Two-sample Mendelian randomization analysis of causal relationship between eczema and autoimmune diseases

Objective:The causal relationship between eczema and autoimmune diseases has not been previously reported.This study aims to evaluate the causal relationship between eczema and autoimmune diseases.Methods:The two‐sample Mendelian randomization(MR)method was used to assess the causal effect of eczema on autoimmune diseases.Summary data from the Genome-Wide Association Study Catalog(GWAS)were obtained from the Integrative Epidemiology Unit(IEU)database.For eczema and autoimmune diseases,genetic instrument variants(GIVs)were identified according to the significant difference(P<5×10−8).Causal effect estimates were generated using the inverse‐variance weighted(IVW)method.MR Egger,maximum likelihood,MR-PRESSO,and MR-RAPS methods were used for alternative analyses.Sensitivity tests,including heterogeneity,horizontal pleiotropy,and leave-one-out analyses,were performed.Finally,reverse causality was assessed.Results:Genetic susceptibility to eczema was associated with an increased risk of Crohn’s disease(OR=1.444,95%CI 1.199 to 1.738,P<0.001)and ulcerative colitis(OR=1.002,95%CI 1.001 to 1.003,P=0.002).However,no causal relationship was found for the other 6 autoimmune diseases,including systemic lupus erythematosus(SLE)(OR=0.932,P=0.401),bullous pemphigoid(BP)(OR=1.191,P=0.642),vitiligo(OR=1.000,P=0.327),multiple sclerosis(MS)(OR=1.000,P=0.965),ankylosing spondylitis(AS)(OR=1.001,P=0.121),rheumatoid arthritis(RA)(OR=1.000,P=0.460).Additionally,no reverse causal relationship was found between autoimmune diseases and eczema.Conclusion:Eczema is associated with an increased risk of Crohn’s disease and ulcerative colitis.No causal relationship is found between eczema and SLE,MS,AS,RA,BP,or vitiligo.

Efficacy of acupoint injection in the treatment of chronic eczema and its influence on peripheral blood T cells

BACKGROUND Chronic eczema significantly impacts daily life,social interactions,and quality of life;however,no curative treatment has been identified.AIM To determine the clinical efficacy of acupoint injection for chronic eczema and its influence on peripheral blood T cells.METHODS Eighty patients with chronic eczema treated at our hospital between June 2022 and March 2023 were randomly assigned to a control group(n=40),which received conventional Western medicine treatment,or an observation group(n=40),which received routine Western medicine treatment plus acupoint injection of triamcinolone acetonide.Response and adverse reaction rates,as well as differences in the levels of serum cytokines IFN-γ,IL-2,IL-4,and IL-10 before and after treatment were investigated.RESULTS No difference in overall response rates were found between the observation and control groups(100%vs 90%,respectively;P>0.05);however,the observation group had a higher marked response rate than the control group(87.5%vs 52.5%;P<0.05).Both groups had decreased Eczema Area and Severity Index scores and increased pruritus after treatment(P<0.05),particularly in the observation group(P<0.05).The observation group had an adverse reaction rate of 2.5%(1/40),which did not differ significantly from that of the control group(P>0.05).The observation group exhibited higher post-treatment INF-γand IL-2 but lower IL-4 levels than the control group(P<0.05);however,no significant inter-group difference was observed in post-treatment IL-10 levels(P>0.05).CONCLUSION Acupoint injection of triamcinolone acetonide is safe and effective in treating chronic eczema.Its therapeutic mechanism is related to the regulation of peripheral blood T cell levels,inhibition of inflammatory reactions,and mitigation of immune imbalance.

Clinical Efficacy of Huanglian Ointment in the Treatment of Chronic Eczema

Objective:To investigate and analyze the clinical efficacy of Huanglian ointment in the treatment of chronic eczema.Methods:114 cases of chronic eczema patients admitted to the Department of Dermatology of our hospital from January 2023 to January 2024 were selected as the study subjects.They were divided into a study group(n=57)and a reference group(n=57)using the double-blind method.The study group was treated with dialyzed Huanglian ointment,while the reference group was treated with conventional treatment.Symptom scores,inflammatory levels,treatment effects,and immune indexes of the two groups were similar before treatment.Results:After treatment,the symptom scores of the study group were significantly lower than those in the reference group(P<0.05).Besides,the interleukin-2(IL-2),tumor necrosis factor-a(TNF-a),interferon-(IFN-),and other inflammatory indicators of the study group were significantly better than those of the reference group(P<0.05).The total efficacy of treatment in the study group was significantly higher than that in the reference group(P<0.05).Furthermore,after treatment,the immunity indexes such as CD3+,CD4+,and CD8+of the study group were significantly better than those of the reference group,(P<0.05).Conclusion:Huanglian ointment is extremely effective for treating chronic eczema so this treatment program should be popularized.

