双歧杆菌联合多磺酸黏多糖封包及地奈德乳膏治疗慢性湿疹的效果及对炎症因子和外周血T淋巴细胞亚群的影响

Effect of Bifidobacterium combined with mucopolysaccharide polysulfate encapsulation and budesonide cream on inflammatory factors and peripheral blood T lymphocyte subsets in patients with chronic eczema

目的:探究双歧杆菌联合多磺酸黏多糖封包及地奈德乳膏治疗慢性湿疹的疗效及对炎症因子和外周血T淋巴细胞亚群的影响。方法:选取2020年6月至2021年12月海南省第五人民医院收治的110例慢性湿疹患者为研究对象,按随机数字表法随机分为对照组与观察组,每组55例。对照组予以多磺酸黏多糖封包^(+)地奈德乳膏治疗,观察组在对照组基础上增加双歧杆菌治疗。比较两组临床疗效及治疗前后瘙痒、皮损面积、皮损严重程度评分及血清炎症因子[干扰素-γ(interferon-γ,IFN-γ)、白细胞介素-4(interleukin-4,IL-4)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]、外周血T淋巴细胞亚群(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平。结果:观察组临床总有效率明显高于对照组(89.09%vs 70.91%,P<0.05)。观察组治疗后瘙痒、皮损面积、皮损严重程度评分均明显低于对照组(均P<0.05)。与对照组相比,观察组治疗后血清IFN-γ水平更高,血清IL-4、TNF-α水平则更低(均P<0.05)。观察组治疗后CD4^(+)、CD4^(+)/CD8^(+)均高于对照组,CD8^(+)则更低(均P<0.05)。两组不良反应总发生率比较差异无统计学意义(7.27%vs 10.91%,P>0.05)。结论:双歧杆菌联合多磺酸黏多糖封包及地奈德乳膏治疗慢性湿疹效果显著,可有效改善患者的临床症状;缓解炎症反应和调节T淋巴细胞亚群可能是其疗效的作用机制。

Objective:To explore the efficacy of Bifidobacterium combined with mucopolysaccharide polysulfate encapsulation and budesonide cream in the treatment of chronic eczema and its influence on inflammatory factors and peripheral blood T lymphocyte subsets.Methods:A total of 110 patients with chronic eczema admitted to the Fifth People’s Hospital of Hainan Province from June 2020 to December 2021 were randomly divided into a control group and an observation group (n=55 in each group).The control group was treated with mucopolysaccharide polysulfate package^(+)budesonide cream,and the observation group was treated with Bifidobacterium on the basis of the control group.The clinical efficacy,pruritus,lesion area,lesion severity score,and serum inflammatory factors[interferon-γ (IFN-γ),interleukin-4 (IL-4),tumor necrosis factor-α (TNF-α)]and peripheral blood T lymphocyte subsets (CD4^(+),CD8^(+),CD4^(+)/CD8^(+)) were compared between the2 groups before and after treatment.Results:The total effective rate of the observation group was significantly higher than that of the control group (89.09%vs 70.91%,P<0.05).The scores of pruritus,lesion area and lesion severity in the observation group after treatment were significantly lower than those in the control group (all P<0.05).Compared with the control group,the serum IFN-γ level in the observation group was higher,and the serum IL-4 and TNF-α levels were lower (all P<0.05).After the treatment,CD4^(+)and CD4^(+)/CD8^(+)were higher and CD8^(+)was lower in the observation group than those in the control group (all P<0.05).There was no significant difference in the total incidence of adverse reactions between the 2 groups (7.27%vs10.91%,P>0.05).Conclusion:Bifidobacterium combined with mucopolysaccharide polysulfate encapsulation and budesonide cream in the treatment of chronic eczema has a good curative effect,which can effectively improve the clinical symptoms of patients.Alleviate inflammation and regulate T lymphocyte subsets may be the mechanism of its curative effect.