臭氧外用对特应性皮炎患者金黄色葡萄球菌定植的干预作用

摘要

Objective:To verify the effect of ozone on Staphylococcus aureus (S.aureus) colonization in patients with atopic dermatitis (AD) and its correlation with the patient's status.Methods:A total of 12 patients with moderate or severe AD,aged from 6 to 65 years,were recruited from outpatient of the Third Xiangya Hospital.The treatment sides were showered with ozonated water and smeared with ozonated oil for 7 days (twice a day),while the control sides were washed with warm running water and smeared with base oil.At different time points,the severity scoring ofatopic dermatitis (SCORAD) scores,sleep and pruritus scores were assessed and compared between the two sides.Meanwhile,plate cultivation was used to quantitatively detect the changes ofS.aureus colonization in skin lesions.Results:After 7 days treatment,erythema and pimples were decreased in the treatment sides.The clear skin texture,smooth skin,improved skin lesions were also observed by dermoscopic examination.The results of reflectance confocal microscopy (RCM) demonstrated that the parakeratosis was improved,the structures were clearer,and the inflammatory cells infiltration was reduced after ozone treatment for 7 days.After ozone treatment for 3 and 7 days,the S.aureus colonization in the treatment sides decreased by (75.55±21.81)％ and (97.24±2.64)％ respectively.Compared to that of control sides,the percentage of S.aureus colony after ozone treatment for 7 days decreased significantly (P＜0.01).After ozone treatment for 7 days,the SCORAD scores,sleep and pruritus scores were significantly decreased (all P＜0.01).There was a linear correlation between the decreasing percentage of S.aureus colony and the declining percentage of SCORAD scores in AD patients.Conclusion:Topical ozone therapy can effectively reduce S.aureus colony in skin lesions and alleviate the severity of AD patients with moderate to severe degree.%目的:研究臭氧外用对特应性皮炎患者皮损处金黄色葡萄球菌定植的作用及其与病情的相关性.方法:招募6～65岁中重度特应性皮炎患者,选取两侧对称皮损作为靶部位,对照侧靶部位皮损采用温水洗浴联合基础油外涂,治疗侧靶部位皮损及全身余处用臭氧水洗浴并联合外用臭氧油,每天治疗2次,连续治疗7d.定量检测靶部位皮损处金黄色葡萄球菌的变化,评估患者治疗前后靶部位皮损及全身病情变化,分析患者病情变化与皮损处金黄色葡萄球菌载量变化的相关性.结果:与治疗前及对照侧皮损比较,治疗第7天治疗侧靶部位皮损红斑和丘疹明显减少,瘙痒减轻;治疗侧靶部位皮损金黄色葡萄球菌载量在治疗第3,7天分别下降(75.55±21.81)％,(97.24-2.64)％;治疗第7天,治疗侧和对照侧金黄色葡萄球菌载量下降差异有统计学意义(P＜0.01);治疗第7天,患者的特应性皮炎评分(scoring of atopic dermatitis,SCORAD)、睡眠及瘙痒评分较治疗前均显著降低(p＜0.01);臭氧治疗皮损处金黄色葡萄球菌载量下降率与SCORAD评分的下降率呈正相关(r=0.916,P=0.001).结论:臭氧外用能有效减少特应性皮炎患者皮损处金黄色葡萄球菌的载量并缓解中重度特应性皮炎患者病情.