Effects of seasonal changes on T-helper 1/T-helper 2 immune balance and eczema onset in rats

Objective: To explore the impact of seasonal changes on the T-helper 1(Th1)/T-helper 2(Th2) immune balance of the body in order to elucidate the internal immunological mechanisms underlying seasonal eczema.Methods: Eighty 4-week-old male Sprague-Dawley rats were divided into 5 season groups kept in corresponding season simulation environments, and subdivided into the model group and the control group. The Eczema Area and Severity Index(EASI) and scratching frequency were evaluated. The serum levels of immunoglobulin E(IgE), interleukin-2(IL-2), interleukin-12(IL-12), and interferon-gamma(IFN-γ), interleukin-4(IL-4), interleukin-25(IL-25), and interleukin-31(IL-31), and melatonin(MT), as well as the MT receptor(MTR) levels in the spleen, were detected by enzyme-linked immunosorbent assay analysis. The mRNA expression levels of T-bet and GATA3 were detected by quantitative real-time polymerase chain reaction.Results: EASI scores and the scratching frequency of the model group were higher in the long summer than in the other 4 seasons. Meanwhile, the serum levels of IgE and the Th2 cytokines IL-4, IL-25, and IL-31, as well as GATA3 mRNA expression levels, were high during the long summer in both groups. However, the serum levels of the Th1 cytokines IL-2, IL-12, and IFN-γ, as well as MT, MTR, and T-bet mRNA levels, were lower during the long summer. In all 5 seasonal groups(spring, summer, long summer, autumn, and winter), the levels of all immune factors, especially IL-4 and IL-31, were higher in the model group than those in the control group,while the concentrations of MT and MTR were lower.Conclusion: Under long light, hot, and humid conditions in the long summer, the body is more likely to suffer from Th2-dominated immune imbalance. This is the internal mechanism behind the high incidence and severity of eczema during the long summer. MT and MTR play a key role in the seasonal onset of eczema.

血清中的免疫炎症生物标志物与慢性湿疹病人的疾病严重程度相关性研究

目的探讨慢性湿疹病人血清免疫炎症生物标志物与疾病严重程度的相关性。方法将2021年9月至2022年8月于武汉市中医医院接受治疗的100例慢性湿疹病人纳入研究,包括局限性湿疹69例、泛发性湿疹31例;根据疾病严重程度分为轻度组37例、中度组34例和重度组29例;将同期该院40例健康体检者纳入对照组。采用酶联免疫吸附测定检测血清免疫炎症生物标志物白细胞介素(IL)-2、IL-4、IL-5、IL-6、γ干扰素(IFN-γ)、IL-10、IL-17、IL-18、IL-23、IL-33、肿瘤坏死因子α(TNF-α)水平;采用流式细胞仪检测外周血分化抗原(CD)4+、CD8+水平;采用Pearson相关分析慢性湿疹病人血清免疫炎症生物标志物与湿疹面积及严重度指数(EASI)评分的相关性。结果对照组、轻度组、中度组、重度组慢性湿疹病人血清IL-2[(10.51±2.10)μg/L比(12.94±2.26)μg/L比(15.03±2.34)μg/L比(17.94±2.56)μg/L]、IL-4、IL-5、IL-6、IL-10、IL-17、IL-18、IL-23、IL-33、TNF-α、IFN-γ、CD8+依次升高,CD4+[(43.24±6.79)%比(37.04±4.25)%比(29.12±2.78)%比(25.62±2.35)%]依次降低(P<0.05)。局限性与泛发性慢性湿疹病人血清IL-2、IL-4、IL-5、IL-6、IL-10、IL-17、IL-18、IL-23、IL-33、TNF-α、IFN-γ、CD4+、CD8+差异无统计学意义(P>0.05)。慢性湿疹病人EASI评分与血清IL-2、IL-4、IL-5、IL-6、IL-10、IL-17、IL-18、IL-23、IL-33、TNF-α、IFN-γ、CD8+呈正相关,与CD4+呈负相关(P<0.05)。结论血清免疫炎症生物标志物与慢性湿疹病人病情严重程度存在显著相关性,可考虑将各指标作为病情评估的相关辅助指标,在临床中推广应用。

