Low-dose intralesional injection of 5-fluorouracil and triamcinolone reduces tissue resident memory T cells in chronic eczema

BACKGROUND Tissue resident memory T(TRM)cells have been reported to play a significant role in the pathogenesis and relapse of chronic eczema.AIM To compare the efficacy and safety of the intralesional injection of 5-fluorouracil(5-FU)and triamcinolone(TA)with those associated with TA alone for the treatment of chronic eczema.METHODS A total of 168 patients were randomized to 5-FU+TA or TA groups and received a one-time intralesional injection of 5-FU+TA or TA only.Biopsies were collected before and 2 wk after treatment for evaluation of histopathological changes.All patients were followed up monthly for up to 1 year.RESULTS No serious adverse event was observed in either group.Although the mean atopic dermatitis severity index scores and effective rates were comparable between the two groups after 2 wk of treatment,the relapse rate was significantly lower in the 5-FU+TA group than in the TA group.Histological examination showed significantly fewer CD8^(+)and CD103^(+)T cells but not CD4^(+)T cells in the 5-FU+TA group.CONCLUSION One-time intralesional injection of 5-FU+TA is effective and safe for chronic eczema treatment and can further reduce the retention of T_(RM) cells in the lesional skin and the relapse rate of chronic eczema.

Research Progress of Cymbaria mongolica Maxim.in the Treatment of Chronic Eczema

Chronic eczema is a kind of skin disease which is difficult to treat.It is easy to occur repeatedly,and itching is intolerable during the attack,which seriously affects the daily life of patients.Through the review of the treatment of chronic eczema with Mongolian medicine Cymbaria mongolica Maxim.,it has the advantages of improving the cure rate and the quality of life,and reducing the recurrence rate,and so on,which provides a scientific basis for the promotion and further research of traditional Mongolian medicine Cymbaria mongolica Maxim.

Shizhenqing granule stimulates the hypothalamic-pituitary-adrenal axis and reduces serum pro-inflammatory factors in a rat model with chronic eczema

Objective:In this study,we examined the effects of Shizhenqing granule(SZQG)on hypothalamicpituitary-adrenal(HPA)axis and serum inflammatory factors in a rat model of chronic eczema,in order to explore the mechanism of action of SZQG in treatment of this disease.Methods:Sixty SpragueeDawley male rats were randomly divided into six groups(with 10 rats per group):blank group;model group;positive control group(prednisone);and the low-,medium-,and high-dose SZQG groups.Except for the blank group,rats in all other groups were treated with 2,4-dinitrochlorobenzene to induce chronic eczema.These rats were administered prednisone or SZQG for 7 consecutive days after successful establishment of the chronic eczema model,and samples were collected 12 h after the last administration.The degree of skin lesions and the changes in serum levels of corticotropin-releasing hormone(CRH),adrenocorticotropic hormone(ACTH),cortisol(CORT),interleukin(IL)-4,interferon(IFN)-g,IL-25,and IL-31 among the groups were compared.Results:SZQG effectively increased the levels of CRH,ACTH,and CORT,which decreased in the serum of rats with chronic eczema,stimulated the function of the HPA axis,and promoted the expression of glucocorticoids.SZQG reduced the serum levels of inflammatory factors including IL-4,IL-25 and IL-31,which were overexpressed in rats with chronic eczema,and increased those of anti-inflammatory factor IFN-g,thereby alleviating the inflammatory symptoms and itching,and ameliorating the clinical symptoms of chronic eczema.Conclusion:SZQG effectively alleviates skin lesions in the chronic eczema rat model by stimulating the function of the HPA axis.

