【摘要】 目的 分析某医院中重度特应性皮炎（AD）患者中西医结合治疗模式与达标情况，为现有新药进展下，中重度AD患者的临床治疗模式及策略提供参考。方法 回顾性分析2020年6月—2023年12月广东省中医院慢病管理团队治疗至少8周的252例中重度AD患者临床资料。根据患者8周内用药情况分为中药组32例、常规西药组2例、中药联合常规西药组115例、度普利尤单抗联合中药组93例、度普利尤单抗联合常规西药组8例和Janus激酶（JAK）抑制剂组2例。分析各组达标治疗及不良反应发生情况。结果 中药组、中药联合常规西药组、度普利尤单抗联合中药组和度普利尤单抗联合常规西药组治疗达标率分别为50.00%、52.17%、90.32%和87.50%，总体比较差异有统计学意义（P<0.05）。度普利尤单抗联合中药组分别对比中药组及中药联合常规西药组在峰值瘙痒数字评定量表（PP-NRS）改善≥4分、皮肤病生活质量指数（DLQI）改善≥4分及治疗达标率方面差异有统计学意义（P<0.05）。达到湿疹面积及严重程度指数较基线改善达到75%(EASI-75)的患者比例方面，度普利尤单抗联合中药组与度普利尤单抗联合常规西药组分别对比中药组及中药联合常规西药组，差异均有统计学意义（均P<0.05）。观察期间报告的不良反应有4例（1.59%），为轻度眼部症状，局部治疗可缓解。结论 当前生物制剂等新药极大提高了中重度AD患者的临床疗效与安全性，与传统西药或中药的联合应用渐成新的治疗趋势，其中与中医药联合有望在短期内提高达标率，且不良风险低，为进一步探讨中西医结合模式下西药减停与维持方案提供可能。更多还原

【Abstract】 Objective In order to analyze the treatment mode and treat-to-target of integrated traditional Chinese and western medicine for patients with moderate and severe atopic dermatitis(AD) in a hospital,so as to provide references for the clinical treatment mode and strategy of moderate and severe AD patients under the development of new drugs. Methods The clinical data of 252 patients with moderate and severe AD treated by the chronic disease management team of Guangdong hospital of provincial Chinese medicine from June 2020 to December 2023 were retrospectively analyzed. The patients were sorted into traditional Chinese medicine group( n=32), conventional western medicine group( n =2), traditional Chinese medicine combined with western medicine group(n=115),dupilumab combined with traditional Chinese medicine group(n=93),dupilumab combined with conventional western medicine group(n=8) and Janus kinase(JAK) inhibitor group(n=2).The treat-to-target and the occurrence of adverse reactions in each group were analyzed. Results The treat-to-target rates of traditional Chinese medicine group,traditional Chinese medicine combined with conventional western medicine group,dupilumab combined with traditional Chinese medicine group and dupilumab combined with conventional western medicine group were 50.00%,52.17%,90.32% and 87.50%,respectively. The overall differences were statistically significant(P<0.05).In terms of the proportion of patients whose peak pruritus numerical rating scale(PP-NRS) improvement≥4 points,dermatology life quality index(DLQI) improvement≥4 points and the treat-to-target rates,there was significant difference between the traditional Chinese medicine group and the dupilumab combined with traditional Chinese medicine group,and between the traditional Chinese medicine combined with western medicine group and the dupilumab combined with traditional Chinese medicine group(P<0.05). In terms of the proportion of patients reaching EASI-75,there were significant differences between the traditional Chinese medicine group and the dupilumab combined with traditional Chinese medicine group,the traditional Chinese medicine group with the dupilumab combined with conventional western medicine group,the traditional Chinese medicine combined with conventional western medicine group and the dupilumab combined with conventional western medicine group(P<0.05). During the observation period,adverse reactions were reported in four cases(1.59%),which were mild ocular symptoms and could be alleviated by local treatment. Conclusion At present,new drugs such as biological agents have greatly improved the clinical efficacy and safety of patients with moderate and severe AD,and the combination with traditional western medicine or traditional Chinese medicine has gradually become a new therapeutic trend,in which the combination with traditional Chinese medicine is expected to improve the rate of treat-to-target in a short time,and the adverse risk is low,which provides the possibility for further discussion on the stopping and maintenance scheme of western medicine under the mode of combination of traditional Chinese and western medicine.更多还原