黄芩苷调节cAMP/PKA/CREB信号通路对湿疹大鼠皮肤屏障功能的影响

目的探讨黄芩苷(BA)调节环磷酸腺苷(cAMP)/蛋白激酶A(PKA)/cAMP反应元件结合蛋白(CREB)通路对湿疹大鼠皮肤屏障功能的影响。方法将SD大鼠随机分为对照组(NC组)、Model组、低剂量BA组(BA-L组,25 mg/kg)、中剂量BA组(BA-M组,50 mg/kg)、高剂量BA组(BA-H组,100 mg/kg)、泼尼松组(PNS组,25 mg/kg)、BAH+cAMP抑制剂(SQ22536)组(100 mg/kg+2.13 mg/kg)、BA-H+PKA抑制剂(H-89)组(100 mg/kg+5 mg/kg),每组12只。除NC组外,其余组大鼠均构建湿疹大鼠模型。建模成功2 d后,分组进行给药处理。检测湿疹面积及严重度指数(EASI)评分、经皮肤水分流失量(TEWL)、角质层含水量(WCSC)变化;酶联免疫吸附试验(ELISA)检测大鼠血清中免疫球蛋白E(IgE)、干扰素-γ(IFN-γ)、白细胞介素-4(IL-4)水平及大鼠背部受试区皮损组织中c AMP蛋白表达;HE染色检测大鼠背部受试区皮损组织病理变化;Western blot检测大鼠背部受试区皮损组织中水通道蛋白3(AQP3)、cathelicidin相关抗菌肽(CRAMP)、p-PKA、p-CREB蛋白表达。结果与NC组比较,Model组大鼠背部受试区皮损组织病理损伤严重,EASI评分、TEWL、IgE、IL-4水平升高,WCSC、IFN-γ水平、AQP3、CRAMP、cAMP、p-PKA、p-CREB蛋白水平降低(P<0.05)。与Model组比较,BA-L组、BA-M组、BA-H组、PNS组大鼠背部受试区皮损组织病理损伤减轻,EASI评分、TEWL、IgE、IL-4水平降低,WCSC、IFN-γ水平、AQP3、CRAMP、cAMP、p-PKA、p-CREB蛋白水平升高(P<0.05);且BA-L组、BA-M组、BA-H组上述指标变化呈剂量依赖性。SQ22536或H-89减弱了高剂量BA对湿疹大鼠皮肤屏障功能的改善作用。结论BA可能通过激活cAMP/PKA/CREB信号通路改善湿疹大鼠皮肤屏障功能。

Investigation on the Material Basis of Sijicao Granules in Treating Eczema Based on Network Pharmacology

[Objectives]To explore the pharmacodynamic material basis of Sijicao granules for the treatment of eczema through chemical composition-network pharmacology.[Methods]First of all,the chemical constituents of Polygonum capitatum and Plantago asiatica from Sijicao granules were collected,and the relevant target information of the constituents was collected by TCMSP,PubChem,DisGeNET,GeneCards and STRING databases.Furthermore,Cytoscape 3.8.2 software was used to construct the chemical compounds-target network map of Sijicao granules.Finally,STRING database was used for PPI protein network analysis,GO functional enrichment analysis and KEGG pathway enrichment analysis of core targets,and molecular docking between core constituents and protein targets was also performed.[Results]30 constituents,including quercetin,kaempferol,luteolin,ellagic acid and gallic acid,were discovered to be the key effective compounds of Sijicao granules in the treatment of eczema.And its core action protein targets were PTGS2,NOS2,AKT1,TP53,IL6,HMOX1.What s more,through GO functional enrichment analysis of biological process(BP),cell component(CC),molecular function(MF)analysis and KEGG pathway enrichment analysis,the main pathways of action of Sijicao granules for the treatment of eczema including IL-17 signaling pathway,T cell receptor signaling pathway,cancer signaling pathway,TNF signaling pathway and Relaxin signaling pathway.In addition,molecular docking results displayed that the primary active constituents quercetin,kaempferol and luteolin were well combined with the core protein targets AKT1 and IL6.[Conclusions]Sijicao granules could play an important role for the treatment of eczema through multi-component,multi-target,multi-pathway and their interaction.

