倒膜联合异维A酸治疗中重度痤疮临床效果研究.doc

倒膜联合异维A酸治疗中重度痤疮临床效果研究[摘要]目的：探讨倒膜联合异维A酸治疗中重度痤疮的临床疗效。方法：将256例门诊中重度痤疮患者随机分为两组，治疗组138例采用中药倒膜联合异维A酸治疗8周，对照组118例口服异维A酸，两组均使用相同的外用药。结果：第8周进行随访，治疗组：痊愈97例（70.29%），显效36例（26.09 %），有效5例（3.62%），无效0例；对照组：痊愈46例（38.98%）,显效52例（44.07%）,有效20例（16.95%），无效0例。结论：中药倒膜联合异维A酸治疗中重度痤疮较单纯口服异维A酸起效快，疗程缩短，效果显著，复发率低。 [关键词]痤疮；倒膜；维甲酸 [中图分类号]R758.73+3 [文献标识码]A [文章编号]1008-6455（2009）03-0353-03 Effect of Chinese medicinal liniment pourmask combining with isotretinoin in treatment of moderate and severe acne QIN Xiao-lei,YANG Fan,CHEN Zhi-ying (Department of Medical Cosmetology,Shenzhen Chronic Diseases Control Center, Shenzhen 518020,Guangdong,China) Abstract: Objective To investigate the clinical effect of Chinese medicinal liniment pourmask combining with isotretinoin in the treatment of moderate and severe acne. Methods 256 cases of moderate and severe acne were divided into two groups: treatment group (138 cases) was treated with Chinese medicinal liniment pourmask and isotretinoin for 1 to 4 weeks, and control group was treated only with isotretinoin for 1 to 4 weeks. Both of the two groups treated with the same drug for external use. Results At 8th week the cure rate, effective rate and improved rate in the t reatment group and control group were 70.29%, 26.09%,3.62%and 38.98%, 44.07%, and 16.95% respectively. Conclusion Chinese medicinal liniment pourmask combining with Isotretinoin is more effective than isotretinoin. Key words:acne;chinese medicinal liniment;ratinoic acid 痤疮是青春期常见的一种毛囊皮脂腺的慢性炎症,其发病率较高,主要发生在面部及胸背部等处,形成粉刺、丘疹、脓疮、结节、囊肿等损害。其病因与雄激素、皮脂分泌增加及毛囊皮脂腺腺管的过度角化、腺管内痤疮丙酸杆菌移生、炎性介质及炎症有关[1]。目前,用于痤疮治疗的药物众多,维甲酸类药物是中重度痤疮的主要用药，但由于其较大的不良反应及较长的疗程限制了其广泛应用。近年来笔者在临床上用倒膜联合口服维甲酸类药物治疗痤疮,其疗效显著优于单纯服用维甲酸类药物,并且使疗程缩短、复发率降低，现报道如下。 1资料和方法 1.1临床资料 1.1.1入选标准：痤疮诊断标准见参考文献2。痤疮分度：参考4级国际改良分型法。Ⅰ级：主要皮损为粉刺，损害数目不超过30个。Ⅱ级：主要皮损为粉刺加潜在性脓疱，皮损总数在31～50个。Ⅲ级：丘疹和脓疱较多，皮损数在51～100个，并可见结节,但数目少于3个。Ⅳ级：皮损数大于100个，并可见结节、囊肿数在3个以上。按照《中国痤疮指南》，Ⅱ、Ⅲ级为中度痤疮，Ⅳ级为重度痤疮。 1.1.2剔除标准：妊娠和哺乳妇女；2周内局部使用过治疗痤疮的药物者；4周内系统使用过抗炎或抗生素者；有