目的 观察壬二酸乳膏联合克拉霉素治疗玫瑰痤疮的临床疗效。方法 选取2020年1月-2022年1月天津市宝坻区人民医院收治的80例玫瑰痤疮患者,按照随机数字表法将所有患者分为对照组和治疗组,每组各40例。对照组口服克拉霉素片,250 mg/次,2次/d。治疗组在对照组基础上外用壬二酸乳膏,早晚温水洁面后于痤疮处将本品均匀薄涂,用力涂搽使其深入皮肤,每日早晚各1次。两组疗程均为8周。观察两组的临床疗效,比较治疗前后两组阵发性潮红发作频率,相关量表[持续性红斑医生评估量表(CEA)、研究者整体评价(IGA)、皮肤病生活质量指数(DLQI)]评分,面部皮损处皮肤生理指标(角质层厚度、真皮乳头密度、真皮乳头毛细血管直径)及毛囊蠕形螨感染情况(受累毛囊数量、蠕形螨感染密度、蠕形螨总数)。结果 治疗后,治疗组总有效率为92.5%,显著高于对照组的75.0%(P<0.05)。治疗后两组阵发性潮红发作频率和CEA评分、IGA评分、DLQI评分均显著降低(P<0.05);且治疗组下降更显著(P<0.05)。治疗后,两组面部皮损处角质层厚度和真皮乳头密度均显著增加,真皮乳头毛细血管直径均显著缩小(P<0.05);且治疗组改善更显著(P<0.05)。治疗后,两组面部皮损处受累毛囊数量、蠕形螨感染密度及蠕形螨总数均较治疗前显著降低(P<0.05);且治疗组改善更显著(P<0.05)。结论 壬二酸乳膏联合克拉霉素治疗玫瑰痤疮的整体疗效确切,能安全有效地缓解患者面部潮红、红斑、丘疹等典型症状,促进皮损处皮肤结构和屏障功能的恢复,减轻毛囊蠕形螨感染。

Objective To observe the clinical efficacy of Azelaic Acid Cream combined with clarithromycin in treatment of rosacea. Methods A total of 80 patients with rosacea treated in Tianjin Baodi District People's Hospital from January 2020 to January 2022 were selected and divided into control group and treatment group according to random number table method, with 40 cases in each group. Patients in the control group were po administered with Clarithromycin Tablets, 250 mg/time, twice daily. Patients in the treatment group were po administered with Azelaic Acid Cream on the basis of control group, after cleansing with warm water in the morning and evening, applied the product evenly and thinly on the acne area, and applied it vigorously to make it deep into the skin, once in the morning and once in the evening. The treatment course of both groups was 8 weeks. The clinical efficacy of the two groups was observed, and the frequency of parochial flushing, the scores of relevant scales[Doctor's Assessment of Persistent erythema (CEA), Investigator's overall Assessment (IGA), Skin disease Life Quality Index (DLQI)], physiological indicators of skin in facial lesions (thickness of stratum corneum, density of dermal papillae, diameter of capillaries of dermal papillae) and Demodex infection (number of affected hair follicles, density of demodex infection, total number of demodex) were compared between the two groups before and after treatment. Results After treatment, the total effective rate of the treatment group was 92.5%, which was significantly higher than that of the control group (75.0%, P < 0.05). After treatment, the frequency of paroxysmal flushing, CEA score, IGA score and DLQI score were significantly decreased in two groups (P < 0.05). The decrease was more significant in treatment group (P < 0.05). After treatment, the corneum thickness and dermal papilla density were significantly increased, and the diameter of dermal papilla capillaries were significantly decreased in both groups (P < 0.05). The improvement was more significant in the treatment group (P < 0.05). After treatment, the number of affected hair follicles, the density of demodex infection and the total number of demodex were significantly decreased in both groups compared with before treatment (P < 0.05). The improvement was more significant in the treatment group (P < 0.05). Conclusion Azelaic Acid Cream combined with clarithromycin has exact overall efficacy in treatment of rosacea, and can safely and effectively relieve the typical symptoms of facial flushing, erythema, and papule, and can promote the recovery of skin structure and barrier function in the skin lesions, which can reduce the infection of demodex folliculus.

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