Clinical Observation of Chuanbai Antipruritic Lotion"Water Film"Wet Compress Combined with Chloramphenicol Prednisone Liniment in the Treatment of Acute Eczema

[Objectives]To observe and analyze the clinical efficacy and possible mechanism of Chuanbai antipruritic lotion"water film"wet compress combined with chloramphenicol prednisone liniment in the treatment of acute eczema.[Methods]A total of 76 acute eczema cases admitted to Shiyan Taihe Hospital from January 2022 to March 2023 were divided into Western medicine treatment group and integrated traditional Chinese and Western medicine group.In the Western medicine treatment group,chloramphenicol and prednisone liniment was applied to the skin lesions and oral administration of cetirizine hydrochloride.The course of treatment in both groups was 2 weeks(w).The levels of interferon-γ(IFN-γ),interleukin-4(IL-4)and the ratio of IFN-γ/IL-4 in the peripheral blood of patients before and 2 weeks after treatment,as well as serum immunoglobulin E(IgE),anti-IgE antibody and histamine(HA)level,and with skin lesions disappearing time,skin oil,transepidermal water loss(TEWL),eczema area and severity index(EASI)score,total effective rate,degree of pruritus and traditional Chinese medicine quality of life scale(EPQOLS)score to evaluate the efficacy.[Results]Compared with the Western medicine treatment group at 2 w,the disappearance time of skin lesions in the integrated traditional Chinese and Western medicine group was shortened,TEWL,itching degree and EASI score,serum IgE and HA,and peripheral blood IL-4 levels were all decreased(P<0.05).IFN-γand IFN-γ/IL-4 ratio,anti-IgE antibody,EPQOLS score and total effective rate were all increased(P<0.05),and the difference was statistically significant.[Conclusions]Chuanbai antipruritic lotion"water film"wet compress combined with chloramphenicol prednisone liniment is an optimized and safe and efficient method for the treatment of acute eczema,which can quickly relieve the symptoms of inflammatory damage of eczema and restore the skin barrier function,dry dampness and relieve itch.Inhibition of the release of histamine active substances and regulation of immunity may be the main mechanisms.

西替利嗪与枸地氯雷他定治疗皮炎/湿疹类皮肤病的多中心、前瞻性、真实世界研究

目的 研究真实世界西替利嗪与枸地氯雷他定治疗皮炎/湿疹类皮肤病的有效性。方法 收集面部皮炎(FD)、手湿疹以及特应性皮炎(AD),并且处方中含有西替利嗪或枸地氯雷他定的患者病历。记录治疗前与第14天随访时患者湿疹面积及严重程度指数评分(EASI)、研究者总体评估(IGA)、视觉模拟量表(VAS)以及湿疹患者自我检查评分量表(POEM),同时记录患者基本信息,伴随疾病、合并用药以及不良反应。结果 本研究共纳入219例患者,其中FD 77例,手湿疹49例,AD 93例。西替利嗪与枸地氯雷他定联合其他治疗对3种皮炎/湿疹在改善EASI评分、IGA评分以及VAS评分均有效(P<0.05)。与基线值相比,治疗后,FD患者中,西替利嗪组与枸地氯雷他定组EASI评分下降分别为0.50 (-0.67,-0.29),0.63 (-0.83,-0.50),差异有统计学意义(P<0.05),IGA、VAS评分下降两组之间差异无统计学意义(P>0.05);手湿疹患者中,EASI、IGA、VAS评分下降两组之间差异均无统计学意义(P>0.05);AD患者中,西替利嗪组与枸地氯雷他定组EASI评分下降分别为0.20 (-0.63,-0.04),0.63 (-0.78,-0.39),IGA评分下降分别为0.25 (-0.33,0.00),0.50 (-0.50,-0.25),差异均有统计学意义(P<0.05)。VAS评分、POEM评分下降情况两组之间差异均无统计学意义(P>0.05)。结论 真实世界中西替利嗪或枸地氯雷他定联合其他治疗可以改善3种皮炎/湿疹的严重程度及瘙痒。枸地氯雷他定相较于西替利嗪,在改善FD、AD的EASI评分方面占有优势,两种药物对FD、手湿疹、AD的止痒作用相当。

