规律间歇维持使用他克莫司软膏对儿童特应性皮炎临床症状的改善及对病情复发的预防效果观察

摘要

目的 探讨规律间歇维持使用他克莫司软膏对儿童特应性皮炎疗效及对病情复发的预防作用.方法 选取在我院就诊的特应性皮炎患儿68例,随机分为A组和B组各34例.2组均连续使用他克莫司软膏治疗6周为第一阶段治疗.B组在第一阶段治疗后停药,如果病情复发,则再次使用第一阶段治疗方案.A组在第一阶段治疗后,持续使用小剂量他克莫司软膏.对比2组患儿的临床疗效和病情复发情况;对比2组患儿第一阶段治疗后的湿疹面积和严重程度指数(EASI)评分、研究者整体评分(IGA)以及瘙痒程度视觉模拟尺评分(VAS)评估结果.结果 A组的首次复发时间为(104.38±65.91)d,显著长于B组(P＜0.05);A组第一阶段治疗后2周和2个月的痊愈率、总有效率均显著高于B组,而复发率则显著低于B组(均P＜0.05);A组第一阶段治疗后2周和2个月的EASI评分、IGA评分以及VAS评分均显著低于B组(均P＜0.05);2组第一阶段治疗后4个月、第一阶段治疗后6个月的EASI评分、IGA评分以及VAS评分对比,差异均无统计学意义(均P＞0.05).2组均未出现严重的不良反应.结论 规律间歇维持使用他克莫司软膏可提高儿童特应性皮炎的治疗效果,延长病情的稳定期,改善患儿的生活质量.%Objective In order to investigate the symptoms improvement and effects of preventing the recurrence of children with atopic dermatitis by regular intervals using Tacrolimus.Methods Sixty-eight cases of atopic dermatitis children were selected and randomly divided into group A and group B including thirty-four cases in each group.Two groups were treated with Tacrolimus for six weeks for the first phase of treatment.After the first phase of treatment,group B stopped using Tacrolimus until the disease relapse,while group A coutinuous used small doses of Tacrolimus.The clinical efficacy and relapse of the two groups were compared.The EASI score,IGA score and VAS score were compared between the two groups after the first phase of treatment.Results The first recurrence time was (104.38±65.91) d in group A,which was significantly longer than that in group B (P＜0.05).The cure rate and total effective rate two weeks and two months after the first phase of treatment in group A were significantly higher than those in group B,while the recurrence rate was significantly lower than that in the group B (all P＜0.05).The EASI score,IGA score and VAS score two weeks and two months after the first phase of treatment in group A were significantly lower than those in group B (all P＜0.05).Four months and six months after the first phase of treatment,the EASI score,IGA score and VAS score of the two group had no significant difference (all P＞0.05).There were no serious adverse reactions in the two groups.Conclusion Regular intervals using Tacrolimus can improve the clinical effects of children atopic dermatitis,prolong the stable period of the disease,improve the quality of life of the patients.