Exploring the association between gastrointestinal heat retention syndrome and adult chronic eczema: A caseecontrol study

Objective:To investigate the association between gastrointestinal heat retention syndrome(GHRS)and adult chronic eczema.Methods:This caseecontrol study compared GHRS/GHRS accompanied by damp-heat syndrome(GHRSDHS)and other patient characteristics between subjects with(cases)and without chronic eczema(controls)to identify potential factors associated with this condition.Semi-structured questionnaires were used to collect data via face-to-face interviews.Participants were recruited from Dongzhimen Hospital affiliated with Beijing University of Chinese Medicine.A logistic regression analysis was performed on the collected data,and odds ratios(ORs)were calculated.Results:A total of 168 cases and 172 controls were recruited.Among the cases of adult chronic eczema,there were 79 subjects with GHRS and 68 with GHRS-DHS.Sex(P=.02,OR=0.54,95%confidence interval[CI]:0.32-0.91),GHRS(P=.04,OR=1.90,95%CI:1.02-3.51),GHRS-DHS(P<.001,OR=4.89,95%CI:2.36-10.15),high sweet food consumption(P=.04,OR=2.03,95%CI:1.03-3.97),and mental stress(P=.01,OR=2.37,95%CI:1.26-4.47)were each found to be associated with chronic eczema.Furthermore,GHRS had a weak positive correlation with eczema EASI severity as measured by the eczema area and severity index(EASI)(P=003).Conclusion:GHRS/GHRS-DHS may be associated with adult chronic eczema.In the future,prospective cohort studies with larger samples should be conducted to investigate the cause and effect association between GHRS and adult chronic eczema.

A Case of Invasive Pulmonary Aspergillosis Resulted from the Treatment of Chronic Eczema

This was an advanced male(87-year-old)with refractory chronic eczema for over 40 years,based on his allergic constitution,accompanied with chronic kidney disease due to primary hypertension(CKD,phase 3).It was so difficult to tolerate the severe itching that the glucocorticoids(GC)had to be applied to it,but some new-onset respiratory symptoms,such as cough,dyspnea after exertion etc.,occurred to this patient.Some classical IPA images were found on his pulmonary CT scanning,which were further comfirmed by the positive findings of GM-test,and then a final diagno­sis of IPA was accordingly established.Unfortunately,a persistent fever emerged after starting an antifungal therapy to the patient,and his IL-2 level was detected to be superhigh.As a response to allergic fever,GC was carefully given intravenously again to treat it,and it turned out to be totally improved since then;suggesting that systemic thinking(integrated with the other clinical evidences)is essential to diagnose IPA,and GC can also be used to improve its symptoms with the existence of antifungal therapy.

Study on effect of Traditional Chinese Medicine Jianpi Chushi decoction and ointment on chronic eczema

Objective:To study the effects of Traditional Chinese Medicine Jianpi Chushi decoction and ointment on chronic eczema.Methods:DNCB acetone solution was used to sensitize the skin of back and ears of 36 rats in order to establish chronic eczema model.A total of 36 rats were divided into four groups of 9 randomly including oral medicine group,external inunctum group,combination therapy group,and model control group respectively.Besides,the blank group of 4 healthy rats were set.The oral medicine group was given Traditional Chinese Medicine Jianpi Chushi decoction [(Poria cocos,Chinese yam,Cortex dictamni,Zaocys dhumnade,Rhizoma atractylodis,Pericarpium citri reticulatae,Scutellaria baicalensis,Radix Sophorae Flavescentis,Raw Radix Paeoniae Alba,Licorice roots(Northwest Origin)] by gastric infusion(1.6 g/m L·5 m L/d); the external inunctum group was given Qingpeng ointment on the skin,the combination therapy group was given Jianpi Chushi decoction by gastric infusion and Qingpeng ointment combination therapy.The model control group was given normal saline(NS) of the same volume by gastric infusion and vaseline on skin.Continuous administration 15 d and stopped for 3 d.The thickness difference and weight difference of left and right ear of every group were measured and the degree of ear swelling were evaluated.The CD4^+ and CD8^+ content and the IL-2,IL-4 level of serum were detected,and the inflammatory cells counts of back skin were recorded.Results:After treatment,the degree of ear swelling of oral medicine group,external inunctum group and combination therapy group significant decreased compared with model control group(P<0.05).The CD4^+,CD8^+ cell content and IL-2 level of oral medicine group,external inunctum group,combination therapy group and model control group significant decreased compared with blank group,and IL-2 level and the inflammatory cells count increased.After 15 d of treatment,the CD4^+,CD8^+ cell content and IL-2 level of serum of oral medicine group,external inunctum group and combination therapy group raised and the IL-4 level and the inflammatory cells count had significant decreased compared with model control group,and the effect of combination therapy group was more obvious(P<0.05).Conclusions:Qral Jianpi Chushi decoction could treat chronic eczema effectively,and oral Chinese medicine combined with ointment could enhance and speed up the efficacy.