湿疹患儿照料者对外用皮质类固醇激素治疗的认知状况调查

目的了解湿疹患儿照料者对外用皮质类固醇激素(TCS)治疗的认知情况及其影响因素,为有针对性开展用药宣教工作,提高患儿用药依从性,改善治疗效果提供参考。方法采用调查问卷对2020年12月—2021年3月首都儿科研究所附属儿童医院皮肤科就诊的171例湿疹患儿照料者进行问卷调查,包括照料者对TCS及其副作用的认知情况、相关知识的获取途径、患儿TCS治疗的依从性,分析照料者对TCS治疗湿疹相关认知的影响因素。结果仅22.22%(38/171)的照料者对TCS“非常了解”,而有16.37%(28/171)“完全不了解”。仅9.36%(16/171)的照料者对TCS副作用“完全了解”。照料者主要从“网络”(46.20%)、“病友或周围人”(38.60%)和“医生”(22.81%)获取TCS治疗湿疹相关知识。TCS使用时,61.99%(106/171)的照料者“完全按医嘱”,35.08%(60/171)“不完全按医嘱”,2.92%(5/171)表示“完全不使用TCS”。在对TCS及其副作用的认知方面,不同年龄、学历和职业状态的照料者之间均存在统计学差异(均P<0.05)。在对TCS治疗湿疹相关资讯获取途径以及对TCS治疗的依从性方面,不同年龄、不同学历的照料者之间存在统计学差异(均P<0.05),而不同职业状态照料者之间无统计学差异(P值分别为0.062、0.074)。结论儿童湿疹照料者对TCS治疗湿疹的认知程度较低,依从性不高。照料者对TCS的认知和用药依从性受年龄和教育程度的影响。临床医生有必要关注不同群体在疾病和用药相关信息获取上的差异,加强宣讲和科普,促进合理用药,改善湿疹儿童皮肤健康管理。

火针联合黄连膏包敷治疗慢性湿疹血虚风燥证的临床观察

目的观察火针联合黄连膏包敷治疗慢性湿疹血虚风燥证的临床疗效。方法将100例慢性湿疹血虚风燥证患者按照随机数字表法分为2组,对照组50例予局部火针方法治疗,治疗组50例在对照组基础上予黄连膏包敷方法治疗。2组均治疗4周。比较2组治疗前后湿疹面积及严重程度指数(EASI)评分、瘙痒程度评分、瘙痒频率评分,并统计2组疗效及复发率。结果治疗组总有效率96.00%(48/50),对照组总有效率82.00%(41/50),治疗组临床疗效优于对照组(P<0.05)。2组治疗后EASI各项评分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后瘙痒程度评分、瘙痒频率评分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。治疗组复发率低于对照组(P<0.05)。结论火针联合黄连膏包敷治疗慢性湿疹血虚风燥证患者效果显著,能够减轻患者的瘙痒症状,降低复发率,值得推广应用。

基于数据挖掘和网络药理学分析中药熏洗方治疗肛周湿疹的用药规律及机制

目的:应用数据挖掘和网络药理学方法探讨中药熏洗方治疗肛周湿疹的用药规律及机制。方法:检索中国知网、万方、维普、中国生物医学文献数据库2011年1月1日至2020年12月31日关于中药熏洗治疗肛周湿疹的文献;采用中医传承辅助平台V3.0软件对处方用药频次、药性、药味、归经、组方规律、药物核心组合进行分析。通过中药系统药理学数据库与分析平台(traditional Chinese medicine systems pharmacology database and analysis platform,TCMSP)检索用药规律所得苦参汤中8味药物的活性成分及其对应的药物靶点;运用人类基因数据库(the human gene database,GeneCards)获取肛周湿疹的疾病靶点;使用Venny 2.1.0作图工具映射药物与疾病交集靶点,并构建韦恩图;运用STRING数据库及Cytoscape 3.8.2软件构建靶点蛋白-蛋白互作网络(protein-protein interactions,PPI),筛选核心作用靶点,构建“药物-活性成分-作用靶点”网络;应用R语言的clusterProfiler包进行基因本体论(gene ontology,GO)及京都基因与基因组百科全书(kyoto encyclopedia of genes and genomes,KEGG)通路富集分析。结果:共筛选出符合标准的文献386篇,纳入中药处方360首,涉及中药188味;用药频次≥10次的药物共51味,四气分类以寒性为主,五味分类以苦味及辛味为主,药物归经以肝经、胃经及脾经为主;组方规律分析得到高频药对30对,最终演化得到核心组合4个,从用药规律得出苦参汤是治疗肛周湿疹的特效方。共筛选出苦参汤中137个活性成分和224个潜在靶点,与肛周湿疹相关作用靶点24个,经拓扑分析得到3个核心治疗靶点;筛选出槲皮素、木犀草素、山柰酚、金合欢素、苦参碱5个有效活性成分;GO富集分析得到1354个生物学过程、34个细胞组成及71个分子功能;KEGG通路富集分析得到97条信号通路。结论:苦参汤是治疗肛周湿疹的中药古方,苦参汤通过多成分、多靶点、多通路发挥治疗肛周湿疹的作用。

