目的 探討消銀顆粒聯(lián)合糠酸莫米松乳膏治療慢性濕疹的臨床療效。方法 選取2018年6月—2019年11月鄭州市中心醫(yī)院收治的136例慢性濕疹患者為研究對象，根據(jù)隨機(jī)分層抽樣法將患者分為對照組（68例）和治療組（68例）。對照組患者取適量糠酸莫米松乳膏涂抹于患處皮膚，1次/d，1周用藥5 d，停藥2 d。治療組患者在對照組治療的基礎(chǔ)上口服消銀顆粒，3.5 g/次，3次/d。兩組均治療1個月。觀察兩組的臨床療效，比較兩組的皮膚生理功能、血清炎癥因子、嚴(yán)重度指數(shù)（EASI）評分、瘙癢評分、靶皮損面積。結(jié)果 治療后，治療組、對照組的總有效率分別為92.65%、75.00%，差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組嚴(yán)重度指數(shù)（EASI）評分、瘙癢評分、靶皮損面積降低（P<0.05），且治療組EASI評分、瘙癢評分、靶皮損面積低于對照組（P<0.05）。治療后，兩組表皮水分流失（TEWL）下降，皮膚油脂、角質(zhì)層含水量（WCSC）升高（P<0.05），且治療組TEWL低于對照組，皮膚油脂、WCSC高于對照組（P<0.05）。治療后，兩組腫瘤壞死因子-α（TNF-α）、白細(xì)胞介素-17（IL-17）、白細(xì)胞介素-23（IL-23）水平均下降（P<0.05），且治療組炎癥因子水平低于對照組（P<0.05）。結(jié)論 消銀顆粒聯(lián)合糠酸莫米松乳膏治療慢性濕疹可有效緩解臨床癥狀，改善皮膚生理功能，降低血清TNF-α、IL-17、IL-23水平，安全性較好。

Objective To investigate the effect of Xiaoyin Granules combined with Mometasone Furoate Cream in treatment of chronic eczema. Methods Patients (136 cases) with chronic eczema in Zhengzhou Central Hospital from June 2018 to November 2019 were randomly divided into the control group (68 cases) and the treatment group (68 cases). Patients in the control group were smeared with appropriate Mometasone Furoate Cream, once daily, 5 times weekly, stopped for 2 d. Patients in the treatment group were po administered with Xiaoyin Granules on the basis of the control group, 3.5 g/time, three times daily. Patients in two groups were treated for 1 month. After treatment, the clinical efficacies were evaluated, and skin physiological function, inflammatory factor, EASI score, pruritus score, and target lesion area in two groups were compared. Results After treatment, the total effective rates of the treatment group and the control group were 92.65% and 75.00%, respectively, and the difference was statistically significant (P<0.05). After treatment, EASI score, pruritus score, and target lesion area of the two groups were decreased (P<0.05), and these indexes in the treatment group were lower than those in the control group (P<0.05). After treatment, the TEWL of two groups were decreased, but the skin oil and the WCSC of two groups were increased (P<0.05). And the TEWL in the treatment group was lower than that in the control group, but the skin oil and the WCSC in the treatment group were higher than those in the control group (P<0.05). After treatment, the levels of TNF-α, IL-17, and IL-23 in two groups were decreased (P<0.05), and the levels of inflammatory factors in the treatment group were lower than those in the control group (P<0.05). Conclusion Xiaoyin Granules combined with Mometasone Furoate Cream in treatment of chronic eczema can effectively relieve clinical symptoms, improve skin physiological function, and reduce serum levels of TNF-α, IL-17, and IL-23, with good safety.

R986

河南省醫(yī)學(xué)科技攻關(guān)計劃項目（201601635）