米诺环素结合复方黄柏液涂剂湿敷对寻常痤疮患者症状改善及皮损修复的效果研究

刘玉东 李秀丽

[摘要]目的：探討米诺环素结合复方黄柏液涂剂湿敷对痤疮患者症状改善及皮损情况的影响。方法：选取2018年2月-2019年12月笔者医院收治的100例寻常痤疮患者，采用随机数字表法分为研究组和对照组，每组50例。对照组给予米诺环素联合2%超分子水杨酸面膜治疗，研究组给予米诺环素联合复方黄柏液涂剂湿敷治疗。分析比较两组治疗效果、IGA、ECCA评分、皮损积分及丘疹脓疱积分，并对不良反应进行统计。结果：经过12周治疗后，研究组有效率为92.0%，对照组为74.0%，组间差异有统计学意义（P<0.05）。两组治疗后IGA、ECCA评分、皮损积分、丘疹脓疱积分均显著低于治疗前（P<0.05），但研究组IGA、ECCA、皮损积分、丘疹脓疱改善情况优于对照组（P<0.05）。两组在水肿、疼痛、瘙痒等不良反应发生率方面差异无统计学意义 （P>0.05） 。研究组复发率明显低于对照组，差异具有统计学意义（P<0.05）。结论：复方黄柏液与米诺环素联合用药不仅能有效控制痤疮，改善患者皮损情况、降低痤疮瘢痕评分，且不良反应小，耐药性低，可维持治疗。

[关键词]米诺环素;复方黄柏液涂剂;寻常痤疮;皮损;痤疮瘢痕

[中图分类号]R758.73+3    [文献标志码]A    [文章编号]1008-6455（2021）07-0061-03

Effects of Minocycline Combined with Compound Huangbai Epithem on Symptoms， Skin Lesions and Acne Scars Score in Acne Patients

LIU Yu-dong1，LI Xiu-li2

（1.Department of Dermatology， Chongming Branch， Shanghai 10th People's Hospital， Shanghai 202157，China;2. Department of Dermatology，the 10th People's Hospital of Shanghai， Shanghai 200072，China）

Abstract： Objective To investigate the effect of minocycline combined with compound Huangbai liquid wet compress on the improvement of symptoms and skin lesions in acne patients. Methods  100 patients with acne admitted to our hospital from February 2018 to December 2019 were selected and divided into a research group and a control group by random number table method， 50 cases in each group. The control group was given minocycline combined with 2% supramolecular salicylic acid， and the study group was given minocycline combined with compound Huangbai liquid wet coating. The treatment effect， IGA， ECCA score， skin lesion score， papule pustule score were analyzed and compared between the two groups， and the adverse reactions were counted. Results  After 12 weeks of treatment， the effective rate was 92.0% in the study group and 74.0% in the control group. The difference between the groups was statistically significant （P<0.05）. After treatment， the IGA， ECCA score， skin lesion score and papule pustule score were significantly lower than before treatment （P<0.05）， but the improvement of IGA， ECCA， skin lesion score and papule pustule in the study group was better than that of the control group. ECCA， skin lesion score， papule pustules （P<0.05）. There was no significant difference between the two groups in the incidence of adverse reactions such as edema， pain， and itching （P>0.05）. The recurrence rate of the study group was significantly lower than that of the control group， and the difference was statistically significant（P<0.05）. Conclusion The combination of Compound Phellodendron and minocycline can not only effectively control acne， improve the skin lesions of patients， and reduce the score of acne scars， and it has small adverse reactions and low drug resistance， and can be maintained for a time.

Key words： minocycline; Huangbai epithem; acne vulgaris; skin lesions; acne scars

寻常痤疮为毛囊皮脂腺的一种慢性炎症性疾病，据报道其发病机理与微生物感染、皮脂分泌异常、炎症介质、毛囊皮脂腺异常角化、内分泌及免疫失调及遗传或精神因素有关[1-2]。虽然寻常痤疮的严重影响有限，但其病情反复、影响外形美观、发病率高等特点亦对患者情绪、心理造成很大压力，直接影响其生活质量。现有治疗痤疮药物多数以抗炎药物为主，其中米诺环素能有效抑制痤疮丙酸杆菌趋化，降低面部游离脂肪酸浓度，改善面部症状，因其抗菌能力强，吸收效果好，常作为临床治疗寻常痤疮的首选药物[3-4]。但采用米诺环素进行治疗，效果不甚理想，且因耐药性的产生，该药物的长期疗效不佳，痤疮复发率高[5]。中医中药药物成分多样，具有多靶联合起效特点，在应对复杂病机疾病时效果明显。……