分、美观度评分比较差异均无统计学意义(P>0.05)。治疗后,两组的红斑评分、表皮剥脱评分、苔癣样变评分、美观度评分均较治疗前降低,且观察组低于同期对照组(P<0.05)。两组患者治疗期间均未见明显不良反应。结论:在糖皮质激素基础上联合应用薇诺娜保湿霜治疗特应性皮炎可有效改善患者皮肤屏障功能,促进客观体征消退,提高皮肤美观度,疗效优于单纯糖皮质激素治疗,且无明显不良反应,使用方便,值得推广。

Objective To observe the effect of Winona moisturizer on the effcacy and skin barrier function of atopic dermatitis （AD）. Methods A total of 82 patients with atopic dermatitis admitted to our hospital from March 2016 to March 2018 were randomly divided into observation group and control group, with 41 cases in each group. The control group was treated with futicasone propionate cream, and the observation group was treated with futicasone propionate cream and Winona moisturizer. Both groups were treated for 2 months. The total effective rate, flaggrin （Flg）, porcine protein （Lor）, cytokeratin 14 （K14）, cytokeratin 17 （K17） of epidermal tissue, and objective signs （erythema, epidermal exfoliation, Moss-like change） score and skin aesthetics score before treatment and after treatment, incidence of adverse reactions were compared between the two groups. Results The total effective rate of the observation group was 95.12%, which was signifcantly higher than 80.49% in the control group （P〈0.05）. There were no signifcant difference in the expression of Flg, Lor, K14 and K17 of epidermal tissue between the two groups before treatment （P〉0.05）. After treatment, the expressions of Flg and Lor of the epidermal tissues in both groups were up-regulated than before treatment, while the expressions of K14 and K17 were down-regulated than before treatment （P〈0.05）. The expression of Flg and Lor in the epidermal tissue of the observation group were higher than those of the control group of same period, and the expression of K14 and K17 in the observation group were lower than those in the control group of same period （P〈0.05）. There were no signifcant differences in the erythema score, epidermal exfoliation score, lichen-like change score and aesthetic score between the two groups before treatment （P〉0.05）. After treatment, the erythema score, epidermal exfoliation score, lichen-like score, and aesthetic score of the two groups were lower than those before treatment, and the observation group were lower than the control group of same period （P〈0.05）. No signifcant adverse reactions were observed during the two treatment periods. Conclusion Glucocorticoid combined with Winona moisturizer for the treatment of atopic dermatitis can effectively improve the skin barrier function of children, promote the resolution of objective signs, improve skin aesthetics, better effcacy than glucocorticoid treatment, and no obvious adverse reactions, use convenient, worth promoting.