【作者】 陈海亭； 赵晔； 巴东霞； 吕媛玲；

【Author】 The Second Affiliated Hospital, Dalian Medical University,1 16023 Chen Hailing, Zhao Ye, Ba Dongxia, Lu Yuanling

【机构】 大连医科大学附属二院皮肤科；

【摘要】 <正>采用丹参酮和塞庚定口服,联合氢乳外用治疗异位性皮炎(AD)32例。结果丹参酮治疗组多数患者用药1周症状及体征即得到明显改善,平均起效时间3.3天。其过程先是瘙痒水肿减轻,继之红斑消退,痂皮剥脱及苔藓化皮疹逐渐消退。痊愈9(2 8.1%),显效18(56.3%),好转2(6.3%),无效3(9.4%),对照组的平均起效时间为6.5天,痊愈6(18.8%),显效8(25%),好转7(21.9%),无效11(34.4%)。丹参酮治疗组的疗效明显优于对照组(x2=11.4 7,p<0.01)。异位性皮炎(AD),在发病病因中存在不可忽视的细菌感染因素。大量研究显示金黄色葡萄球菌可诱发加重本类病,金葡菌和某些链球菌株的超抗原可使直接结合于抗原递呈细胞的多克隆T细胞活化。这些超抗原成为AD加重的原因,当T细胞受到细菌超抗原刺激后,对皮质类固醇的免疫作用不敏感。提示了抗生素与皮质类崮醇合用治疗皮炎湿疹类,减少皮肤表面细菌超抗原浓度,能提高疗效。丹参酮是活血化淤中药丹参的有效成分之一,具有改善微循环及抗菌作用。对革兰氏阳性球菌,特别是金黄色葡萄球菌、耐药菌株及链球菌有较强抗菌作用[4,5]。所以丹参酮联合氢乳可以对抗AD的金葡菌、减少超抗原产生,对急性期可获得满意的效果。丹参酬的活血化淤改善微循环对AD后期的慢性皮损也有进一步加快消退的作用。同时AD存在对西药类抗生素过敏的倾向,采用丹参酮中药也可以减少过敏因素。对早期及晚期皮损疗效都明显优于对照组。虽然有2例病人出现一过性少量皮疹,伴轻度的瘙痒,停药后很快消失。因此对AD在抗组胺及激素外用药的治疗基础上联合丹参酮是一个较理想的治疗方法。更多还原

【Abstract】 We adopted oral administration of Daniston Danshentong and cyproheptadine respectively,combinating with external use of Hydrocortisone ointment in the treatment of 32 cases of Atopic Dermatitis patients. (AD) The result showed that symptoms and skin lesions in daniston danshentong group improved obviously, the total excellent response rate is 84.4%, while that in normal control group is 43.8%. Daniston Danshentong group has obviously better effect than normal control group. (x2=l 1 .47, P<0.01)Bacterial infection is one important factor in the appearance of AD. Super antigen of staphylococcus Aureus and some streptococcus strains can activate multicolone T cells combining directly with antigen presenting cells. When being incited by bacterial super antigen, T cells become insensitive to immune function of steroid, which indicates combination use of antibiotics and steroid in the therapy of eczema can decrease bacterial antigen concentration on the skin surface and increse therapeutic effect.Daniston Danshentong, ingrediant of dansheng, has microcirculation improvement and antibacterial function. Grans positive coccus, especially staphylococcus aureus, resistant strains and streptococcus are very sensitive to daniston danshentong. Combination of daniston danshentong and hydrocortisone had satisfactory effect in acute stage by decreasing production of super antigen. Daniston danshentong can also promote chronic skin lesions in AD to subside through microcirculation improvement. Besides, AD has tendency to be allergic to antibiotics, so daniston danshentong can reduce this danger. Daniston danshentong group were obviously better than normal control group. Though two patients appeared some skin lesions during the therapy, which disappeared immediately after stopping use of daniston danshentong. We conclded that combination use of daniston danshentong, antihistamines and external use of hydrocortisone preparation is a relatively good therapeulic measure.更多还原