序贯外用糠酸莫米松乳膏与他克莫司软膏治疗儿童特应性皮炎的临床观察

Study of childhood atopic dermatitis sequentially treated with topical mometasone furoate cream and tacrolimus ointment

目的:观察序贯外用0.1%糠酸莫米松乳膏与0.03%他克莫司软膏治疗儿童特应性皮炎的疗效、安全性及复发率。方法:收集该院门诊符合入选标准的儿童特应性皮炎患儿270例,随机分为3组。观察组外用0.1%糠酸莫米松乳膏,每晚1次,连续使用2周后,换用0.03%他克莫司软膏,早晚各1次,继续使用2周;对照A组外用0.1%糠酸莫米松乳膏,每晚1次,连续使用4周;对照B组外用0.03%他克莫司软膏,早晚各1次,连续使用4周。治疗结束后观察3组患者临床疗效和不良反应,随访4周,比较复发率。结果:①观察组的湿疹面积及严重指数(eczema area and severity index,EASI)评分[(2.70±1.74)分]、痊愈率(12.8%)及有效率(80.2%)与对照A组[(2.66±1.56)分、15.8%、88.2%]比较,差异无统计学意义,与对照B组[(5.51±2.96)分、3.8%、61.3%]比较,差异有统计学意义(P<0.05);②观察组不良反应发生率(7.0%)低于对照A组(18.4%)和对照B组(15.0%);③观察组复发率(13.2%)与对照B组(10.6%)比较,差异无统计学意义,但低于对照A组(26.9%),差异有统计学意义(P<0.05)。结论:序贯外用0.1%糠酸莫米松乳膏与0.03%他克莫司软膏治疗儿童特应性皮炎,临床疗效好,复发率低,安全性高,值得临床推广。

Objective:To study the clinical efficacy,safety and recurrence rate of childhood atopic dermatitis sequentially treated with topical 0.1%mometasone furoate cream and 0.03% tacrolimus ointment.Methods:A total of 270 cases of outpatients with childhood atopic dermatitis were divided into the treatment group(90 cases),control group A(90 cases)and control group B(90 cases).The treatment group received 0.1%mometasone furoate cream once a night for two weeks,followed 0.03%tacrolimus ointment twice-daily for additional two weeks,while control group A was treated with 0.1% mometasone furoate cream once a night,and control group B was treated with 0.03% tacrolimus ointment twice-daily for four weeks.Clinical efficacy and adverse reactions were evaluated at the end of the study,and the recurrence rate was assessed 4 weeks after the end of the treatment.Results:①The eczema area and severity index(EASI)score after treatment,cure rate,and total effective rate in the treatment group[(2.70±1.74)、12.8%、80.2%]were similar to that in control group A[(2.66±1.56)、15.8%、88.2%],but significantly different from that in the control group B[(5.51±2.96)、3.8%、61.3%];②The rate of adverse reactions was lower in the treatment group than in the controls(7.0%versus 18.4%and 15.0%).Moreover,the recurrence rate in the treatment group was comparable to that in the control group B(13.2% versus 10.6%),but lower than that in the control group A(26.9%).Conclusions:Sequential use of 0.1%mometasone furoate cream and 0.03% tacrolimus ointment is effective and safe for childhood atopic dermatitis,with lower recurrence rate.It is worth to try.