荆防方加减联合LED-LLLT红外-黄光照射治疗风热型面部激素依赖性皮炎临床观察

Clinical Observation on Modified Jingfangfang Combined with Low-Level Light Therapy with Light-Emitting Diodes for the Treatment of Wind-heat Type Facial Corticosteroid Addictive Dermatitis

为观察荆防方加减联合(light-emitting diodes-low-level light therapy,LED-LLLT)红外-黄光照射治疗风热型面部激素依赖性皮炎(FCAD)临床疗效,将83例风热型面部激素依赖性皮炎患者随机分配到治疗组41例,对照组42例。两组患者均外用皮肤屏障修复剂、LED-LLLT红外-黄光照射,治疗组另给予荆防方加减内服,均治疗8周。比较治疗前、治疗后不同时间瘙痒、灼热、红斑、疼痛、紧绷感程度和皮肤病生活质量指数(DLQI)评分;检测治疗前后皮肤屏障功能、血清IFN-γ、IL-4水平及评价临床疗效。结果表明:治疗后4周,治疗组总有效率75.61%,对照组总有效率54.76%;治疗后8周,治疗组总有效率92.68%,对照组总有效率76.19%,治疗组均优于对照组,比较差异均有统计学意义(P<0.05)。在治疗后2、4、8周,两组患者在瘙痒、灼热、疼痛、紧绷感、红斑面积积分均下降(P<0.05);在治疗后2、4、8周,治疗组瘙痒积分均低于同时间对照组积分(P<0.05);在治疗后8周,治疗组红斑面积积分等方面低于对照组(P<0.05)。治疗后4、8周,治疗组(dermatology life quality index,DLQI)评分均低于对照组(P<0.05)。治疗后两组患者(trans epidermal water loss,TEWL)降低、表皮含水量增加、角质层增厚,治疗组优于对照组(P<0.05)。治疗组与对照组IFN-γ、IL-4水平与治疗前比较差异有统计学意义(P<0.05)。结论:荆防方加减联合LED-LLLT红外-黄光照射治疗风热型面部激素依赖性皮炎能够明显改善患者症状,提高生活质量。

To observe the clinical effect of modified Jingfangfang combined with low-level light therapy with light-emitting diodes(LED-LLLT)on wind-heat type Facial Corticosteroid Addictive Dermatitis(FCAD),83 patients with wind-heat type FCAD were randomly assigned to 41 cases in the treatment group and 42 cases in the control group.Patients in both groups were treated with skin barrier repair agents and 830 nm/590 nm LED-LLLT externally,and the treatment group was additionally given modified Jingfangfang internal medication,both for 8 weeks.Pruritus,burning,erythema,pain,tightness and Dermatological Life Quality Index(dermatology life quality index,DLQI)scores at different times before and after treatment were compared,and clinical efficacy of skin barrier function,serum IFN-γlevels and IL-4 levels before and after treatment and evaluation were detected.Results show that 4 weeks after treatment,the total effective rates were 75.61%in the treatment group and 54.76%in the control group.8 weeks after treatment,the total effective rate of the treatment group was 92.68%,and that of the control group was 76.19%.It demonstrates that the treatment group was better than the control group,and the difference between the two groups was statistically significant(P<0.05).At 2 weeks,4 weeks,and 8 weeks after treatment,the scores of itching,burning,pain,tightness,and erythema area decreased in both groups(P<0.05).Meanwhile,the scores of pruritus in the treatment group were lower than those in the control group at the same time(P<0.05).At 8 weeks after treatment,the erythema area scores were lower the treatment group than in the control group(P<0.05).DLQI scores of the treatment group were lower than those of the control group at 4 weeks and 8 weeks after treatment(P<0.05).After treatment,TEWL decreased,epidermal water content increased,and stratum corneum thickened in both group,with the treatment group outperforming the control group(P<0.05).IFN-γlevels and IL-4 levels of the treatment group and the control group were significantly different from pre-treatment(P<0.05).Modified Jingfangfang combined with LED-LLLT to treat wind-heat type FCAD can significantly improve the symptoms of patients and the quality of life.