目的 分析金花消痤丸聯(lián)合異維A酸治療重度痤瘡的臨床療效。方法 選取2021年1月—2023年8月白銀市中心醫(yī)院收治的92例重度痤瘡患者，按隨機數(shù)字表法分為對照組和治療組，每組各46例。對照組口服異維A酸軟膠囊，10 mg/次，2次/d。治療組在此基礎(chǔ)上口服金花消痤丸，4 g/次，3次/d。兩組療程8周。觀察兩組的臨床療效，比較治療前后痤瘡綜合評分系統(tǒng)（GAGS）評分、簡式抑郁-焦慮-壓力量表（DASS-21）評分、36項健康調(diào)查簡表（SF-36）評分和面部皮損處皮膚生理指標(biāo)的變化。結(jié)果 治療后，治療組總有效率是95.65%，對照組是82.61%，兩組比較差異顯著（P＜0.05）。治療后，兩組GAGS中各區(qū)域分值及其總評分均顯著降低（P＜0.05）；治療后，治療組GAGS評分低于對照組（P＜0.05）。治療后，兩組DASS-21評分均顯著降低，SF-36評分則均顯著增加（P＜0.05）；DASS-21、SF-36評分以治療組患者改善更顯著（P＜0.05）。治療后，兩組角質(zhì)層含水量均顯著增加，皮脂含量、經(jīng)皮水分丟失（TEWL）值、pH值均顯著降低（P＜0.05）；治療后，治療組皮膚生理指標(biāo)改善更顯著（P＜0.05）。結(jié)論 金花消痤丸聯(lián)合異維A酸治療重度痤瘡的效果確切，能有效減輕皮損表現(xiàn)，抑制皮脂分泌，促進皮膚屏障功能恢復(fù)，降低對患者情緒狀態(tài)和生活質(zhì)量的影響。

Objective To analyze the clinical effect of Jinhua Xiaocuo Pills combined with isotretinoin in treatment of severe acne. Methods Ninety-two patients with severe acne treated in Baiyin Central Hospital from January 2021 to August 2023 were selected and divided into control group and treatment group according to random number table method, with 46 cases in each group. Patients in the control group were po administered with Isotretinoin Soft Capsules, 10 mg/time, twice daily. Patients in the treatment group were po administered with Jinhua Xiaocuo Pills on the basis of the control group, 4 g/time, three times daily. Both groups were treated for 8 weeks. The clinical effects of the two groups were observed, and the changes of GAGS score, DASS-21 score, 36-item health survey Summary Form (SF-36) score and skin physiological indexes of facial lesions were compared before and after treatment. Results After treatment, the total effective rate was 95.65% in the treatment group and 82.61% in the control group, with significant difference between the two groups (P < 0.05). After treatment, GAGS scores and total scores in both groups were significantly decreased (P < 0.05). After treatment, GAGS score in the treatment group was lower than that in the control group (P < 0.05). After treatment, DASS-21 scores were significantly decreased, while SF-36 scores were significantly increased in both groups (P < 0.05). The improvement of DASS-21 and SF-36 scores in the treatment group was more significant (P < 0.05). After treatment, water content of stratum corneum was significantly increased, sebum content, transcutaneous water loss (TEWL) value and pH value were significantly decreased in both groups (P < 0.05). After treatment, the improvement of skin physiological indexes in the treatment group was more significant (P < 0.05). Conclusion Jinhua Xiaocuo Pills combined with isotretin has definite effect in treatment of severe acne, and can effectively reduce the manifestations of skin lesions, inhibit sebum secretion, promote the recovery of skin barrier function, and reduce the impact on the emotional state and quality of life of patients.

R986