Clinical efficacy of combined skin acupuncture and external washing therapy of Zhuang nationality medicine in the treatment of chronic eczema

目的:评价壮医皮肤针配合壮医药物外洗治疗慢性湿疹的临床疗效。方法:将120例慢性湿疹患者随机分为试验组(60例)和对照组(60例),试验组应用壮医皮肤针配合壮医药物外洗治疗,对照组给予糠酸莫米松乳膏外涂,分析两组连续治疗4周前、后的红斑、丘疹/硬肿、表皮剥脱、苔藓化、渗出/结痂等单项积分、瘙痒症状积分和EASI总积分的变化,比较两组连续治疗4周后的临床疗效和不良反应情况。结果:治疗4周后两组在各项皮损积分、瘙痒症状积分和湿疹面积及严重程度指数(EASI)积分上均低于治疗前,且试验组的瘙痒评分和EASI分值较对照组下降更为明显,差异具有统计学意义(P<0.05)。试验组总有效率为81.03%,显著高于对照组总有效率61.11%,差异具有统计学意义(Z=-2.391,P=0.017)。结论:采用壮医皮肤针配合壮医药物外洗治疗慢性湿疹的疗效优于糠酸莫米松乳膏。

TREATMENT OF 40 CASES OF CHRONIC ECZEMA WITH POINT-INJECTION OF COMPOUND RADIX SALVIAE MILTIORRHIZAE INJECTION

The authors have used point-injection of compound Radix Salviae Miltiorrhizae Injection to treat 40 cases of chronic eczema and achieved a satisfactory therapeutic effect. The total effective rate was 95%.

朱仁康运用滋阴除湿汤治疗慢性湿疹经验

本文对朱仁康教授运用滋阴除湿汤治疗慢性湿疹经验进行总结。朱仁康教授认为,湿疹发病不离湿邪,湿邪贯穿疾病各阶段。发作期以标实为主,风邪袭表,腠理疏松,营阴外泄,留滞为湿,风湿相结于皮腠;慢性期以阴虚为主,久病伤正,湿伏于里,营阴亏虚而外燥。朱仁康教授针对慢性湿疹营阴亏损、湿邪留恋的疾病特点,创立滋阴除湿汤,并强调营阴与湿邪同源异途,并存不悖,滋阴与除湿之法并用,使阴复而无助湿之弊,湿去而无伤阴之瑕,可取得满意疗效。

盐酸左西替利嗪片内服与丙酸氟替卡松乳膏外用联合治疗慢性湿疹的效果与不良反应分析

目的探讨盐酸左西替利嗪片内服与丙酸氟替卡松乳膏外用联合治疗慢性湿疹的效果与不良反应。方法选择2022年3月至2023年3月我院收治的慢性湿疹患者160例,随机分为对照组和观察组各80例。对照组给予盐酸左西替利嗪片内服,观察组在对照组基础上给予丙酸氟替卡松乳膏外用。对比两组的临床疗效、临床症状消失时间、皮损情况和不良反应。结果观察组总有效率高于对照组(P<0.05)。观察组疼痛、肥厚、鳞屑、红斑消失时间短于对照组,治疗后皮损症状积分和皮损面积低于对照组(P<0.05)。两组的不良反应发生率比较无统计学差异(P>0.05)。结论盐酸左西替利嗪片内服与丙酸氟替卡松乳膏外用联合治疗慢性湿疹可显著提高临床疗效,加快患者临床症状消失,改善皮损情况,且安全性较高,值得临床推广应用。

