大黄甘草汤外敷联合多西环素对中重度丘疹脓疱性玫瑰痤疮患者症状及皮肤屏障功能的影响

Effects of External Application of Dahuang Gancao Decoction Combined with Doxycycline on Symptoms and Skin Barrier Function of Patients with Moderate to Severe Papulopustular

目的探究大黄甘草汤外敷联合多西环素对中重度丘疹脓疱性玫瑰痤疮患者症状及皮肤屏障功能的影响。方法选取2020年1月2022年2月本院中医皮肤科收治的85例中重度丘疹脓疱性玫瑰痤疮患者为研究对象。采用简单随机化法分为观察组(n=42)和对照组(n=43)。对照组采用多西环素治疗;观察组在此基础上联合使用大黄甘草汤外敷治疗。比较2组患者治疗前与治疗30 d后医师红斑评估量表(CEA)、皮肤病生活质量指数(DLQI)、抑郁自评量表(SDS)、焦虑自评量表(SAS)和干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)及皮肤障碍功能;观察2组患者临床疗效与不良反应。结果2组患者治疗30d后CEA、DLQI、SDS和SAS评分均低于治疗前,差异均有统计学意义(均P<0.05);观察组CEA、DLQI、SDS和SAS评分均低于对照组,差异均有统计学意义(均P<0.05)。2组患者治疗30d后IFN-γ水平高于治疗前,差异有统计学意义,而TNF-α和IL-4水平低于治疗前,差异有统计学意义(P<0.05);观察组IFN-γ水平高于对照组,差异有统计学意义,而TNF-α和IL-4水平低于对照组,差异有统计学意义(P<0.05)。2组患者治疗30 d后经皮水分流失量(TEWL)和红斑水平低于治疗前,差异有统计学意义,而表皮含水量和油脂水平高于治疗前,差异有统计学意义(P<0.05);观察组TEWL和红斑水平低于对照组,差异有统计学意义,而表皮含水量和油脂水平高于对照组,差异有统计学意义(P<0.05)。观察组总有效率高于对照组(95.24%比79.07%,χ^(2)=4.930,P=0.026);总不良反应发生率低于对照组,但2组中不良反应发生率比较,差异无统计学意义(9.52%比11.65%,χ^(2)=0.099,P=0.753)。结论大黄甘草汤外敷能有效提高临床疗效、改善生活质量、促进皮肤障碍功能的修复、降低不良反应和炎性因子水平。

Objective In order to explore the effects of external application of Dahuang Gancao decoction combined with doxycycline on the symptoms and skin barrier function of patients with moderate to severe papulopustular rosacea.Methods A total of 85 patients with moderate to severe papular pustular rosacea admitted to the department of traditional Chinese medicine dermatology of our hospital from January 2020 to February 2022 were selected as the research subjects.The patients were divided into an observation group(n=42)and a control group(n=43)using a random number table method.The control group was treated with doxycycline.The observation group was treated with external application of Dahuang Gancao decoction on this basis.The clinician's erythema assessment(CEA),dermatology life quality index(DLQI),self-rating depression scale(SDS),self-rating anxiety scale(SAS)and interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),interleukin-4(IL-4),and skin barrier function were observed in both groups before and after 30 days of treatment.The clinical efficacy and adverse reactions of both groups were observed.Results After 30 days of treatment,the scores of CEA,DLQI,SDS and SAS in both groups were lower than those before treatment,and the differences were statistically significant(P<0.05).After 30 days of treatment,the scores of CEA,DLQI,SDS and SAS in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After 30 days of treatment,the levels of IFN-γin both groups were higher than before treatment,and the differences were statistically significant.However,the levels of TNF-α and IL-4 were lower than before treatment,and the differences were statistically significant(P<0.05).After 30 days of treatment,the level of IFN-γ in the observation group was higher than that in the control group,and the differences were statistically significant.However,the levels of TNF-α and IL-4 were lower than those in the control group,and the difference was statistically significant(P<0.05).After 30 days of treatment,the TEWL and erythema levels in both groups were lower than those before treatment,and the differences were statistically significant.However,the epidermal water content and oil levels were higher than those before treatment,and the differences were statistically significant(P<0.05).After 30 days of treatment,the TEWL and erythema levels in the observation group were lower than those in the control group,and the differences were statistically significant.However,the epidermal water content and oil levels were higher than those in the control group,and the differences were statistically significant(P<0.05).The total effective rate of the observation group was higher than that of the control group(95.24%vs.79.07%,χ^(2)=4.930,P=0.026).The total incidence of adverse reactions in the observation group was lower than that in the control group(9.52%vs.11.65%).However,there was no significant difference in the incidence of adverse reactions between both groups(χ^(2)=0.099,P=0.753).Conclusion External application of Dahuang Gancao decoction can effectively improve clinical efficacy,improve quality of life,promote the repair of skin barrier function,and reduce adverse reactions and inflammatory factor levels.