咪唑斯汀或西替利嗪联合超分子水杨酸治疗特应性皮炎疗效及对血清炎性因子的影响
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摘要
目的探讨咪唑斯汀与西替利嗪分别联合超分子水杨酸治疗特应性皮炎的疗效及对血清白细胞介素4(IL-4)、IL-5、γ干扰素(IFN-γ)、肿瘤坏死因子-α(TNF-α)的影响。方法选择医院2015年2月至2017年9月收治的特应性皮炎患者106例,根据治疗方式的不同分为咪唑斯汀组和西替利嗪组,各53例。咪唑斯汀组给予咪唑斯汀联合超分子水杨酸治疗,西替利嗪组给予西替利嗪联合超分子水杨酸治疗。结果咪唑斯汀组治疗总有效率为88.68%,高于西替利嗪组的73.58%(χ~2=3.944,P=0.047);治疗后,两组患者湿疹面积及严重程度指数(EASI)、视觉模拟疼痛评分(VAS)均较治疗前下降(P<0.05),且咪唑斯汀组下降更明显(P<0.05);两组患者血清IL-4,IL-5,IFN-γ,TNF-α水平均较治疗前下降(P<0.05),且咪唑斯汀组下降更明显(P<0.05);两组患者不良反应总发生率比较(9.43%比7.55%)无显著差异(χ~2=0.121,P=0.727)。结论咪唑斯汀联合超分子水杨酸治疗特应性皮炎疗效优于西替利嗪联合超分子水杨酸,可有效降低患者血清IL-4,IL-5,IFN-γ,TNF-α水平,值得推广。
Objective To investigate the effects of mizolastine or cetirizine combined with supramolecular salicylic acid in the treatment of atopic dermatitis and their effects on serum IL-4,IL-5,IFN-γ and TNF-α. Methods Totally 106 patients with atopic dermatitis admitted to our hospital from February 2015 to September 2017 were selected and divided into the mizolastine group and the cetirizine group according to the different treatment methods,53 cases in each group. The mizolastine group was treated with mizolastine combined with supramolecular salicylic acid, while the cetirizine group was treated with cetirizine combined with supramolecular salicylic acid.Results The total effective rate of the mizolastine group was 88. 68%, which was significantly higher than 73. 58% of the cetirizine group( χ~2= 3. 944, P = 0. 047). After treatment, the eczema area, scores of EASI and VAS in the two groups were significantly decreased than those before treatment( P < 0. 05),and the decrease in the mizolastine group was more significant( P < 0. 05). The levels of serum IL-4,IL-5,IFN-γ and TNF-α in the two groups were significantly decreased than those before treatment( P < 0. 05),and the decrease in the mizolastine group was more significant( P < 0. 05). The total incidence rate of adverse reactions between the two groups had no significant difference( 9. 43% vs. 7. 55%, χ~2= 0. 121, P = 0. 727). Conclusion Compared with cetirizine combined with supramolecular salicylic acid,mizolastine combined with supramolecular salicylic acid in the treatment of atopic dermatitis has better clinical effect,and it has more significant efficacy in reducing the levels of serum IL-4,IL-5,IFN-γ and TNF-α,which is worthy of promotion.
