目的 探讨消银颗粒联合糠酸莫米松乳膏治疗慢性湿疹的临床疗效。方法 选取2018年6月—2019年11月郑州市中心医院收治的136例慢性湿疹患者为研究对象，根据随机分层抽样法将患者分为对照组（68例）和治疗组（68例）。对照组患者取适量糠酸莫米松乳膏涂抹于患处皮肤，1次/d，1周用药5 d，停药2 d。治疗组患者在对照组治疗的基础上口服消银颗粒，3.5 g/次，3次/d。两组均治疗1个月。观察两组的临床疗效，比较两组的皮肤生理功能、血清炎症因子、严重度指数（EASI）评分、瘙痒评分、靶皮损面积。结果 治疗后，治疗组、对照组的总有效率分别为92.65%、75.00%，差异有统计学意义（P<0.05）。治疗后，两组严重度指数（EASI）评分、瘙痒评分、靶皮损面积降低（P<0.05），且治疗组EASI评分、瘙痒评分、靶皮损面积低于对照组（P<0.05）。治疗后，两组表皮水分流失（TEWL）下降，皮肤油脂、角质层含水量（WCSC）升高（P<0.05），且治疗组TEWL低于对照组，皮肤油脂、WCSC高于对照组（P<0.05）。治疗后，两组肿瘤坏死因子-α（TNF-α）、白细胞介素-17（IL-17）、白细胞介素-23（IL-23）水平均下降（P<0.05），且治疗组炎症因子水平低于对照组（P<0.05）。结论 消银颗粒联合糠酸莫米松乳膏治疗慢性湿疹可有效缓解临床症状，改善皮肤生理功能，降低血清TNF-α、IL-17、IL-23水平，安全性较好。

Objective To investigate the effect of Xiaoyin Granules combined with Mometasone Furoate Cream in treatment of chronic eczema. Methods Patients (136 cases) with chronic eczema in Zhengzhou Central Hospital from June 2018 to November 2019 were randomly divided into the control group (68 cases) and the treatment group (68 cases). Patients in the control group were smeared with appropriate Mometasone Furoate Cream, once daily, 5 times weekly, stopped for 2 d. Patients in the treatment group were po administered with Xiaoyin Granules on the basis of the control group, 3.5 g/time, three times daily. Patients in two groups were treated for 1 month. After treatment, the clinical efficacies were evaluated, and skin physiological function, inflammatory factor, EASI score, pruritus score, and target lesion area in two groups were compared. Results After treatment, the total effective rates of the treatment group and the control group were 92.65% and 75.00%, respectively, and the difference was statistically significant (P<0.05). After treatment, EASI score, pruritus score, and target lesion area of the two groups were decreased (P<0.05), and these indexes in the treatment group were lower than those in the control group (P<0.05). After treatment, the TEWL of two groups were decreased, but the skin oil and the WCSC of two groups were increased (P<0.05). And the TEWL in the treatment group was lower than that in the control group, but the skin oil and the WCSC in the treatment group were higher than those in the control group (P<0.05). After treatment, the levels of TNF-α, IL-17, and IL-23 in two groups were decreased (P<0.05), and the levels of inflammatory factors in the treatment group were lower than those in the control group (P<0.05). Conclusion Xiaoyin Granules combined with Mometasone Furoate Cream in treatment of chronic eczema can effectively relieve clinical symptoms, improve skin physiological function, and reduce serum levels of TNF-α, IL-17, and IL-23, with good safety.

R986

河南省医学科技攻关计划项目（201601635）