NB-UVB联合酮康唑洗剂、伊曲康唑治疗马拉色菌毛囊炎疗效观察

摘要

Objective To investigate the clinical curative effects of NB-UVB combined with ketoconazole lotion and itraconazole in treatment of Malassezia folliculitis.Methods A total of 210 patients with Malassezia folliculitis were randomly divided into three groups,with 70 patients in each group. The patients in group A were treated by oral administration of itraconazole capsules,200mg once,once a day, continuous medication for 1 month.The patients in group B,on the basis of group A,were treated by external application of 2% ketoconazole lotion on skin lesion position,once a day for 1 month.The patients in group C,on the basis of group B,were treated by NB-UVB treatment meter irradiation on skin lesion position,with the wavelength being 311nm,the initial energy density of 0.3J/cm2,increasing gradually at 0.05 ~ 0.1J/cm2every time to local erythema appearance,with 2 to 3 times a week, continuous irradiation treatment for 1 month.Then the clinical curative effects,average effective time and cure time,recurrence rate at 3m,6m,12m after treatmen and adverse reactions were observed and compared among the three groups. Results The total effective rate in group C was 92.86%,which was significantly higher than that in group A(60.00%) and group B(75.71%),the difference was statistically significant( P <0.05).The average effective time and cure time in group C were significantly lower than those in group A and group B ( P <0.05), moreover,which in group B were significantly lower than those in group A ( P <0.05). After treatment,there were no significant differences in recurrence rate and incidence rate of adverse reactions among the three groups ( P >0. 05). Conclusion NB-UVB combined with ketoconazole lotion and itraconazole can safely and effectively treat Malassezia folliculitis,moreover,which can improve cure rate,shorten treatment time and reduce the recurrence rate, therefor,which is worth using widely in clinical practice.%目的 探讨窄谱柴外线(NB-UVB)联合酮康唑洗剂、伊曲康唑治疗马拉色菌毛囊炎的临床疗效.方法将210例马拉色菌毛囊炎患者随机分为A、B、C组,每组70例.A组:单纯口服伊曲康唑胶囊,口服200 mg/次, 1次/d,连续用药1个月.B组在A组的基础上,在皮损处外用2%的酮康唑洗剂,外用1次/d,连续用药1个月.C组在B组的基础上,用 NB-UVB 治疗仪照射皮损,波长为311 nm,初始能量密度为0.3 J/cm2,并每次以0.05 ~0.1 J/cm2渐增至局部出现红斑.治疗2~3次/周,连续照射治疗1个月.比较3组的临床疗效,平均显效时间及治愈时间,治疗后3、6、12个月的复发率,以及3组的不良反应.结果 C组的临床总有效率明显高于A组和B组差异均有统计学意义(P<0.05).C组的平均显效时间与治愈时间少于A、B组,差异有统计学意义.治疗后3个月3组均无复发,6个月后3组复发率比较,差异无统计学意义(P>0.05).3组不良反应发生率比较,差异无统计学意义(P>0.05).结论 NB-UVB联合酮康唑洗剂、伊曲康唑能够安全有效地治疗马拉色菌毛囊炎,联合治疗提高了治愈率、缩短了治疗时间、降低了复发率,值得推广.