知柏地黄汤加减联合1%吡美莫司乳膏治疗血热风燥型面部脂溢性皮炎

Efficacy of Modified Zhibai Dihuang Decoction Combined with 1%Pimecrolimus Cream on Facial Seborrheic Dermatitis of Blood-heat and Wind-dryness Type

目的:探究知柏地黄汤加减联合1%吡美莫司乳膏治疗血热风燥型面部脂溢性皮炎疗效及其对皮肤屏障功能的影响。方法:选取2020年1月-2022年12月于笔者医院接受治疗的208例面部脂溢性皮炎患者,采用单双球法随机分为对照组和观察组,各104例,对照组给予1%吡美莫司乳膏治疗,观察组给予知柏地黄汤加减联合1%吡美莫司乳膏治疗。治疗4周后,比较两组临床疗效,治疗前和治疗4周后患者皮肤屏障功能[经皮水分丢失量(Trans epidermal water loss,TEWL)、皮脂含量、红斑指数、pH]、血清指标[组织蛋白酶S(Cathepsin S,Cat S)、白介素-4(Interleukin-4,IL-4)、γ干扰素(Interferon-γ,IFN-γ)]、免疫功能[CD3^(+)T淋巴细胞(CD3^(+))、CD4^(+)T淋巴细胞(CD4^(+))、CD4^(+)/CD8^(+)],记录治疗期间两组不良反应(灼烧、刺痛、红斑、瘙痒)发生情况。结果:治疗4周后,观察组总有效率高于对照组(P<0.05);两组TEWL、皮脂含量、红斑指数、Cat S、IL-4、IFN-γ水平较治疗前降低,且观察组低于对照组(P<0.05)。两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平较治疗前升高,观察组高于对照组(均P<0.05);pH较治疗前升高,观察组高于对照组(P<0.05);观察组不良反应发生率低于对照组(P<0.05)。结论:知柏地黄汤加减联合1%吡美莫司乳膏可有效治疗面部脂溢性皮炎(血热风燥型),改善患者皮肤屏障功能、血清指标水平,增强患者免疫功能,减少不良反应。

Objective To explore the efficacy of modified Zhibai Dihuang decoction combined with 1%pimecrolimus cream in the treatment of facial seborrheic dermatitis of blood-heat and wind-dryness type and its effects on skin barrier function.Methods 208 patients with facial seborrheic dermatitis who received treatment in the hospital from January 2020 to December 2022 were selected and randomly divided into control group and observation group by single-double ball method,with 104 cases in each group.The control group was treated with 1%pimecrolimus cream,and the observation group was given modified Zhibai Dihuang decoction combined with 1%pimecrolimus cream.The clinical efficacy after 4 weeks of treatment,and skin barrier function[transepidermal water loss(TEWL),sebum secretion rate,erythema volume,pH],serum markers[cathepsin S(Cat S),interleukin-4(IL-4),gamma interferon(IFN-γ)]and immune function[CD3^(+)T lymphocyte(CD3^(+)),CD4^(+)T lymphocyte(CD4^(+)),CD4^(+)/CD8^(+)]before treatment and after 4 weeks of treatment were compared between the two groups of patients,and the adverse reactions(burning,tingling,erythema,pruritis)in both groups during treatment were recorded.Results After 4 weeks of treatment,the total effective rate in observation group was higher than that in control group(P<0.05).The TEWL,sebum secretion rate,erythema volume,Cat S,IL-4 and IFN-γin both groups were reduced compared with those before treatment,and the above indicators in observation group were lower than those in control group,and the CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)were increased compared to before treatment,and the indicators in observation group were higher than those in control group(all P<0.05).The pH was increased compared to before treatment,and the pH in observation group was higher compared with that in control group(P<0.05).The incidence rates of adverse reactions in observation group were lower compared to control group(P<0.05).Conclusion Modified Zhibai Dihuang decoction combined with 1%pimecrolimus cream can effectively treat facial seborrheic dermatitis of blood-heat and wind-dryness type,improve the skin barrier function and serum markers,enhance the immune function and reduce the adverse reactions.