基于数据挖掘的刘兰林教授运用温病学三焦理论辨治慢性难治性湿疹的用药规律

目的:运用数据挖掘技术研究刘兰林教授辨治慢性湿疹的用药规律。方法:收集整理刘兰林教授治疗慢性湿疹的105张门诊处方单,借助Microsoft Excel 2010、SPSS Statistics 22.0、SPSS Modeler 18.0计算机软件建立数据库并进行频数及聚类分析。结果:所收集的处方涉及中药147味,18类,使用频数≥20次的常用药物有牡丹皮、蝉蜕、白鲜皮等,清热药、利水渗湿药位居前2位,药性上寒温搭配,药味以甘、苦、辛为主,归经多入肝、胃、脾、肺经。聚类分析出牡丹皮、大青叶、生地黄、淡竹叶、水牛角、玄参、首乌藤,蝉蜕、防风、僵蚕、徐长卿等7种组合。结论:刘兰林教授以温病学三焦理论为指导,将慢性湿疹病机核心责之于湿热内蕴,外发肌肤,治疗遵循三焦辨治原则,治以清热祛湿,调畅气机,分消上中下三焦湿热之邪,酌情配以凉血散瘀,祛风通络之品,用药喜寒温搭配,甘苦合化及苦辛相伍,擅以犀角地黄汤、升降散、五苓散、四妙散等经典名方加减。

消风散加减联合复方黄柏液涂剂治疗血虚风燥型慢性肛周湿疹临床观察

目的:观察消风散加减联合复方黄柏液涂剂治疗血虚风燥型慢性肛周湿疹的临床疗效。方法:将64例已确诊的血虚风燥型慢性肛周湿疹患者,按随机数字表法分组,观察组、对照组各32例,观察组采用消风散加减联合复方黄柏液涂剂外敷治疗,对照组采用复方黄柏液涂剂外敷治疗,疗程为4周,比较2组的治疗效果。结果:观察组的治疗总有效率明显高于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的肛周瘙痒、肛周渗液、皮损面积、皮损形态及白介素-4(IL-4)、肿瘤坏死因子-α(TNF-α)及血清总IgE水平均低于对照组,差异具有统计学意义(P<0.05)。结论:消风散加减联合复方黄柏液涂剂治疗血虚风燥型慢性肛周湿疹有较好疗效。

火针联合甘草油封包治疗慢性湿疹的临床观察

目的观察火针联合甘草油封包治疗慢性湿疹的临床疗效。方法将60例慢性湿疹患者按照随机数字表法分为2组,对照组30例予复方氟米松软膏治疗,治疗组30例在对照组的基础上加用火针联合甘草油封包治疗。2组均治疗1周为1个疗程,治疗3个疗程后统计疗效,比较2组治疗前后湿疹面积及严重度指数(EASI)评分及瘙痒症状评分变化情况。结果治疗组总有效率93.33%(28/30),对照组总有效率66.67%(20/30),治疗组总有效率高于对照组(P<0.05)。与本组治疗前比较,2组治疗后EASI评分均降低(P<0.05),且治疗组治疗后EASI评分低于对照组(P<0.05)。与本组治疗前比较,2组治疗后瘙痒症状评分均降低(P<0.05),且治疗组治疗后瘙痒症状评分低于对照组(P<0.05)。结论火针联合甘草油封包治疗慢性湿疹临床疗效确切,可有效促进患者皮损修复,减轻瘙痒症状,提高临床疗效,安全可靠。

