rbFGF联合硫酸羟氯喹及重组胶原蛋白敷料治疗玫瑰痤疮疗效分析

Effect Analysis of rbFGF Combined with HCQ and RHCD in the Treatment of Rosacea

目的:探讨玫瑰痤疮应用重组牛碱性成纤维细胞生长因子(Recombinant bovine basic fibroblast growth factor,rbFGF)联合硫酸羟氯喹(Hydroxychloroquine,HCQ)、重组胶原蛋白敷料(Recombinant human collagen dressing,RHCD)治疗对患者面部美观度、皮损情况的影响。方法:选取2019年2月-2023年1月首都医科大学附属北京安贞医院收治的玫瑰痤疮患者83例(红斑型31例、丘疹型27例、肥大型25例),均接受HCQ+RHCD+rbFGF治疗,连续进行治疗8周。分析不同分型患者治疗8周后临床疗效、治疗满意度,治疗前、治疗8周后皮损情况、外周血摄食抑制因子1(Nesfatin-1)、Toll样受体2(Toll-like receptor 2,TLR2)、血清髓过氧化物酶(Myeloperoxidase,MPO)、可溶性白介素-2受体(Soluble interleukin-2 receptor,SIL-2R)水平、生活质量评分、面部美观评分。结果:治疗8周后,红斑型、丘疹型患者的总有效率均高于肥大型(P<0.05)。治疗8周后不同分型患者皮疹颜色、数量、灼热/瘙痒感各项评分、外周血Nesfatin-1、TLR2、血清MPO、SIL-2R水平均降低,其中红斑型、丘疹型患者低于肥大型,自我感知、情感功能、痤疮症状、社会功能各项评分、视觉模拟评分法(VAS)评分均升高,其中红斑型、丘疹型患者高于肥大型(P<0.05)。治疗8周后,红斑型、丘疹型患者的治疗总满意度均高于肥大型(P<0.05)。结论:rbFGF联合HCQ、RHCD治疗玫瑰痤疮,有助于缓解患者的皮损情况,抑制机体炎症反应,提升生活质量及对治疗的满意程度,提高患者的面部美观度,其中对红斑型、丘疹型玫瑰痤疮的治疗效果较肥大型更好。

Objective To investigate the effect of recombinant bovine basic fibroblast growth factor(rbFGF)combined with hydroxychloroquine sulfate(HCQ)and recombinant human collagen dressing(RHCD)on facial appearance and skin lesions in patients with rosacea.Methods From February 2019 to January 2023,83 patients with rosacea admitted to Beijing Anzhen Hospital affiliated with Capital Medical University were selected.The cohort included 31 cases of erythematotelangiectatic rosacea,27 cases of papulopustular rosacea,and 25 cases of phymatous rosacea.All patients were treated with a combination of HCQ,RHCD,and rbFGF for 8 weeks.Clinical efficacy,treatment satisfaction,skin lesion severity before and after 8 weeks of treatment,and levels of peripheral blood nesfatin-1,Toll-like receptor 2(TLR2),serum myeloperoxidase(MPO),and soluble interleukin-2 receptor(sIL-2R)were analyzed.Quality of life(QoL)scores and facial appearance scores were also assessed across different types of patients.Results After 8 weeks of treatment,the total effective rate in patients with erythematotelangiectatic and papulopustular rosacea was significantly higher(P<0.05).Compared to baseline,after 8 weeks of treatment,scores for rash color,quantity,and burning/itching sensation,as well as levels of peripheral blood nesfatin-1,TLR2,serum MPO,and sIL-2R,decreased across all patient types.The decreases were more pronounced in patients with erythematotelangiectatic and papulopustular rosacea compared to those with phymatous rosacea.QoL scores,self-perception,emotional function,acne symptoms,social function,and visual analogue scale(VAS)scores all improved,with greater increases observed in the erythematotelangiectatic and papulopustular groups compared to the phymatous group(P<0.05).Conclusion Treatment with rbFGF combined with HCQ and RHCD in patients with rosacea helps to alleviate skin lesions,reduce inflammatory response,improve quality of life and treatment satisfaction,and enhance facial appearance.The therapeutic effect is more pronounced in patients with erythematotelangiectatic and papulopustular rosacea compared to those with phymatous rosacea.