目的 探讨除湿止痒软膏联合复方曲安奈德乳膏治疗肛周湿疹的临床疗效。方法 选取上海市徐汇区大华医院在2021年2月—2024年1月收治的82例肛周湿疹患者，按计算机随机排列法将所有患者分为对照组和治疗组，每组各41例。对照组局部涂抹复方曲安奈德乳膏，每日早晚各1次，1指尖单位（FTU）/次。治疗组在对照组基础上局部涂抹除湿止痒软膏，3次/d，1 FTU/次。两组共治疗4周。比较两组患者的临床疗效、湿疹症状、病情程度、血清指标。结果 治疗后，治疗组的总有效率为95.12%，对照组的总有效率为78.05%，组间比较差异有统计学意义（P＜0.05）。治疗后，两组的发作频率、每次持续时间、瘙痒程度评分显著降低（P＜0.05）；治疗组的发作频率、每次持续时间、瘙痒程度评分明显低于对照组（P＜0.05）。治疗后，两组的湿疹面积及严重度指数（EASI）评分显著降低（P＜0.05），且治疗组的EASI评分明显低于对照组（P＜0.05）。治疗后，两组患者的血清白细胞介素-17（IL-17）、白三烯B4（LTB4）、白细胞介素-4（IL-4）水平均显著降低（P＜0.05）；治疗组的血清IL-17、LTB4、IL-4水平低于对照组（P＜0.05）。结论 除湿止痒软膏联合复方曲安奈德乳膏可提高肛周湿疹的治疗效果，改善瘙痒症状，控制病情，减轻炎症反应。

Objective To explore the clinical efficacy of Chushi Zhiyang Ointment combined with Compound Triamcinolone Acetonide Cream in treatment of perianal eczema. Methods Patients (82 cases) with perianal eczema in Shanghai Xuhui District Dahua Hospital from February 2021 to January 2024 were divided into control and treatment groups according to the computer random arrangement method, and each group had 41 cases. Patients in the control group were applied topically with Compound Triamcinolone Acetonide Cream, once in the morning and once in the evening, 1 fingertip unit (FTU)/time. Patients in the treatment group were applied topically with Chushi Zhiyang Ointment on the basis of the control group, 1 FTU/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies, the eczema symptoms, severity, and serum indicators in two groups were compared. Results After treatment, the total effective rate was 95.12% in the treatment group, and the total effective rate was 78.05% in the control group, and the difference between groups was statistically significant (P < 0.05). After treatment, the frequency and duration of perianal eczema, and the score of itch degree in two groups were significantly decreased (P < 0.05), and the frequency and duration of perianal eczema, and the score of itch degree in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the EASI score of two groups was significantly decreased (P < 0.05), and the EASI score of the treatment group was significantly lower than that of the control group (P < 0.05). After treatment, the serum levels of IL-17, LTB4, and IL-4 in two groups were significantly decreased (P < 0.05), and the serum levels of IL-17, LTB4, and IL-4 in the treatment group were lower than those in the control group (P < 0.05). Conclusion Chushi Zhiyang Ointment combined with Compound Triamcinolone Acetonide Cream can improve the therapeutic effect of perianal eczema, improve itching symptoms, control the condition, and reduce inflammation reactions.

R976

上海市“治未病”预防保健服务体系建设项目（ZY3-FWMS-1-1001-KYJS-19）