米诺环素联合外用卤米松乳膏治疗大疱性类天疱疮的疗效及不良反应

Efficacy and adverse reactions of minocycline combined with halometasone cream for external use in the treatment of bullous pemphigoid

目的分析米诺环素联合外用卤米松乳膏治疗大疱性类天疱疮的疗效及不良反应。方法选取2016年4月至2019年4月山西白求恩医院收治的40例大疱性类天疱疮患者,按入院顺序分为对照组和观察组,每组20例。对照组应用卤米松乳膏治疗,观察组使用米诺环素联合卤米松乳膏治疗。观察比较两组患者治疗前后新生水疱数量、临床疗效、外周血嗜酸性粒细胞计数(EOS)及不良反应发生情况。结果治疗前,两组新发水疱数比较差异未见统计学意义(P>0.05)。治疗后,观察组新发水疱数少于对照组(P<0.05)。对照组有效率[65.00%(13/20)]低于观察组[95.00%(19/20)],P<0.05。治疗前,两组外周血EOS比较差异未见统计学意义(P>0.05)。治疗后,观察组外周血EOS低于对照组(P<0.05)。两组细菌感染、色素沉着及肾功能不全等不良反应发生率比较差异未见统计学意义(P>0.05)。结论米诺环素联合外用卤米松乳膏治疗大疱性类天疱疮能有效改善患者临床症状,降低其新生水疱数,提高临床有效率,明显降低外周血EOS,且不良反应发生情况无明显增多,安全性高。

Objective To investigate the clinical efficacy and adverse reactions of minocycline combined with halometasone cream in the treatment of bullous pemphigoid.Methods Forty patients with bullous pemphigoid treated in Shanxi Bethune Hospital from April 2016 to April 2019 were selected and divided into control group and observation group according to the admission order, with 20 cases in each group. Patients in the control group were treated with halometasone cream externally, while patients in the observation group were treated with minocycline combined with halometasone cream externally. The number of new blisters, clinical efficacy, eosinophil (EOS) count in peripheral blood and adverse reactions were observed and compared between the two groups.Results There was no statistical difference in the number of new blisters between the two groups before treatment (P>0.05). After treatment, the number of new blisters was less in the observation group, compared to the control group (P<0.05). The effective rate of the control group was 65.00% (13/20), significantly lower than the 95.00% (19/20) of the observation group (P<0.05). EOS count in peripheral blood showed no difference between the two groups before treatment (P>0.05);while, EOS count was lower in the observation group than that in the control group after treatment (P<0.05). There was no significant difference in the incidence of adverse reactions such as bacterial infection, pigmentation or renal insufficiency between the two groups (P>0.05).Conclusions Minocycline combined with halometasone cream in the treatment of bullous pemphigoid can effectively and safely improve the clinical symptoms of patients, reduce the number of new blisters, and decrease peripheral blood EOS count, without increasing the incidence of adverse reactions, which is of great clinical significance.