复方黄柏液湿敷治疗中毒性表皮坏死松解症的临床疗效观察
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摘要
目的探讨复方黄柏液对中毒性表皮坏死松解症患者的疗效。方法收集2013年9月-2018年2月西安交通大学第二附属医院收治的以单纯单次血浆置换治疗(POPE)为基础治疗方案的中毒性表皮坏死松解症(TEN)患者19例,随机分为2组,治疗组为复方黄柏液与乳酸依沙吖啶溶液交替湿敷,对照组为乳酸依沙吖啶溶液湿敷。记录ICU住留院天数等指标,并采用STENS表格评估每位患者入住和离开ICU时的TEN严重程度,用RVI评价TEN的疾病恢复速度。结果治疗组和对照组患者的入院STENS评分差异无统计学意义(33. 1±2. 1 vs. 30. 9±2. 3),出院STENS评分之间差异有统计学意义(5. 1±1. 0 vs. 15. 3±4. 1),ICU住留时间之间差异有统计学意义(5. 2±1. 0 vs. 17. 3±5. 0),疾病恢复速率RVI之间差异有统计学意义(5. 5±1. 0 vs. 1. 0±0. 5)。两组均未见明显的皮肤感染或过敏病例。结论复方黄柏液湿敷治疗中毒性表皮坏死松解症疗效显著,安全性良好。
Objective To investigate the therapeutic effect of external application of compound Huangbai solution on the patients with toxic epidermal necrosis( TEN). Methods Nineteen patients with TEN were treated in the Second Affiliated Hospital of Xi' an Jiaotong University from September 2013 to February 2018 with pure one-time plasma exchange( POPE) therapy. They were randomly divided into two groups,thetreatment group which was treated with external application of compound Huangbai solution and Ethacridine lactate solution alternately and the control group which was treated with external application of Ethacridine lactate solution alone. The indicators were recorded,including the length of ICU stay,and the STENS score was used to evaluate the severity of TEN at ICU admission and ICU discharge. In addition,the rate of TEN disease recovery was evaluated by recovery velocity index( RVI).Results No significant difference was found between the treatment group and control group in the STENS score at ICU admission( 33. 1 ± 2. 1 vs. 30. 9 ± 2. 3),while significant difference was noted between the two groups in the STENS score at ICU discharged( 5. 1 ± 1. 0 vs. 15. 3 ± 4. 1). There were significant differences in length of ICU stay between the treatment group and control group( 5. 2 ± 1. 0 vs. 17. 3 ±5. 0),and significant difference was found between the treatment group and control group in the RVI( 5. 5 ± 1. 0 vs. 1. 0 ± 0. 5). Conclusion External application of compound Huangbai solution is effective and safe in the treatment of TEN.
Objective To investigate the therapeutic effect of external application of compound Huangbai solution on the patients with toxic epidermal necrosis( TEN). Methods Nineteen patients with TEN were treated in the Second Affiliated Hospital of Xi' an Jiaotong University from September 2013 to February 2018 with pure one-time plasma exchange( POPE) therapy. They were randomly divided into two groups,thetreatment group which was treated with external application of compound Huangbai solution and Ethacridine lactate solution alternately and the control group which was treated with external application of Ethacridine lactate solution alone. The indicators were recorded,including the length of ICU stay,and the STENS score was used to evaluate the severity of TEN at ICU admission and ICU discharge. In addition,the rate of TEN disease recovery was evaluated by recovery velocity index( RVI).Results No significant difference was found between the treatment group and control group in the STENS score at ICU admission( 33. 1 ± 2. 1 vs. 30. 9 ± 2. 3),while significant difference was noted between the two groups in the STENS score at ICU discharged( 5. 1 ± 1. 0 vs. 15. 3 ± 4. 1). There were significant differences in length of ICU stay between the treatment group and control group( 5. 2 ± 1. 0 vs. 17. 3 ±5. 0),and significant difference was found between the treatment group and control group in the RVI( 5. 5 ± 1. 0 vs. 1. 0 ± 0. 5). Conclusion External application of compound Huangbai solution is effective and safe in the treatment of TEN.
引文
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[11]刘健,韩剑,贾志伟,等.正常皮肤与破损皮肤复方黄柏液的透皮吸收情况比较[J].中国中医药科技,2016,23(6):683-684.
[2]Lerch M,Mainetti C,Terziroli Beretta-Piccoli B,et al.Current perspectives on Stevens-Johnson syndrome and toxic epidermal necrolysis[J].Clinic Rev Allerg Immunol,2018,54(1):147-176.
[3]饶燕,陶春蓉.糖皮质激素联合免疫球蛋白治疗中毒性表皮坏死松解症25例临床观察[J].中国皮肤性病学杂志,2017,31(2):165-166.
[4]李元红,复方黄柏液皮肤科新用[J].中国中医急症,2006,15(6):672.
[5]沈芳,谢韶琼,宋勋,等,复方黄柏液联合糖皮质激素乳膏治疗急性湿疹60例临床观察[J].中国皮肤性病学杂志,2015,29(12):1314-1316.
[6]Aihara M,Kano Y,Fujita H.Efficacy of additional i.v.immunoglobulin to steroid therapy in Stevens-Johnson syndrome and toxic epidermal necrolysis[J].J Dermatol,2015,42(8):768-777.
[7]Sorrell J,Anthony L,Rademaker A,et al.Score of toxic epidermal necrosis predicts the outcomes of pediatric epidermal necrolysis[J].Pediatr Dermatol,2017,34(4):433-437.
[8]Boulard C,Duvert Lehembre S,Picard-Dahan C.Calculation of cut-off values based on the Autoimmune Bullous Skin Disorder Intensity Score(ABSIS)and Pemphigus Disease Area Index(PDAI)pemphigus scoring systems for defining moderate,significant and extensive types of pemphigus[J].Br J Dermatol,2016,175(1):142-149.
[9]Han F,Zhang J,Guo Q,et al.Successful treatment of toxic epidermal necrolysis using plasmapheresis:A prospective observational study[J].J Crit Care,2017,42(1):65-68.
[10]王玉团,许丽丽,徐丽华.HPLC-PAD法同时测定复方黄柏液涂剂中9种成分的含量[J].中国现代中药,2016,18(12):1649-1652.
[11]刘健,韩剑,贾志伟,等.正常皮肤与破损皮肤复方黄柏液的透皮吸收情况比较[J].中国中医药科技,2016,23(6):683-684.