湿毒膏联合亚甲蓝肛周封闭术对慢性肛周湿疹的治疗效果

目的:探究湿毒膏联合亚甲蓝肛周封闭术对慢性肛周湿疹患者肛周皮损、瘙痒及复发的影响。方法:选取2020年10月—2023年3月赣州市中医院诊治的慢性肛周湿疹患者80例,使用随机抽签法分对照组(n=40,给予亚甲蓝肛周封闭术治疗)及观察组(n=40,给予湿毒膏联合亚甲蓝肛周封闭术治疗)。评价对比两组临床疗效、肛周皮损及瘙痒程度、炎症因子、生活质量、复发率。结果:观察组、对照组总有效率分别为90.0%、72.5%,与对照组相比,观察组显著更高,差异有统计学意义(P<0.05);治疗4周后,两组湿疹面积及严重程度指数评分、视觉模拟评分法评分均明显下降,且与对照组[(3.79±1.18)、(3.32±0.94)分]比较,观察组[(2.61±0.79)、(2.72±0.75)分]均显著更低(P<0.05);治疗4周后,两组白介素(IL)-6及肿瘤坏死因子-α(TNF-α)水平均明显下降,IL-10水平均明显上升,且与对照组[(38.40±6.12)、(43.47±5.37)、(3.63±0.72)ng/L]比较,观察组IL-6、TNF-α[(29.39±5.24)、(32.17±5.12)ng/L]均显著更低,IL-10[(4.47±0.56)ng/L]显著更高(P<0.05);治疗2、4周后,两组皮肤病生活质量指数评分均明显下降,且与对照组[(10.08±2.05)、(7.35±1.16)分]比较,观察组[(8.34±1.44)、(5.21±0.92)分]均显著更低(P<0.05);观察组治愈患者中复发2例,复发率为18.18%,对照组治愈患者中复发2例,复发率为28.57%,两组复发率比较,差异无统计学意义(P>0.05)。结论:湿毒膏联合亚甲蓝肛周封闭术治疗慢性肛周湿疹,效果良好,可有效减轻肛周皮损、瘙痒程度及炎症反应,促进患处愈合,改善患者生活质量。

止痛消炎膏治疗慢性湿疹分子作用机制网络药理学研究

目的基于网络药理学探讨止痛消炎膏治疗慢性湿疹的分子作用机制。方法通过中药系统药理学数据库和分析平台(TCMSP)、中医药综合数据库(TCMID)、PubChem数据库筛选止痛消炎膏的潜在活性成分[口服生物利用度(OB)≥30%,类药性(DL)≥0.18]。采取SwissTargetPrediction数据库预测其作用靶点,与DisGeNET数据库、GeneCards数据库、治疗靶点数据库(TTD)获得慢性湿疹疾病靶点相映射,得到止痛消炎膏治疗慢性湿疹的潜在靶点。利用Cytoscape3.7.2软件构建止痛消炎膏-活性成分-靶点网络图,构建蛋白质-蛋白质相互作用(PPI)网络图,并在R软件中使用Bioconductor生物信息软件包对止痛消炎膏的作用靶点进行GO功能分析和KEGG通路富集分析。结果止痛消炎膏中有186个潜在活性成分,将止痛消炎膏与湿疹作用靶点相匹配,两者取交集后获得药物-疾病共同靶点115个;番泻叶甙、白当归醚、白当归脑、大黄酸、大黄苷、迷迭香酸等可能是止痛消炎膏治疗慢性湿疹的主要活性成分,其作用于TNF、IL-6、AKT1、CXCL8、IL-2、STAT3等靶点,参与转录调控及药物反应等生物过程,通过卡波西氏肉瘤相关疱疹病毒感染、TNF信号通路、Toll样受体信号通路、C型凝集素受体信号通路等发挥治疗慢性湿疹的作用。结论番泻叶甙、白当归醚、白当归脑、大黄酸、大黄苷、迷迭香酸等在止痛消炎膏治疗慢性湿疹中具有重要意义;调节炎症通路及干预炎症的发生发展可能是止痛消炎膏治疗慢性湿疹的作用机制。

消风汤联合丙酸氟替卡松乳膏治疗慢性湿疹患者的效果

目的:观察消风汤联合丙酸氟替卡松乳膏治疗慢性湿疹患者的效果。方法:回顾性分析2022年4月至2023年4月该院收治的70例慢性湿疹患者的临床资料,按照治疗方法不同将其分为对照组和观察组各35例。对照组采用丙酸氟替卡松乳膏治疗,观察组在对照组基础上联合消风汤治疗,两组均持续治疗28 d。比较两组临床疗效,治疗前后症状严重程度[湿疹面积及严重度指数(EASI)]评分、炎性因子[γ干扰素(IFN-γ)、肿瘤坏死因子-α(TNF-α)、白细胞介素-17(IL-17)]水平、皮肤屏障功能指标[皮肤油脂(SC)、经表皮水分流失(TEWL)、角质层含水量(WCSC)]水平,以及不良反应发生率。结果:观察组治疗总有效率为94.29%(33/35),高于对照组的77.14%(27/35),差异有统计学意义(P<0.05);治疗后,观察组EASI评分低于对照组,差异有统计学意义(P<0.05);治疗后,观察组IFN-γ、TNF-α、IL-17、TEWL水平均低于对照组,SC、WCSC水平均高于对照组,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:消风汤联合丙酸氟替卡松乳膏治疗慢性湿疹患者可提高治疗总有效率,降低症状严重程度评分和炎性因子水平,改善皮肤屏障功能指标水平,效果优于单纯丙酸氟替卡松乳膏治疗。

