目的 探討雷公藤多苷片聯(lián)合西替利嗪治療泛發(fā)性濕疹的臨床療效。方法 選取2018年5月—2021年6月昆山市第一人民醫(yī)院收治的118例泛發(fā)性濕疹患者，按照隨機數(shù)字表法將118例患者隨機分成對照組和治療組，每組各59例。對照組口服鹽酸西替利嗪片，10 mg/次，1次/d。治療組在對照組基礎上口服雷公藤多苷片，1.0 mg/kg，分3次于早、中、晚餐后服用。兩組均連續(xù)治療4周。觀察兩組的臨床療效，比較兩組濕疹面積及嚴重度指數(shù)（EASI）評分、瘙癢視覺模擬量表（VAS）評分、濕疹生活質量量表（EQOLS）評分、外周血嗜酸性粒細胞（EOS）計數(shù)及血清一氧化氮（NO）、白細胞介素（IL）-10、IL-17水平。結果 治療后，治療組總有效率是91.5%，顯著高于對照組的78.0%（P<0.05）。治療后，兩組EASI中皮損癥狀、皮損面積評分及總分和瘙癢VAS評分均較治療前顯著降低（P<0.05）；且均以治療組下降更顯著（P<0.05）。治療后，兩組EQOLS中各維度（疾病、生理、心理、社會）評分及總分較治療前均顯著下降（P<0.05）；且均以治療組改善更顯著（P<0.05）。與治療前對比，兩組治療后外周血EOS計數(shù)及血清NO、IL-10、IL-17水平均顯著下降（P<0.05）；且治療后，治療組外周血EOS計數(shù)和血清學因子低于對照組（P<0.05）。結論 雷公藤多苷片聯(lián)合西替利嗪治療泛發(fā)性濕疹具有較好的臨床療效，能有效緩解患者臨床癥狀，調節(jié)機體免疫狀態(tài)，抑制體內炎癥反應，提高生活質量，且安全性較好，值得臨床推廣。

Objective To investigate the clinical efficacy of Tripterygium Glycosides Tablets combined with cetirizine in treatment of generalized eczema. Methods A total of 118 patients with generalized eczema admitted to Kunshan First People's Hospital from May 2018 to June 2021 were selected, and they were randomly divided into control group and treatment group according to random number table method, with 59 cases in each group. Patients in the control group were po administered with Cetirizine Hydrochloride Tablets, 10 mg/time, once daily. Patients in the treatment group were po administered with Tripterygium Glycosides Tablets on the basis of the control group, 1.0 mg/kg, they took it three times after breakfast, lunch and dinner. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, eczema area and severity index (EASI) score, visual analog scale (VAS) score, eczema quality of life scale (EQOLS) score, peripheral blood eosinophilia (EOS) count, and serum nitric oxide (NO), interleukin (IL)-10 and IL-17 levels were compared between the two groups. Results After treatment, the total effective rate in treatment group was 91.5%, significantly higher than 78.0% in control group (P < 0.05). After treatment, EASI symptoms score, EASI area score, total scores, and pruritus VAS scores in two groups were significantly decreased compared with before treatment (P< 0.05). The decrease was more significant in the treatment group (P< 0.05). After treatment, EQOLS scores of various dimensions (disease, physiological, psychological and social) and total scores in both groups were significantly decreased compared with those before treatment (P < 0.05). The improvement was more significant in the treatment group (P< 0.05). Compared with before treatment,peripheral blood EOS count and serum NO, IL-10 and IL-17 levels in two groups were significantly decreased after treatment (P < 0.05). After treatment, the peripheral blood EOS count and serological factors in the treatment group were lower than those in the control group (P< 0.05). Conclusion Tripterygium Glycosides Tablets combined with cetirizine has good clinical effect in treatment of generalized eczema, and can effectively relieve the clinical symptoms of patients, regulate the immune state of the body, inhibit the inflammatory response in the body, improve the life quality with good safety, which is worthy of clinical promotion.

R986

昆山市科學技術局科技計劃項目（KS19058）