多磺酸粘多糖乳膏联合阿达帕林凝胶治疗玫瑰痤疮的疗效及对皮肤屏障功能的影响

Efficacy of Mucopolysaccharide Polysulfate Cream Combined with Adapalene Gel in the Treatment of Acne Rosacea and Its Influence on Skin Barrier

目的:研究多磺酸粘多糖乳膏联合阿达帕林凝胶治疗玫瑰痤疮的疗效及对皮肤屏障功能的影响。方法:选取2019年8月-2021年8月笔者医院126例玫瑰痤疮患者进行前瞻性随机对照试验,以随机数字表法将患者均分为观察组和对照组,各63例,两组均给予盐酸多西环素片口服同时采用阿达帕林凝胶局部外涂治疗,观察组患者另加用多磺酸粘多糖乳膏治疗,两组疗程均为8周。比较两组治疗有效率,治疗后皮肤屏障功能、角质层分析结果和炎症反应水平。结果:治疗8周后,观察组治疗有效率为85.71%,高于对照组(68.25%),差异有统计学意义(P<0.05);治疗8周后,两组角质层含水量和表皮油脂含量均明显升高(P<0.05),两组经表皮失水率(Transepidermal water loss,TEWL)和红斑指数(Erythema index,EI)明显降低(P<0.05),且观察组角质层含水量和表皮油脂含量高于对照组,TEWL和EI低于对照组,差异有统计学意义(P<0.05);治疗8周后,两组皮肤粘脱蛋白质含量、丝氨酸蛋白酶活性及血清抗菌肽LL-37、白介素6(Interleukin 6,IL-6)、基质金属蛋白酶9(Matrix metalloproteinase 9,MMP-9)水平均较治疗前明显降低(P<0.05),且观察组各项指标均低于对照组,差异有统计学意义(P<0.05)。结论:多磺酸粘多糖乳膏和阿达帕林凝胶联合治疗丘疹脓疱型玫瑰痤疮可有效改善局部炎症反应,减轻皮肤组织损伤,促进皮肤屏障功能恢复,提升治疗效果。

Objective To study the efficacy of mucopolysaccharide polysulfate cream combined with adapalene gel in the treatment of acne rosacea and its influence on skin barrier.Methods 126 patients with acne rosacea in the hospital between August 2019 and August 2021 were selected for prospective randomized controlled trial.The patients were evenly divided into the observation group(63 cases)and the control group(63 cases)by using the random number table method.Both groups were given oral administration of doxycycline hydrochloride tablets and local treatment with adapalene gel,and the patients in the observation group were additionally treated with mucopolysaccharide polysulfate cream.The course of treatment in both groups was 8 weeks.The effective rate of treatment,skin barrier function,stratum corneum analysis results and inflammatory response were compared between the two groups.Results After 8 weeks of treatment,the treatment effectiveness rate of the observation group was 85.71%,which was higher than that of the control group(68.25%)(P<0.05).At 8 weeks of treatment,the water content of stratum corneum(WCSC)and epidermal sebum content(SC)in the two groups were significantly increased(P<0.05)while the transepidermal water loss(TEWL)and erythema index(EI)were significantly decreased(P<0.05).The WCSC and SC in the observation group were higher than those in the control group while the TEWL and EI were lower than those in the control group(P<0.05).At 8 weeks of treatment,the content of stratum corneum adhesion protein,the activity of serine protease and the levels of serum antimicrobial peptide LL-37,interleukin-6(IL-6)and matrix metalloproteinase 9(MMP-9)were declined significantly(P<0.05),and the above indicators in the observation group were lower than those in the control group(P<0.05).Conclusion Mucopolysaccharide polysulfate cream combined with adapalene gel in the treatment of papulopustular rosacea can effectively improve the local inflammatory response,relieve the skin tissue damage,promote the recovery of skin barrier function,and enhance the therapeutic effect.