目的：研究重组人表皮生长因子（rhEGF）凝胶联合他克莫司治疗面部激素依赖性皮炎的临床效果，并观察其对皮肤功能的影响及复发情况。方法将48例面部激素依赖性皮炎门诊患者随机分为治疗组（rhEGF凝胶联合他克莫司）和对照组（单用他克莫司），每组24例。于治疗前、治疗4周后门诊复诊时测定患者面部皮损处表皮含水量、油脂及经皮水分丢失（TEWL）；于治疗后第1、2、4周按照湿疹皮炎严重指数评分（EASI）法计算疗效指数，治疗期间观察患者不良反应及复发情况等。结果与治疗前相比，治疗4周后治疗组和对照组皮损表皮含水量、油脂均升高，TEWL降低（均P＜0.05），治疗前、后2组间差异均无统计学意义。治疗1周治疗组总显效率与对照组差异无统计学意义（45.8%vs.20.8%，P＞0.05），治疗2、4周时，治疗组总显效率均高于对照组（79.2%vs.50.0%，91.2%vs.62.5%，均P＜0.05）。治疗组治疗过程中均未出现不良反应，且其复发率明显低于对照组（12.5%vs.37.5%，χ2=4.03， P＜0.05）。结论 rhEGF凝胶对面部激素依赖性皮炎有较好的辅助治疗效果，可显著改善皮肤功能，且复发率低。%Objective To study the clinical effects of recombinant human epidermal growth factor (rhEGF) gel combined with tacrolimus treatment on facial hormone-dependent dermatitis, and to investigate its influence in skin function and recurrence of dermatitis. Methods Forty-eight outpatients with facial hormone-dependent dermatitis were randomly divided into treatment group (n=24, treatment with tacrolimus combined rhEGF gel) and control group (n=24, treatment with tacrolimus). The moisture of skin, sebum content and transepidermal water loss (TEWL) were examined before treatment and 4 weeks after treatment in two groups. Eczema area and severity index (EASI) were calculated at 1 week, 2 weeks and 4 weeks after treatment. The adverse reactions and recurrence of dermatitis were observed during the treatment as well. Results Compared with pre-treatment, the moisture of skin and sebum content were increased (P<0.05) and the TEWL was decreased (P<0.05) after 4-week treatment. The differences were not statistically significant between two groups. The obvious effective rate of the treatment group (45.8%) was not significantly different from that of the control group (20.8%) after 1 week of treatment (P>0.05), but it is much higher in treatment group after two-week treatment (79.2%vs. 50.0%, P<0.05) and after four-week treatment (91.2% vs. 62.5%, P<0.05). Furthermore, there was no adverse reaction in the treatment group, and the recurrence rate was much lower in treatment group (12.5%) than that of the control group (37.5%,χ2=4.03,P<0.05). Conclusion Recombinant human epidermal growth factor gel has an auxiliary curative effect on facial hormone-dependent dermatitis and can significantly improve skin function, and the recurrence rate of dermatitis is low.
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