畅枢汤对异维A酸治疗中重度痤疮的“减毒增效”作用

Effects of Changshu Decoction on Reducing Toxicity and Increasing Efficiency of Isotretinoin in the Treatment of Moderate to Severe Acne

目的比较畅枢汤联合异维A酸与异维A酸单用治疗中重度痤疮的疗效与安全性,以探讨畅枢汤对异维A酸治疗痤疮的"减毒增效"作用。方法依据中国痤疮诊疗指南痤疮严重程度分级标准,将本院皮肤科就诊的中重度寻常痤疮患者82例随机分组。观察组(40例)给予异维A酸胶囊联合畅枢汤口服;对照组(42例)给予异维A酸胶囊口服。分别于治疗前及治疗后记录痤疮及瘢痕的类型、数量、皮肤黏膜不良反应,同时完成全球痤疮严重程度评分(EGSS)及痤疮瘢痕评分(ECCA)。结果治疗后2周、4周、8周,观察组的疗效优于对照组(P=0.007,0.013,0.001);治疗前与治疗后8周EGSS及ECCA评分差异有统计学意义(P<0.01,P=0.035);观察组皮肤黏膜不良反应发生率低于对照组。结论畅枢汤可协同异维A酸治疗中重度痤疮的疗效;减轻异维A酸诱导的皮肤黏膜不良反应;二者联合可有效预防痤疮瘢痕的形成。

Objective To compare the efficacy and safety of Changshu decoction combined with isotretinoin and isotretinoin alone in the treatment of moderate to severe acne,and to explore the"detoxification and synergistic"effect of Changshu decoction on isotretinoin in the treatment of acne.Methods According to the Chinese acne diagnosis and treatment guidelines,82 patients with moderate to severe acne vulgaris were randomly divided into two groups.The observation group(40 cases)was given isotretinoin capsules combined with Changshu decoction;the control group(42 cases)was given isotretinoin capsules only.The type and quantity of acne and scar,and adverse reactions of skin and mucosa were recorded before and after treatment.Meanwhile,EGSS and ECCA scores were completed.Results After 2,4 and 8 weeks of treatment,the curative effect of the observation group was better than that of the control group(P=0.007,0.013,0.001);There were significant differences in EGSS and ECCA scores before and 8 weeks after treatment(P<0.01,P=0.035);The incidence of adverse reactions in the observation group was lower than that in the control group.Conclusion Changshu decoction can cooperate with isotretinoin in the treatment of moderate and severe acne;reduce the adverse reactions of skin and mucosa induced by isotretinoin;the combination of the two can effectively prevent the formation of acne scar.