针刺联合吡美莫司乳膏治疗特应性皮炎的疗效观察

Observations on the Efficacy of Acupuncture plus Pimecrolimus Cream for Atopic Dermatitis

目的观察针刺联合吡美莫司乳膏治疗特应性皮炎的临床疗效。方法将66例特应性皮炎患者随机分为对照组和观察组,每组33例。对照组予吡美莫司乳膏,观察组在对照组治疗基础上予针刺。观察两组治疗前后特应性皮炎症状积分(SCORAD)和皮肤病生活质量指数(DQLI)及血清claudin-1、白介素(interleukin,IL)-17A水平变化,并比较两组临床疗效和复发率。结果观察组总有效率高于对照组(P<0.05);观察组复发率低于对照组(P<0.05)。治疗后,两组SCORAD、DQLI评分均降低(P<0.05),且观察组低于对照组(P<0.05)。治疗后,对照组血清claudin-1、IL-17A水平无明显改变(P>0.05);观察组血清claudin-1水平升高(P<0.05),血清IL-17A水平降低(P<0.05),与对照组比较差异有统计学意义(P<0.05)。结论针刺联合吡美莫司乳膏治疗特应性皮炎疗效显著,可缓解临床症状,改善生活质量,降低复发率,这可能与其调节血清claudin-1、IL-17A水平有关。

Objective To investigate the clinical efficacy of acupuncture plus pimecrolimus cream for atopic dermatitis.Methods Sixty-six patients were randomized to control and observation groups,with 33 cases in each group.Both groups received basic treatment.The control group was treated with pimecrolimus cream and the observation group,with acupuncture in addition.The scoring atopic dermatitis(SCORAD)Index score and the dermatology quality of life index(DQLI)score were recorded and serum claudin-1 and interleukin(IL)-17A levels were measured in the two groups before and after treatment.The clinical efficacies and the recurrence rates were compared between the two groups.Results The total efficacy rate was higher in the observation group than in the control group(P<0.05).The recurrence rate was lower in the observation group than in the control group(P<0.05).After treatment,the SCORAD score and the DQLI score decreased in the two groups(P<0.05)and were lower in the observation group than in the control group(P<0.05).After treatment,serum claudin-1 and IL-17A levels did not change significantly in the control group(P>0.05),whereas serum claudin-1 levels increased(P<0.05)and IL-17A levels decreased(P<0.05)in the observation group with statistically significant differences compared with the control group(P<0.05).Conclusions Acupuncture plus pimecrolimus cream has a marked therapeutic effect on atopic dermatitis.It can relieve the clinical symptoms,improve the quality of life and reduce the recurrence rate,which may be related to its regulating serum claudin-1 and IL-17A levels.