目的 觀察壬二酸乳膏聯(lián)合克拉霉素治療玫瑰痤瘡的臨床療效。方法 選取2020年1月-2022年1月天津市寶坻區(qū)人民醫(yī)院收治的80例玫瑰痤瘡患者,按照隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組,每組各40例。對(duì)照組口服克拉霉素片,250 mg/次,2次/d。治療組在對(duì)照組基礎(chǔ)上外用壬二酸乳膏,早晚溫水潔面后于痤瘡處將本品均勻薄涂,用力涂搽使其深入皮膚,每日早晚各1次。兩組療程均為8周。觀察兩組的臨床療效,比較治療前后兩組陣發(fā)性潮紅發(fā)作頻率,相關(guān)量表[持續(xù)性紅斑醫(yī)生評(píng)估量表(CEA)、研究者整體評(píng)價(jià)(IGA)、皮膚病生活質(zhì)量指數(shù)(DLQI)]評(píng)分,面部皮損處皮膚生理指標(biāo)(角質(zhì)層厚度、真皮乳頭密度、真皮乳頭毛細(xì)血管直徑)及毛囊蠕形螨感染情況(受累毛囊數(shù)量、蠕形螨感染密度、蠕形螨總數(shù))。結(jié)果 治療后,治療組總有效率為92.5%,顯著高于對(duì)照組的75.0%(P<0.05)。治療后兩組陣發(fā)性潮紅發(fā)作頻率和CEA評(píng)分、IGA評(píng)分、DLQI評(píng)分均顯著降低(P<0.05);且治療組下降更顯著(P<0.05)。治療后,兩組面部皮損處角質(zhì)層厚度和真皮乳頭密度均顯著增加,真皮乳頭毛細(xì)血管直徑均顯著縮小(P<0.05);且治療組改善更顯著(P<0.05)。治療后,兩組面部皮損處受累毛囊數(shù)量、蠕形螨感染密度及蠕形螨總數(shù)均較治療前顯著降低(P<0.05);且治療組改善更顯著(P<0.05)。結(jié)論 壬二酸乳膏聯(lián)合克拉霉素治療玫瑰痤瘡的整體療效確切,能安全有效地緩解患者面部潮紅、紅斑、丘疹等典型癥狀,促進(jìn)皮損處皮膚結(jié)構(gòu)和屏障功能的恢復(fù),減輕毛囊蠕形螨感染。

Objective To observe the clinical efficacy of Azelaic Acid Cream combined with clarithromycin in treatment of rosacea. Methods A total of 80 patients with rosacea treated in Tianjin Baodi District People's Hospital from January 2020 to January 2022 were selected and divided into control group and treatment group according to random number table method, with 40 cases in each group. Patients in the control group were po administered with Clarithromycin Tablets, 250 mg/time, twice daily. Patients in the treatment group were po administered with Azelaic Acid Cream on the basis of control group, after cleansing with warm water in the morning and evening, applied the product evenly and thinly on the acne area, and applied it vigorously to make it deep into the skin, once in the morning and once in the evening. The treatment course of both groups was 8 weeks. The clinical efficacy of the two groups was observed, and the frequency of parochial flushing, the scores of relevant scales[Doctor's Assessment of Persistent erythema (CEA), Investigator's overall Assessment (IGA), Skin disease Life Quality Index (DLQI)], physiological indicators of skin in facial lesions (thickness of stratum corneum, density of dermal papillae, diameter of capillaries of dermal papillae) and Demodex infection (number of affected hair follicles, density of demodex infection, total number of demodex) were compared between the two groups before and after treatment. Results After treatment, the total effective rate of the treatment group was 92.5%, which was significantly higher than that of the control group (75.0%, P < 0.05). After treatment, the frequency of paroxysmal flushing, CEA score, IGA score and DLQI score were significantly decreased in two groups (P < 0.05). The decrease was more significant in treatment group (P < 0.05). After treatment, the corneum thickness and dermal papilla density were significantly increased, and the diameter of dermal papilla capillaries were significantly decreased in both groups (P < 0.05). The improvement was more significant in the treatment group (P < 0.05). After treatment, the number of affected hair follicles, the density of demodex infection and the total number of demodex were significantly decreased in both groups compared with before treatment (P < 0.05). The improvement was more significant in the treatment group (P < 0.05). Conclusion Azelaic Acid Cream combined with clarithromycin has exact overall efficacy in treatment of rosacea, and can safely and effectively relieve the typical symptoms of facial flushing, erythema, and papule, and can promote the recovery of skin structure and barrier function in the skin lesions, which can reduce the infection of demodex folliculus.

R986