目的:探究他克莫司联合窄谱UVB治疗特应性皮炎的疗效.方法:选取2021年2月-2022年12月笔者医院就诊120例的特应性皮炎患者,并按照简单随机化随机分为A组(采用他克莫司治疗,40例)、B组(采用润肤霜联合窄谱UVB治疗,40例)和C组(采用他克莫司联合窄谱UVB治疗,40例),持续治疗2个月.于治疗前、治疗1个月和治疗2个月后,比较三组特应性皮炎患者的临床体征[特应性皮炎评分量表(Scoring atopic dermatitis index,SCORAD)、中文版特应性皮炎控制工具量表(Chinese version of atopic dermatitis control tool,ADCT)]、瘙痒情况[峰值瘙痒数字评定量表(Peak pruritis-numerical rating scale,PP-NRS)]、细胞因子[血清载脂蛋白A1(Apolipoprotein A1,ApoA1)、载脂蛋白B(Apolipoprotein B,ApoB)、白细胞介素4(IL-4)、白细胞介素10(IL-10)]水平、美学效果[皮炎整体面积、客观体征评分(红斑、表皮剥脱、苔藓样变)]和生活质量[皮肤病生活质量量表(DLQI)].记录治疗期间三组患者的不良反应,比较其治疗后3个月随访期间复发情况.结果:治疗1个月和治疗2个月后,三组的SCORAD、ADCT、PP-NRS、ApoB、IL-4、IL-10、皮炎整体面积、进行客观体征评分和DLQI评分均较治疗前显著下降,且C组显著低于A组和B组(均P＜0.05);三组的ApoA1均较治疗前显著提高,且C组显著高于A组和B组(均P＜0.05).治疗期间,三组患者的不良反应发生率无显著差异(P＞0.05);治疗后3个月随访期间,C组的复发情况显著低于A组和B组(P＜0.05).结论:他克莫司联合窄谱UVB治疗在特应性皮炎患者中具有显著的治疗效果,能够有效地缓解特应性皮炎症状和瘙痒情况,改善患者生活质量,提升美学效果.
Observation on Efficacy of Tacrolimus Combined with Narrow-band UVB in Treating Atopic Dermatitis
Objective To explore the efficacy of tacrolimus combined with narrow-band UVB in the treatment of atopic dermatitis.Methods A total of 120 patients with atopic dermatitis who were treated at the author's hospital from February 2021 to December 2022 were selected and randomly divided into three groups using a simple randomization method:group A(tacrolimus,40 cases),group B(moisturizer combined with narrow-band UVB,40 cases),and group C(tacrolimus combined with narrow-band UVB,40 cases).All three groups were treated continuously for 2 months.Clinical signs[Scoring Atopic Dermatitis Index(SCORAD),Chinese version of Atopic Dermatitis Control Tool(ADCT)],pruritus[Peak Pruritus-Numerical Rating Scale(PP-NRS)],cytokines[serum apolipoprotein A1(ApoA1),apolipoprotein B(ApoB),interleukin-4(IL-4),interleukin-10(IL-10)],aesthetic effects[overall area of dermatitis,scores of objective signs(erythema,exfoliation,lichenoid change)],and quality of life[Dermatological Life Quality Index(DLQI)]were compared among the three groups before treatment,and after 1 month and 2 months of treatment.The adverse reactions in the three groups were recorded during treatment,and recurrence was assessed during a 3-month follow-up period after treatment.Results After 1 and 2 months of treatment,SCORAD,ADCT,PP-NRS,ApoB,IL-4,IL-10,overall dermatitis area,objective sign scores,and DLQI scores in all three groups were significantly reduced compared to before treatment,with group C showing significantly lower levels in these indicators compared to group A and group B(all P＜0.05).ApoA1 levels were significantly increased in all three groups compared to before treatment,with group C showing significantly higher levels than groups A and B(all P＜0.05).There were no significant differences in the incidence rates of adverse reactions among the three groups during treatment(P＞0.05).The recurrence rate in group C during the 3-month follow-up period was significantly lower than that in group A and group B(P＜0.05).Conclusion Tacrolimus combined with narrow-band UVB has a significant therapeutic effect on patients with atopic dermatitis,effectively relieving symptoms and pruritus,improving quality of life,and enhancing aesthetic outcomes.
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