Objective To investigate the effects of mizolastine or cetirizine combined with supramolecular salicylic acid in the treatment of atopic dermatitis and their effects on serum IL-4,IL-5,IFN-γ and TNF-α. Methods Totally 106 patients with atopic dermatitis admitted to our hospital from February 2015 to September 2017 were selected and divided into the mizolastine group and the cetirizine group according to the different treatment methods,53 cases in each group. The mizolastine group was treated with mizolastine combined with supramolecular salicylic acid, while the cetirizine group was treated with cetirizine combined with supramolecular salicylic acid.Results The total effective rate of the mizolastine group was 88. 68%, which was significantly higher than 73. 58% of the cetirizine group( χ~2= 3. 944, P = 0. 047). After treatment, the eczema area, scores of EASI and VAS in the two groups were significantly decreased than those before treatment( P < 0. 05),and the decrease in the mizolastine group was more significant( P < 0. 05). The levels of serum IL-4,IL-5,IFN-γ and TNF-α in the two groups were significantly decreased than those before treatment( P < 0. 05),and the decrease in the mizolastine group was more significant( P < 0. 05). The total incidence rate of adverse reactions between the two groups had no significant difference( 9. 43% vs. 7. 55%, χ~2= 0. 121, P = 0. 727). Conclusion Compared with cetirizine combined with supramolecular salicylic acid,mizolastine combined with supramolecular salicylic acid in the treatment of atopic dermatitis has better clinical effect,and it has more significant efficacy in reducing the levels of serum IL-4,IL-5,IFN-γ and TNF-α,which is worthy of promotion.
引文
[1]刘斌,李静,胡惠清,等.白芍总苷对Nc/Nga小鼠特应性皮炎的保护作用[J].中国麻风皮肤病杂志,2017,33(1):31-33.
[2]张德骞.自拟通窍止鼽汤联合西替利嗪治疗变应性鼻炎的疗效及对TNF-α和IL-4水平的影响[J].西部中医药,2015,27(5):28-30.
[3]付曼妮,解翠林,石娴,等.他克莫司软膏联合氯雷他定片治疗特应性皮炎的临床疗效及机制研究[J].现代生物医学进展,2017,17(11):2127-2130.
[4]吕慧青,冯金环,王清玲,等.育阴化湿汤治疗慢性期特应性皮炎疗效及对IL-4与INF-γ的影响[J].山东中医药大学学报,2016,39(6):521-523.
[5]贾慧军,王建茹,陈海,等.复方敏维糖浆对湿疹和荨麻疹患者血清IL-4、IL-17及IFN-γ水平的影响及其临床意义[J].检验医学与临床,2017,14(16):2335-2337.
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[8]张舫,丁梦,王南南,等.白芍总苷对糜烂型口腔扁平苔藓外周血TNF-α,IFN-γ及IL-10水平的影响[J].现代生物医学进展,2017,17(17):3374-3376.
[9]朱勇斌,蔡幸生,徐海玲.血清IFN-γ、IL-4、IL-5及IL-17对儿童哮喘影响及相关性研究[J].临床肺科杂志,2016,21(8):1401-1403.
[10]杨帆,郑梁,徐风瑞,等.重组人粒细胞-巨噬细胞集落刺激因子促进皮肤软组织撕脱伤创面修复效果临床观察[J].解放军医药杂志,2017,29(3):80-83.
[11]赵巍,刘俊峰,林颖,等.特应性皮炎小鼠模型皮损中MiR-155表达及血清IL-4水平的分析[J].中国皮肤性病学杂志,2016,27(1):13-16.
[12]宫泽琨,杨雨潮,解奎霞,等.特应性皮炎患儿外周血胸腺基质淋巴细胞生成素与白介素-25的表达及相关性[J].中国皮肤性病学杂志,2016,27(1):17-19.
[13]韩国虎,刘申吒,李蔚,等.IL-23促进食管鳞状细胞癌细胞上皮间质转化和迁移[J].江苏大学学报(医学版),2016,26(2):102-107.
[14]陈仕胜,喻苏婷,周鹏飞,等.特应性皮炎患儿外周血CD4+T细胞miR-155的表达与疾病严重程度的相关性[J].中国麻风皮肤病杂志,2015,30(11):679-681.
[15]Kuanprasert N,Barnetson RS.Clinical improvement and significant reduction of total serum Ig E in patients suffering from severe atopic dermatitis treated with oral azathioprine[J].Australasian Journal of Dermatology,2015,43(2):125-127.
[16]王媛媛,胡明洁,张静,等.利多卡因对金黄色葡萄球菌外毒素TSST-1刺激的特应性皮炎患者外周血单一核细胞的影响[J].中华皮肤科杂志,2015,48(1):28-32.