湿包疗法在成人中重度特应性皮炎及其他皮炎湿疹类皮肤病中的疗效观察

目的观察湿包疗法(WWT)在特应性皮炎及其他皮炎湿疹类皮肤病中的疗效及安全性。方法回顾分析2015年1月—2023年5月在首都医科大学附属北京友谊医院皮肤科住院期间应用WWT治疗的特应性皮炎(AD)及其他皮炎湿疹类皮肤病患者,总结WWT的疗效及不良反应。结果共收集44例患者,病种包括AD、红皮病、嗜酸性粒细胞增多性皮炎、湿疹、AD结节痒疹型、光敏性皮炎以及药疹。治疗后患者湿疹面积及严重程度指数(EASI)、研究者总体评估(IGA)、体表受累面积(BSA)、瘙痒-数字评价量表(NRS)均得到显著改善,外周血嗜酸性粒细胞水平较前下降。AD结节痒疹型组WWT应用时间显著高于AD、红皮病和湿疹组。应用0.05%卤米松乳膏进行WWT组的EASI评分下降率显著高于0.1%糠酸莫米松乳膏组和青鹏软膏组。应用0.05%卤米松乳膏进行WWT组患者治疗后IGA评分显著低于青鹏软膏组。结论WWT治疗成人中重度AD及皮炎湿疹类疾病的疗效肯定,安全性好。

玫芦消痤膏治疗湿疹作用机制的网络药理学研究

目的:研究苗药玫芦消痤膏治疗湿疹的作用机制,探索玫芦消痤膏治疗湿疹的作用靶标及信号途径。方法:在中药系统药理学数据库和分析平台,以及多个数据库中,联合检索筛选玫芦消痤膏活性成分-作用靶点,基因名注释使用UniProt数据库,并在OMIM数据库、GeneCards数据库、DrugBank数据库中检索湿疹的相关疾病靶标,再采用Rversion 3.6.2软件及Cytoscape 3.7.1软件构建玫芦消痤膏治疗湿疹的成分-作用靶点-通路网络,最后利用R语言中Bioc Manager包进行基因本体功能注释及KEGG通路富集分析。结果:经筛选得到玫芦消痤膏活性成分35个,槐定碱、槲皮素、苦参碱、木犀草素、鞣花酸、花生四烯酸、芦荟大黄素等是关键活性成分;作用靶标基因97个,核心蛋白有丝裂原活化蛋白激酶3前列腺素内过氧化物合酶,丝裂原活化蛋白激酶1、内皮一氧化氮合成酶、激素受体1、雄激素受体、脑源性神经营养因子、转录因子、过氧化物酶体增生激活受体等,参与调控高级糖基化终末产物-受体、肿瘤坏死因子、白细胞介素17、丝裂原活化蛋白激酶、PI3K-Akt等信号通路,从而发挥抗炎等作用。结论:玫芦消痤膏能有效缓解湿疹症状,可能与肿瘤坏死因子、PI3K-Akt等经典炎症通路有关,为后续分析玫芦消痤膏的药理机制和实验验证提供了理论支撑。

基于CiteSpace的中医药治疗湿疹的可视化分析

目的:运用文献计量学方法分析近10年中医药治疗湿疹的研究现状、热点及趋势。方法:选取中国知网数据库2013年1月至2023年3月收录的中医药治疗湿疹的研究文献,运用CiteSpace软件对相关文献的作者、研究机构、关键词进行可视化分析。结果:共纳入文献1556篇,筛选后得到1468篇。近十年来,研究逐渐深入,形成了李萍团队、田静团队和冯常青团队等合作较为密切的团队。主要研究机构为成都中医药大学、辽宁中医药大学、北京中医药大学。合作关系仍以省市内为主,跨区域合作较少。关键词分析获得10个关键词聚类和20个突现词,“慢性湿疹”是出现频率最高的关键词,“急性湿疹”是最大的聚类(排除了湿疹、湿疮、浸淫疮与临床疗效、临床观察、中医、中药、综述等非重要学术价值的词汇)。研究热点最初以证候研究、临床疗效研究为主,逐渐转向临床经验、中医外治法研究,然后meta分析、用药规律及数据挖掘获得了一定热度,现网络药理学、病因病机、作用机制成为新的研究热点。结论:中医药治疗湿疹的相关研究涉及较广。湿疹的病因病机、外治法等是未来的研究趋势,但存在研究团队相对集中、合作不够紧密、研究内容集中于慢性湿疹等问题,未来应加强合作,扩大中医药治疗湿疹的研究范围。

