联合药物方案辅助超脉冲CO2点阵激光对慢性湿疹患者疗效及安全性的影响

The efficacy and safety of combined drug regimen-assisted ultra-pulse CO2 lattice laser on patients with chronic eczema

目的观察联合药物方案辅助超脉冲CO2点阵激光对慢性湿疹患者的疗效和安全性。方法回顾性研究,选择2016年1月至2018年12月同济大学附属杨浦医院收治的慢性湿疹患者68例,按照治疗方法将患者分为对照组(n=34)和观察组(n=34)。对照组患者给予复方氟米松软膏联合复方甘草酸苷片治疗,观察组患者在对照组的基础上加用超脉冲CO2点阵激光治疗。比较两组患者的临床疗效、症状评分、生活质量、细胞因子和不良反应等。结果观察组患者治愈20例(58.82%),显效8例(23.53%),有效4例(5.88%),总有效率为94.12%,明显高于对照组76.47%的总有效率,差异具有统计学意义(P<0.05)。治疗前两组患者的瘙痒程度评分、EASI评分和DQOLS评分相近,差异均无统计学意义(t=0.229、0.088、0.061,P>0.05);治疗后两组患者的上述评分均明显改善,观察组患者的瘙痒程度评分和EASI评分分别为(1.03±0.17)分和(3.68±0.92)分,低于对照组,DQOLS评分为(76.95±13.28)分,高于对照组,差异均具有统计学意义(t=6.737、7.065、4.912,P<0.05)。治疗前两组患者的IL-2、IL-4、IL-10、IFN-γ和IgE水平相近,差异均无统计学意义(t=0.128、0.168、0.226、0.150、0.264,P>0.05);治疗后观察组患者的IL-4、IL-10和IgE水平分别为(159.73±22.51)pg/L、(129.53±17.26)pg/L和(241.82±22.95)mmol/L,低于对照组,IL-2和IFN-γ水平分别为(189.62±39.84)pg/L和(181.16±38.53)pg/L,高于对照组,差异均具有统计学意义(t=3.199、4.035、10.862、9.765、8.380,P<0.05)。观察组不良反应的发生率为14.71%,对照组为11.76%,差异无统计学意义(χ^2=0.128,P=0.720)。结论复方氟米松软膏和复方甘草酸苷片联合药物方案辅助超脉冲CO 2点阵激光能够明显提高慢性湿疹患者的临床疗效,改善临床症状和生活质量,调节细胞因子的表达,且安全性较好,值得在临床推广应用。

Objective To study the efficacy and safety of combined drug regimen-assisted ultra-pulse CO2 lattice laser on the patients with chronic eczema.Methods 68 patients with chronic eczema treated in Yangpu Hospital Affiliated to Tongji University from January 2016 to December 2018 were randomly divided into control group(n=34)and observation group(n=34),using random number table method.The patients in the control group were treated with compound flumethasone ointment combined with Compound Glycyrrhizin tablets.The patients in the observation group were treated with ultra-pulsed CO2 lattice laser on the basis of the control group.The clinical efficacy,symptom score,quality of life,cytokines and adverse reactions were compared between the two groups.Results In the observation group,20 cases(58.82%)were cured,8 cases(23.53%)were markedly effective,and 4 cases(5.88%)were effective.The total effective rate was 94.12%,significantly higher than the total effective rate of 76.47%in the control group(P<0.05).Before treatment,the scores of pruritus degree,EASI and DQOLS of the two groups were similar(t=0.229,0.088,0.061,P>0.05).After treatment,the above scores of the two groups were significantly improved,the itching degree score and EASI score of the patients in the observation group were respectively(1.03±0.17)points and(3.68±0.92)points,lower than those in the control group,while the DQOLS score was(76.95±13.28)points,higher than the control group,the difference was statistically significant(t=6.737,7.065,4.912,P<0.05).Before treatment,the levels of IL-2,IL-4,IL-10,IFN-γand IgE in the two groups were similar(t=0.128,0.168,0.226,0.150,0.264,P>0.05).After treatment,the levels of IL-4,IL-10 and IgE in the observation group were respectively(159.73±22.51)pg/L,(129.53±17.26)pg/L and(241.82±22.95)mmol/L,lower than those in the control group,while the levels of IL-2 and IFN-γwere respectively(189.62±39.84)pg/L and(181.16±38.53)pg/L,higher than the control group,the differences were statistically significant(t=3.199,4.035,10.862,9.765,8.380,P<0.05).The incidence of adverse reactions was 14.71%in the observation group and 11.76%in the control group(χ^2=0.128,P=0.720).Conclusion Compound Flumetasone Ointment and compound glycyrrhizin tablets regimen-assisted ultra-pulsed CO2 lattice laser can significantly improve the clinical efficacy of patients with chronic eczema,improve clinical symptoms and quality of life,regulate the expression of cytokines,and it is safety.Therefore,it is worthy of clinical application.