[17]马晓蕾,高那,刘政邑,等.苯烯莫德对特应性皮炎患者外周血单个核细胞白细胞介素4和10、γ干扰素、T细胞转化因子β水平的影响[J].中华皮肤科杂志,2017,50(1):26-28.
[2]张德骞.自拟通窍止鼽汤联合西替利嗪治疗变应性鼻炎的疗效及对TNF-α和IL-4水平的影响[J].西部中医药,2015,27(5):28-30.
[3]付曼妮,解翠林,石娴,等.他克莫司软膏联合氯雷他定片治疗特应性皮炎的临床疗效及机制研究[J].现代生物医学进展,2017,17(11):2127-2130.
[4]吕慧青,冯金环,王清玲,等.育阴化湿汤治疗慢性期特应性皮炎疗效及对IL-4与INF-γ的影响[J].山东中医药大学学报,2016,39(6):521-523.
[5]贾慧军,王建茹,陈海,等.复方敏维糖浆对湿疹和荨麻疹患者血清IL-4、IL-17及IFN-γ水平的影响及其临床意义[J].检验医学与临床,2017,14(16):2335-2337.
[6]张学军.皮肤性病学[M].第8版.北京:人民卫生出版社,2013:111.
[7]Yawalkar N,Schmid S,Braathen LR,et al.Perforin and granzyme B may contribute to skin inflammation in atopic dermatitis and psoriasis[J].British Journal of Dermatology,2015,144(6):1133-1139.
[8]张舫,丁梦,王南南,等.白芍总苷对糜烂型口腔扁平苔藓外周血TNF-α,IFN-γ及IL-10水平的影响[J].现代生物医学进展,2017,17(17):3374-3376.
[9]朱勇斌,蔡幸生,徐海玲.血清IFN-γ、IL-4、IL-5及IL-17对儿童哮喘影响及相关性研究[J].临床肺科杂志,2016,21(8):1401-1403.
[10]杨帆,郑梁,徐风瑞,等.重组人粒细胞-巨噬细胞集落刺激因子促进皮肤软组织撕脱伤创面修复效果临床观察[J].解放军医药杂志,2017,29(3):80-83.
[11]赵巍,刘俊峰,林颖,等.特应性皮炎小鼠模型皮损中MiR-155表达及血清IL-4水平的分析[J].中国皮肤性病学杂志,2016,27(1):13-16.
[12]宫泽琨,杨雨潮,解奎霞,等.特应性皮炎患儿外周血胸腺基质淋巴细胞生成素与白介素-25的表达及相关性[J].中国皮肤性病学杂志,2016,27(1):17-19.
[13]韩国虎,刘申吒,李蔚,等.IL-23促进食管鳞状细胞癌细胞上皮间质转化和迁移[J].江苏大学学报(医学版),2016,26(2):102-107.
[14]陈仕胜,喻苏婷,周鹏飞,等.特应性皮炎患儿外周血CD4+T细胞miR-155的表达与疾病严重程度的相关性[J].中国麻风皮肤病杂志,2015,30(11):679-681.
[15]Kuanprasert N,Barnetson RS.Clinical improvement and significant reduction of total serum Ig E in patients suffering from severe atopic dermatitis treated with oral azathioprine[J].Australasian Journal of Dermatology,2015,43(2):125-127.
[16]王媛媛,胡明洁,张静,等.利多卡因对金黄色葡萄球菌外毒素TSST-1刺激的特应性皮炎患者外周血单一核细胞的影响[J].中华皮肤科杂志,2015,48(1):28-32.
[17]马晓蕾,高那,刘政邑,等.苯烯莫德对特应性皮炎患者外周血单个核细胞白细胞介素4和10、γ干扰素、T细胞转化因子β水平的影响[J].中华皮肤科杂志,2017,50(1):26-28.