糖皮质激素降阶梯疗法治疗慢性湿疹患者的效果

Effects of Glucocorticoids de-escalation therapy on patients with chronic eczema

目的:观察糖皮质激素降阶梯疗法治疗慢性湿疹患者的效果。方法:选取2022年6月至2023年8月于该院就诊的78例慢性湿疹患者进行前瞻性研究,按照随机数字表法将其分为观察组和对照组各39例。对照组采用常规糖皮质激素治疗,观察组采用糖皮质激素降阶梯疗法治疗,比较两组临床疗效,治疗前后湿疹症状体征评分、炎性指标[白细胞介素(IL)-6、IL-17、肿瘤坏死因子-α(TNF-α)]水平、皮肤病生活质量指数(DLQI)评分,以及不良反应发生率。结果:观察组治疗总有效率为94.87%(37/39),高于对照组的76.92%(30/39),差异有统计学意义(P<0.05);治疗后,观察组皮损面积、浸润或苔藓样变、瘙痒等湿疹症状体征评分和总分均低于对照组,差异有统计学意义(P<0.05);治疗后,观察组IL-6、IL-17、TNF-α水平均低于对照组,差异有统计学意义(P<0.05);治疗后,两组DLQI评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:糖皮质激素降阶梯疗法治疗慢性湿疹患者可提高治疗总有效率,降低湿疹症状体征评分、炎性指标水平和DLQI评分,效果优于常规糖皮质激素治疗。

Objective:To observe effects of Glucocorticoids de-escalation therapy on patients with chronic eczema.Methods:A prospective study was conducted on 78 patients with chronic eczema who were treated in this hospital from June 2022 to August 2023.They were divided into observation group and control group according to the random number table method,39 cases in each group.The control group was treated with conventional Glucocorticoids,while the observation group was treated with Glucocorticoids de-escalation therapy.The clinical efficacy,the eczema symptom and sign score,the inflammatory factor[interleukin(IL)-6,IL-17,tumor necrosis factor-α(TNF-α)]levels,the dermatology life quality index(DLQI)score,and incidence of adverse reactions were compared between the two groups before and after the treatment.Results:The total effective rate of the observation group was 94.87%(37/39),which was higher than 76.92%(30/39)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the scores of eczema symptoms and signs such as skin lesion area,infiltration or lichenification,pruritus and the total score in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the levels of IL-6,IL-17 and TNF-αin the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the DLQI scores of the two groups were lower than those before the treatment,and the observation group was lower than the control group,the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Glucocorticoids de-escalation therapy for the patients with chronic eczema can improve the total effective rate of treatment and reduce the eczema symptoms and signs scores,the inflammatory factor levels and the DLQI scores.Moreover,it is superior to the conventional Glucocorticoids therapy.