目的 探讨复方黄柏液联合异维A酸治疗痤疮的临床疗效。方法 选取2022年6月—2025年6月扬州大学附属医院收治的102例痤疮患者，以随机数字表法分为对照组和治疗组，每组各51例。对照组患者在痤疮部位涂抹适量异维A酸凝胶，2次/d。治疗组患者在对照组的基础上在痤疮部位涂抹适量复方黄柏液，早晚各涂抹1次。两组患者均治疗1个月。评估组间临床疗效、中医证候积分、炎症因子细胞间黏附分子-1（ICAM-1）、白细胞介素-1β（IL-1β）、基质金属蛋白酶-9（MMP-9）水平、皮肤屏障功能、免疫功能指标辅助性T细胞17（Th17）、调节性T细胞（Treg）水平及Th17/Treg和痤疮特异性生命质量调查表（QoL-Acne）评分。结果 治疗组总有效率（90.20%）高于对照组的74.51%（P＜0.05）。治疗后，两组丘疹脓疱积分、皮肤潮红积分、皮疹痒痛积分、舌红苔黄积分均显著降低（P＜0.05）；治疗后，治疗组中医证候各项积分均低于对照组（P＜0.05）。治疗后，两组ICAM-1、IL-1β、MMP-9水平均显著降低（P＜0.05）；治疗组炎症因子ICAM-1、IL-1β、MMP-9均低于对照组（P＜0.05）。治疗后，两组经皮水分丢失量降低，表皮油脂量、表皮水分量升高（P＜0.05）；治疗组经皮水分丢失量小于对照组，表皮油脂量、表皮水分量均高于对照组（P＜0.05）。治疗后，两组Th17、Th17/Treg降低，Treg升高（P＜0.05）；治疗后，治疗组Th17、Th17/Treg低于对照组，Treg高于对照组（P＜0.05）。治疗后，两组自我感知评分、社交角色评分、情绪角色评分、痤疮症状评分较前显著升高（P＜0.05）；治疗后，治疗组QoL-Acne各项评分均高于对照组（P＜0.05）。结论 复方黄柏液联合异维A酸治疗痤疮的疗效显著，可改善患者中医证候，抑制炎症因子水平，增强患者皮肤屏障功能，改善机体免疫功能，提高患者的生活质量。

Objective To explore the clinical effect of Compound Huangbai Solution combined with isotretinoin in treatment of acne. Methods A total of 102 patients with acne admitted to Affiliated Hospital of Yangzhou University from June 2022 to June 2025 were selected and randomly divided into a control group and a treatment group using a random number table method, with 51 cases in each group. Patients in the control group were treated with an appropriate amount of Isotretinoin Gel to the acne lesions twice daily. Patients in the treatment group were treated with an appropriate amount of Compound Huangbai Solution to the acne lesions each morning and evening on the basis of the control group. Both groups were treated for one month. Clinical efficacy, TCM syndrome scores, levels of inflammatory factors [intercellular adhesion molecule-1 (ICAM-1), interleukin-1β (IL-1β), matrix metalloproteinase-9 (MMP-9)], skin barrier function, immune function indicators [helper T cell 17 (Th17), regulatory T cell (Treg), and Th17/Treg ratio], and acne-specific quality of life (QoL-Acne) scores were evaluated between the two groups. Results The total clinical effective rate in the treatment group (90.20%) was higher than that in the control group (74.51%) (P < 0.05). After treatment, scores for papules, skin flushing, rash pain/itching, and red tongue with yellow coating were significantly reduced in both groups (P < 0.05). After treatment, each TCM syndrome score in the treatment group was lower than that in the control group (P < 0.05). After treatment, levels of ICAM-1, IL-1β, and MMP-9 were significantly decreased in both groups (P < 0.05). The levels of these inflammatory factors in the treatment group were lower than those in the control group (P < 0.05). After treatment, transepidermal water loss decreased, while sebum content and skin hydration increased in both groups (P< 0.05).The treatment group showed lower TEWL, and higher sebum content and skin hydration compared to the control group (P < 0.05). After treatment, Th17 and Th17/Treg decreased, while Treg increased in both groups (P < 0.05). After treatment, the treatment group had lower Th17 and Th17/Treg, and higher Treg than the control group (P < 0.05). After treatment, scores for self-perception, social role, emotional role, and acne symptoms significantly increased in both groups (P < 0.05). After treatment, each QoL-Acne score in the treatment group was higher than that in the control group (P < 0.05). Conclusion Compound Huangbai Solution combined with isotretinoin has a significant therapeutic effect on acne, improving TCM syndromes, inhibiting inflammatory factor levels, enhancing skin barrier function, modulating immune function, and improving the quality of life of patients.

R986

扬州市卫生健康委医学科研立项项目（2023-2-04）