川百止痒洗剂联合丙酸氟替卡松乳膏治疗急性湿疹湿热浸淫证的疗效及对血清IL-4和IFN-γ水平的影响

刘婷 倪通 李遇梅

[摘要]目的：探讨川百止痒洗剂联合丙酸氟替卡松乳膏治疗急性湿疹湿热浸淫证的疗效及对血清白细胞介素（IL）-4、干扰素（IFN）-γ水平的影响。方法：选取2019年2月-2020年6月东南大学医学院附属南京同仁医院收治的104例急性湿疹患者，按随机数字表法分为对照组和观察组，每组52例。对照组给予丙酸氟替卡松乳膏，观察组在对照组治疗基础上使用川百止痒洗剂。两组均治疗4周，比较两组瘙痒程度、皮疹形态、湿疹面积和严重度指数（EASI）评分、临床疗效、血清IL-4和IFN-γ水平以及不良反应情况。结果：治疗后，两组瘙痒程度、皮疹形态、EASI评分明显降低，且观察组瘙痒程度、皮疹形态及EASI评分明显低于对照组（P<0.01）;观察组总有效率明显高于对照组（P<0.05）;治疗后，两组血清IL-4和IFN-γ水平明显下降，且观察组血清IL-4和IFN-γ水平显著低于对照组（P<0.01）。结论：川百止痒洗剂联合丙酸氟替卡松乳膏治疗急性湿疹湿热浸淫证疗效明显，可有效改善患者的症状体征，抑制血清IL-4和IFN-γ水平，且不良反应少。

[关键词]急性湿疹;川百止癢洗剂;湿热浸淫证;细胞介素-4;干扰素-γ

[中图分类号]R758.23    [文献标志码]A    [文章编号]1008-6455（2021）07-0115-04

Efficacy of Chuanbai Zhiyang Lotion Combined with Fluticasone Propionate Cream in Treating Damp Heat Immersed Type of Acute Eczemaand Its Effect on Serum Levels of IL-4 and IFN-γ

LIU Ting1，NI Tong1，LI Yu-mei2

（1.Department of Dermatology，Nanjing Tongren Hospital，Southeast University School of Medicine，Nanjing 211102，Jiangsu，China; 2.Department of Dermatology，Affiliated Hospital of Jiangsu University，Zhenjiang 212013，Jiangsu，China）

Abstract： Objective To investigate the efficacy of Chuanbai Zhiyang lotion combined with fluticasone propionate cream in treating damp heat immersed type of acute eczema and its effect on serum levels of interleukin（IL）-4 and IFN（interferon）-γ. Methods  A total of 104 patients with acute eczema who were admitted to Nanjing Tongren Hospital of Southeast University School of Medicine from February 2019 to June 2020 were divided into control group and observation group according to the random number table method， with 52 cases in each. The control group was given fluticasone propionate cream， and the observation group was treated with Chuanbaizhiyang lotion based on the treatment of the control group. The two groups were treated continuously for 4 weeks.The degree of pruritus， rash shape， eczema area and severity index （EASI） score， clinical efficacy， serum IL-4 and IFN-γ levels， and adverse reactions were compared between the two groups. Results  After treatment，scores of itch degree， rash shape，and EASI in the two groups were significantly reduced，and the observation group was significantly lower than those in the control group（P<0.01）.The total effective rate of the observation group was significantly higher than that of the control group（P<0.05）.After treatment， serum levels of IL-4 and IFN-γ in both groups were significantly decreased，and the observation group was significantly lower than those in the control group （P<0.01）. Conclusion  The efficacy of Chuanbai Zhiyang lotion combined with fluticasone propionate cream in treating damp heat immersed type of acute eczema is significant，can effectively improve the symptoms and signs of patients，inhibit serum levels of IL-4 and IFN-γ，and have fewer adverse reactions.

Key words： acute eczema; Chuanbai Zhiyang lotion; damp heat immersed type; interleukin-4; IFN-γ

急性湿疹是一种由复杂因素诱发所致变态反应性皮肤病，如不及时给予有效治疗可演变为亚急性、慢性湿疹，病情反复发作[1]。急性湿疹的病因病机纷繁复杂，西医临床仍缺乏特效药物，主要使用药物，如：采用抗组胺类药物、外用糖皮质激素等，具有一定疗效，但仅能对症治疗以暂时缓解临床症状[2-3]。中医学将湿疹归为“浸淫疮”范畴，认为多因禀赋薄弱、饮食不节以及情志失调等伤及脾胃，湿热内蕴，复感风湿热邪，内在湿热与外感风湿热邪相搏结，浸淫肌肤所致，而急性湿疹以湿热为主，治疗以清热燥湿止痒为主要治则[4]。川百止痒洗剂具有疏风止痒、燥湿解毒的作用，适用于风邪侵入、湿毒内蕴及腠理失和所引起的皮肤瘙痒症[5]。……