复方氟米松软膏治疗慢性泛发性湿疹的疗效

目的探索复方氟米松软膏应用于慢性泛发性湿疹患者的效果。方法在本院于2022年4月—2023年7月收治的慢性泛发性湿疹患者中随机抽取86例为对象,以随机数字表法分入观察组和对照组中,两组均给予富马酸酮替芬片+盐酸雷尼替丁胶囊+赛庚啶片口服,在此基础上,对照组43例应用卤米松/三氯生乳膏外涂治疗,观察组43例应用复方氟米松乳膏外涂治疗,均治疗4周,对比两组的治疗总有效率、血清炎症因子水平、免疫因子表达、转录因子表达、湿疹面积及严重程度指数(EASI)、不良反应发生率等。结果观察组患者的白细胞介素4(IL-4)、白细胞介素5(IL-5)、白细胞介素10(IL-10)水平、以及免疫球蛋白E(IgE)水平、嗜酸性粒细胞(EOS)计数均低于对照组(均P<0.05),且观察组的血清白细胞介素2(IL-2)水平高于对照组(P<0.05);观察组的Th1和Th2细胞所占比例低于对照组,Th1/Th2比值高于对照组(均P<0.05);观察组患者的T-bet基因表达和GATA-3基因表达均低于对照组,且T-bet/GATA-3比值高于对照组(均P<0.05);观察组治疗4周后和停药4周后的EASI评分均低于对照组(均P<0.05);观察组的治疗总有效率高于对照组(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论与卤米松/三氯生乳膏相比,复方氟米松软膏在慢性泛发性湿疹患者中应用效果肯定,更有助于缓解炎症反应和免疫反应,改善免疫功能,且用药安全性高。

鲁艳芳教授治疗儿童慢性湿疹经验探析

慢性湿疹是儿科临床中常见的皮肤过敏性疾病,尤其好发于婴幼儿及学龄期儿童,病因复杂且病情反复,表现为局部皮肤浸润肥厚,呈苔藓样改变,且伴有顽固性瘙痒,严重影响儿童的身心健康和生长发育。西医多以止痒、抗过敏等对症治疗为主,常选用抗组胺药物、外用激素或免疫抑制剂,易产生药物依赖性等不良作用,且临床疗效欠佳。鲁艳芳教授认为儿童慢性湿疹多因血热风燥、邪伏肌表所致,强调清热润燥、祛风凉血为其治疗原则,自拟消疹止痒方为治疗儿童慢性湿疹经验方,临床运用取得显著疗效。

久痒膏治疗慢性期肛周湿疹40例的疗效观察

目的:观察久痒膏治疗慢性期肛周湿疹的疗效。方法:研究采用随机分组的方法,将80例慢性期肛周湿疹患者分为对照组和观察组,每组各40例。对照组则给予曲安奈德益康唑乳膏外涂,观察组给予宁夏中医医院自制的久痒膏外涂治疗,观察两组的临床症状、皮疹面积以及用药期间的不良反应。结果:对照组总有效率为67.5%,临床综合评分有效率66.0%;观察组总有效率为90.0%,临床综合评分有效率87.0%。各个指标的结果之间存在显著的统计学差异(P<0.05)。结论:久痒膏对于治疗慢性期肛周湿疹具有确切的疗效,该药膏能有效改善患者的生活质量。

活血润肤颗粒外洗方治疗亚急性及慢性手部湿疹疗效观察

目的:观察活血润肤颗粒外洗方治疗亚急性及慢性手部湿疹的临床疗效。方法:30例均用活血润肤颗粒外洗方浸泡治疗。结果:治愈9例,好转17例,无效3例,1例失访,总有效率89.7%。结论:活血润肤颗粒外洗方治疗亚急性及慢性手部湿疹效果较好。