血清人软骨糖蛋白-39、可溶性E-选择素与儿童湿疹及严重程度的相关性

目的探究血清人软骨糖蛋白-39(YKL-40)、可溶性E-选择素(E-selectin)与儿童湿疹的相关性及与湿疹严重程度的关系。方法选取2019年3月至2020年3月延安大学附属医院收治的湿疹病儿120例为观察组,根据湿疹面积及严重程度指数(EASI)评分将病儿分为轻度组(42例)、中度组(40例)和重度组(38例)。选取同期进行体检者50例作为对照组。检测血清YKL-40、E-selectin水平;比较临床资料;采用Pearson法分析观察组YKL-40、E-selectin水平的相关性;Spearman法分析血清YKL-40、E-selectin水平与病情严重程度的相关性;logistic分析发生重度湿疹的影响因素。结果观察组年龄和性别与对照组比较均差异无统计学意义(P>0.05),而观察组病儿在过敏性鼻炎[18.33%(32/120)]、过敏史[65.00%(78/120)]、糖尿病家族史[57.50%(69/120)]、YKL-40[(38.05±4.80)g/L]和E-selectin水平[(64.12±6.83)μg/L]上与对照组[10.00%(6/50)、28.00%(14/50)、38.00%(19/50)、(24.69±3.44)g/L、(56.38±6.18)μg/L]差异有统计学意义(t/χ^(2)=4.37、19.46、5.38、17.85、6.92,P<0.05);轻度组、中度组和重度组的YKL-40[(30.95±3.51)g/L、(38.28±4.69)g/L、(45.66±6.34)g/L]和E-selectin水平[(58.82±6.05)μg/L、(63.96±6.85)μg/L、(70.15±7.68)μg/L]均依次显著升高,差异有统计学意义(F=88.67、26.71,P<0.05);观察组血清YKL-40、E-selectin呈正相关(r=0.68,P=0.001);血清YKL-40、E-selectin与病情严重程度呈正相关(r=0.68、0.58,均P<0.001);过敏史、糖尿病家族史、YKL-40和E-selectin为患湿疹严重程度的独立危险因素(P<0.05)。结论血清YKL-40和E-selectin水平升高,湿疹病儿病情可能会加重,二者均为湿疹严重程度的独立危险因素。

苋黄洗剂联合复方敏维糖浆治疗儿童湿疹的疗效及对炎性因子的影响

目的探讨苋黄洗剂联合复方敏维糖浆对小儿湿疹的治疗效果并分析其对炎性因子的影响。方法选择2023年1月至2023年9月在我院接受治疗的108例湿疹患儿,按照随机数字表法将病例组分为治疗A组(54例)和治疗B组(54例),A组采用复方敏维糖浆治疗,B组采用苋黄洗剂联合复方敏维糖浆治疗,对两组患儿的临床疗效、EASI评分及治疗前后细胞因子白介素-2(IL-2)、白介素-4(IL-4)、白介素-10(IL-10)、干扰素-γ(IFN-γ)水平进行比较。结果治疗一疗程后两组EASI评分均较治疗前下降,其中B组EASI评分低于A组(P<0.05),B组治疗总有效率高于A组,复发率低于A组(P<0.05)。治疗后,2组IL-4、IL-10水平均较治疗前降低,IL-2与IFN-γ水平均较治疗前升高,且B组降低或升高的程度大于A组。结论苋黄洗剂联合复方敏维糖浆对小儿湿疹的治疗效果较单一复方敏维糖浆治疗显著,联合治疗可降低复发率,提高有效率,减轻炎症反应,改善免疫平衡,安全可靠,值得临床推广应用。

复方苓榆洗剂与冰黄肤乐软膏治疗婴幼儿急性湿疹临床疗效比较

目的:探讨复方苓榆洗剂、冰黄肤乐软膏治疗婴幼儿急性湿疹的临床疗效,为急性湿疹患儿的临床治疗及康复提供参考。方法:选取2022年1月至2023年1月我院收治的120例急性湿疹婴幼儿,按随机数表法分为A、B两组各60例。A组采用复方苓榆洗剂治疗,B组给予冰黄肤乐软膏进行皮肤外部涂抹治疗。比较两组患儿临床疗效及家属对治疗的满意度。结果:A组患儿临床疗效、家属对治疗的满意度明显高于B组(P<0.05)。两组患儿治疗后红斑、丘疹/丘疱疹/水疱、糜烂、渗出/结痂/鳞屑、皮损、瘙痒等各症状评分低于治疗前,其中A组治疗后上述评分低于B组(P<0.05)。结论:复方苓榆洗剂治疗急性湿疹婴幼儿的临床疗效优于冰黄肤乐软膏。

