目的 观察五妙水仙膏联合吡美莫司乳膏治疗局限性神经性皮炎的临床疗效。方法 回顾性分析2022年4月—2024年5月湖南省中西医结合医院皮肤科收治的98例局限性神经性皮炎患者临床资料，根据药物治疗方案不同分为对照组49例和治疗组49例。对照组采用吡美莫司乳膏，取适量涂抹患处，2次/d。治疗组在对照组的基础上给予五妙水仙膏涂抹患处，2次/d。两组用药20 d。观察两组临床疗效，比较两组患者治疗前后湿疹面积及严重程度指数（EASI）评分、皮肤病生活质量指标调查表评分（DLQI）、白细胞介素1β（IL-1β）、P物质（SP）、白细胞介素6（IL-6）、5-羟色胺（5-HT）水平。结果 治疗后，治疗组总有效率是97.96%，显著高于对照组的81.63%（P＜0.05）。治疗后，治疗组皮肤烧灼感、皮肤胀痛、皮肤瘙痒好转时间均短于对照组（P＜0.05）。治疗后，两组EASI评分、DLQI评分较同组治疗前显著降低（P＜0.05）；治疗后，治疗组EASI评分、DLQI评分均低于对照组（P＜0.05）。治疗后，两组IL-1β、SP、IL-6、5-HT水平均较同组治疗前显著降低（P＜0.05）；治疗后，与对照组对比，治疗组的IL-1β、SP、IL-6、5-HT水平均较低（P＜0.05）。结论 五妙水仙膏联合吡美莫司乳膏治疗局限性皮炎具有较好疗效，能改善患者皮损状态，降低机体炎性反应，提升明显患者生活质量，值得借鉴与应用。

Objective To investigate the therapeutic effect of Wumiao Shuixian Cream combined with pimecrolimus in treatment of localized neurodermatitis. Methods The clinical data of 98 patients with localized neurodermatitis admitted to the Dermatology Department of Hunan Hospital of Integrated Traditional Chinese and Western Medicine from April 2022 to May 2024 were retrospectively analyzed. According to different drug treatment regimens, 49 cases were divided into control group and 49 cases were divided into treatment group. Patients in control group were given Pimecrolimus Cream, applied appropriate amount to affected area, twice daily. Patients in treatment group were given Wumiao Shuixian Cream on the basis of the control group, applied to affected area twice daily. Both groups were treated for 20 d. The clinical efficacy of two groups was observed, and the levels of eczema area and severity index (EASI), Dermatosis Quality of Life Index (DLQI), interleukin-1β (IL-1β), Substance P (SP), interleukin-6 (IL-6) and 5-hydroxytryptamine (5-HT) before and after treatment were compared between two groups. Results After treatment, the total effective rate of treatment group was 97.96%, which was significantly higher than that of control group (81.63%, P< 0.05). After treatment, the improvement time of skin burning sensation, skin swelling pain, and skin pruritus in treatment group was shorter than that in control group (P < 0.05). After treatment, EASI score and DLQI score in 2 groups were significantly decreased compared with before treatment (P< 0.05). After treatment, EASI scores and DLQI scores in treatment group were lower than those in control group (P < 0.05). After treatment, the levels of IL-1β, SP, IL-6, and 5-HT in 2 groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the levels of IL-1β, SP, IL-6, and 5-HT in treatment group were lower than those in control group (P < 0.05). Conclusion Wumiao Shuixian Cream combined with pimecrolimus has good curative effect in treatment of localized neurodermatitis, and can improve the skin lesions of patients, reduce the inflammatory response of the body, and improve the quality of life of patients, which is worth learning and applying.

R986

湖南省中医药科研计划项目（B2024018）