他克莫司对儿童特应性皮炎疗效及体表马拉色菌定植的影响

摘要

Objectives To evaluate the influence of tacrolimus ointment on malassezia's colonization in the lesional areas of the children with atopic dermatitis (AD).Methods The children with AD were randomly divided into a treatment group and a control group.Both groups orally administered loratadine tablets.In addition,the treatment group were treated with 0.03％ tacrolimus ointment and the control group was given Vitamin E cream twice a day for 3 weeks.The SCORAD integral drop index was used to evaluate the efficacy.Values of SCORAD and malassezia colonization density were compared before,day 7,14,and 21 of,and 14 and 28 days after the treatment.Pearson correlation analysis was used to assess the dependability between malassezia colonization density and the severity of disease.Results The SCORAD value of the treatment group markedly decreased after the treatment.The efficacy rate was 95.65 ％ in treatment group and 66.67 ％ in the control group (P ＜ 0.05).28 days after the treatment,one case recurred and the efficacy rate was 91.30％ in the treatment group and 3 cases recurred and the efficacy rate was 50.00％ in the control group,with significant differences (P ＜ 0.05).There was no significant correlation between malassezia colonization density and SCORAD integral before and after the treatment.Day 7,14,and 21 of the treatment,Malassezia colonization densities were lower in the treatment group than in the control group(P ＜ 0.05).Conclusions 0.03％ tacrolimus ointment for children with AD is effective and safe,has a low recurrence rate,and can reduce the malassezia colonization density on the surface of lesional area.%目的 评价他克莫司软膏对特应性皮炎患儿体表马拉色菌定植的影响.方法 将特应性皮炎患儿随机分为2组,均给予氯雷他定片口服作为基础治疗,治疗组同时给予0.03％他克莫司软膏,对照组同时给予维生素E乳,每日2次,疗程3周,根据SCORAD积分下降指数做疗效判定.比较治疗前、治疗第7d、14 d、21 d及治疗结束后第14d、28 d时的SCORAD积分及皮损表面马拉色菌定植密度;对马拉色菌定植密度与疾病严重程度进行Pearson相关性分析.结果 治疗结束时,治疗组SCORAD积分显著下降,治疗组和对照组的有效率分别为95.65％和66.67％(P＜0.05).治疗结束后第28 d时,治疗组有1例复发,治疗总有效率为91.30％,对照组有3例复发,有效率为50％,治疗组复发率低于对照组(P＜0.05).马拉色菌定植密度与SCORAD积分在治疗前后无明显相关性(P＞0.05).治疗组第7d、14d、21 d时马拉色菌定植密度较对照组低(P均＜0.05).结论 0.03％他克莫司软膏治疗儿童特应性皮炎有效、安全,复发率低,并可以减少皮损表面马拉色菌定植.