皮肤病的超适应证用药思路

Strategies of Off-indication Use of Drug for Dermatosis

对于临床难治性皮肤病,教科书和指南中的方法往往效果不佳,超适应证用药对皮肤科医生来说不可避免。提出了超适应证选择药物的假说,依据的线索有4条,分别是根据炎症属性(促炎/抗炎)用药;根据神经属性用药;根据合并症用药;借鉴中医治则用药。其应用原则:药无禁忌就可使用,以能覆盖患者尽量多症状的药物为优先,可应用于皮肤病及其他免疫相关性疾病的治疗。新的分类方法带来新的治病思路,给传统药物带来新的适应证。

For refractory diseases in clinical dermatosis practice,approaches in textbook and guideline are often ineffective and fruitless,then off-indication use of drug is inevitable.The paper proposed assumptions of over off-indication use of drug according to four clues.They are medication according to inflammatory properties(pro/anti),medication according to neurologic attributes,medication according to complications,and medication based on TCM treatment principles.No contraindication is the main principle of drug application to follow.It is encouraged to choose medications that cover more symptoms.These strategies are indicated for dermatosis and other immunological disorders.New classifications lead to new treating strategies and bring about new indications for traditional medications.