从脾胃升降理论探讨湿疹的病机与治疗

湿疹是由多种内外因素引起的炎症性皮肤疾病,以皮疹多形态,常对称分布,有渗出倾向,自觉瘙痒,易反复发作,易成慢性为主要特点。中医医家多认为湿疹病因总由禀赋不耐,风、湿、热邪阻滞肌肤所致,与脾密切相关,湿邪是其发病核心病因。脾升胃降为全身气机升降的枢纽。脾胃升降失常,痰湿内生,百病由生。该文从脾胃升降理论探讨湿疹的病机,着重探讨在湿疹发生发展过程中病机演变以及分期诊治原则。

基于JAK1/STAT5信号通路探讨肤痒静凝胶治疗慢性湿疹作用机制

目的:探讨肤痒静凝胶对慢性湿疹大鼠模型蛋白酪氨酸激酶1(janus protein kinase 1,JAK1)/信号转导与转录激活子5(signal transducerand activator of transcription 5,STAT5)信号通路调控作用的分子机制。方法:将36只SPF级Wistar大鼠随机分为正常组、模型组、青鹏软膏组(2500 mg·kg^(-1)·d^(-1))、肤痒静凝胶低(0.08 g/g)、中(0.16 g/g)、高(0.32 g/g)剂量组。除正常组外,其余组大鼠均采用2,4-二硝基氯苯丙酮液背部诱导慢性湿疹样病变。造模3周后青鹏软膏组及肤痒静凝胶低、中、高剂量组分别涂抹相应药物治疗;模型组涂抹空白凝胶基质,每日1次,共2周,正常组不做处理。观察慢性湿疹大鼠背部皮损的严重程度和病理变化;Western blot法检测大鼠背部皮肤组织中磷酸化蛋白酪氨酸激酶1(p-JAK1)和磷酸化信号转导与转录激活子5(p-STAT5)蛋白表达;qRT-PCR法检测大鼠背部皮肤组织中胸腺基质淋巴细胞生成素(thymic stromallymphopietin,TSLP)、JAK1、STAT5、白细胞介素-10(IL-10)和IL-17 mRNA表达水平;酶联免疫吸附法(ELISA)测定大鼠血清中IL-4、IL-6、IL-10、IL-13和IL-17水平。结果:与正常组比较,模型组大鼠血清中IL-4、IL-6、IL-13和IL-17水平明显升高,IL-10水平明显降低(P<0.05),背部皮损组织中p-JAK1、p-STAT5蛋白和TSLP、JAK1、STAT5、IL-17 mRNA表达水平明显升高,IL-10 mRNA水平明显降低(P<0.05)。与模型组比较,青鹏软膏组、肤痒静凝胶低、中、高剂量组大鼠血清中IL-4、IL-6、IL-13和IL-17水平明显降低,IL-10水平明显升高(P<0.05),背部皮损组织中p-JAK1、p-STAT5蛋白和TSLP、JAK1、STAT5、IL-17 mRNA表达水平明显降低,IL-10 mRNA水平明显升高(P<0.05)。与肤痒静凝胶低、中剂量组比较,青鹏软膏组大鼠血清中IL-4、IL-6、IL-13和IL-17水平明显降低,IL-10水平明显升高(P<0.05),背部皮损组织中p-JAK1、p-STAT5蛋白和TSLP、JAK1、STAT5、IL-17 mRNA表达水平明显降低,IL-10 mRNA水平明显升高(P<0.05)。与青鹏软膏组比较,肤痒静凝胶高剂量组大鼠血清中IL-4、IL-6、IL-10、IL-13和IL-17水平无明显差异(P>0.05),背部皮损组织中p-JAK1、p-STAT5蛋白和TSLP、JAK1、STAT5、IL-10、IL-17 mRNA表达水平无明显差异(P>0.05)。结论:肤痒静凝胶可能通过调控JAK1/STAT5信号通路相关炎症因子、蛋白和基因的表达发挥治疗慢性湿疹的作用。