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单位:050051石家庄市第二医院皮肤科(宋慧丽、李健、冯红、孙燕);050051石家庄市井陉县医院妇产科(王玉霞)
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【摘要】目的 探讨复方倍他米松联合利多卡因皮损内注射治疗神经性皮炎的效果。方法 选取2017年9月至2018年9月在石家庄市第二医院接受治疗的91例神经性皮炎患者,完全随机分为对照组(43例)和观察组(48例)。对照组给予丙酸倍他米松乳膏皮损部位外用治疗,1次/d,连续治疗12周;观察组给予复方倍他米松注射液联合利多卡因注射液皮损内注射治疗,每2周注射1次,连续治疗12周。比较2组治疗12周后临床疗效,治疗前、治疗4周及治疗12周后的皮损硬度、瘙痒症状积分,治疗前后皮损处经表皮水分流失(TEWL)、角质层含水量(WCSC)和皮肤油脂。记录2组治疗期间不良反应发生情况。结果 观察组治疗总有效率明显高于对照组[93.8%(45/48)比46.5%(20/43)](P<0.05)。2组治疗后皮损硬度、瘙痒症状积分均低于治疗前,且观察组治疗后皮损硬度、瘙痒症状积分均明显低于对照组,差异均有统计学意义(均P<0.05)。治疗后,观察组患者皮损处TEWL水平明显低于对照组,皮损处WCSC、皮肤油脂水平明显高于对照组(均P<0.05)。治疗期间,2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论 复方倍他米松联合利多卡因皮损内注射治疗神经性皮炎疗效显著,且安全性较高,能够明显降低皮损处皮肤硬度,缓解瘙痒症状,提高皮损处皮肤生理功能水平。
【Abstract】Objective To observe the curative effect of compound betamethasone combined with lidocaine skin injection on neurodermatitis. Methods A total of 91 patients with neurodermatitis admitted to the Second Hospital of Shijiazhuang between September 2017 and September 2018 were randomly divided into control group(n=43) and observation group(n=48). The control group was treated with external application of betamethasone dipropionate ointment at skin lesion once daily for 12 weeks. The observation group was treated with skin lesion injection of compound betamethasone and lidocaine once every 2 weeks for 12 weeks. Clinical efficacy, hardness of skin lesion and pruritus scores, trans-epidermal water loss(TEWL), water content of stratum corneum(WCSC), sebum content and adverse reactions were analyzed. Results The total effective rate in observation group was significantly higher than that in observation group [93.8%(45/48) vs 46.5%(20/43)](P<0.05). Skin lesion hardness and pruritus scores significantly decreased after treatment in both groups; the scores in observation group were significantly lower than those in control group(all P<0.05). After treatment, TEWL in observation group was significantly lower and WCSC and sebum content were significantly than those in control group(all P<0.05). There was no significant difference of the incidence of adverse reactions between groups(P>0.05). Conclusion Compound betamethasone combined with lidocaine skin injection is safe and effective in treating neurodermatitis; it can significantly reduce the hardness of skin lesion, relieve pruritus and improve the physiological function of skin.
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