非甾体类抗炎药和糖皮质激素对紫外线诱导红斑的影响

摘要/Abstract

摘要： 【摘要】目的探讨非甾体和糖皮质激素对紫外线红斑的抑制效应。方法日光模拟器和紫外线光疗仪对30例受试者的后背部进行1 ~ 3个最小红斑量（MED）照射。照射前0.5 h和照射后即刻抹药两种方式，照射后的4 h、24 h、48 h用色度仪进行红斑程度评价。组内比较用t检验，组间比较用方差分析。结果日光模拟器照射前0.5 h给药，2.5%和5％的氟芬那酸丁酯可以抑制1 ～ 3 MED的UV照射后红斑（P ＞ 0.05）；双氯芬酸只对1MED紫外线红斑有抑制作用（4 h和48 h），P ＞ 0.05；卤米松会增加红斑反应的强度（P ＜ 0.05）。日光模拟器照射后即刻抹药外用非甾体和糖皮质激素对紫外线红斑的作用与空白对照相比，差异无统计学意义。紫外线光疗仪照射后即刻抹药，2.5%氟芬那酸丁酯、5%氟芬那酸丁酯和卤米松在4 h时，对于1 MED的紫外线照射的红斑反应有抑制作用（P ＜ 0.05）；双氯芬酸对于1 ～ 3 MED的紫外线照射引起的红斑反应在4、24、48 h时均有明显的抑制作用（P ＜ 0.05）。结论照射前外用氟芬那酸丁酯可以抑制1 ～ 3 MED紫外线红斑反应。照射后立即给药，抑制红斑反应的作用强度由强到弱依次为双氯芬酸、氟芬那酸丁酯和卤米松。【关键词】氟芬那酸；糖皮质激素类；紫外线；红斑

关键词: 红斑, 紫外线, 糖皮质激素类, 氟芬那酸

Abstract: LIU Hui-xian, SUN Nan, GUO Jian-mei, WU Yan. Department of Dermatology and Venereology, Peking University First Hospital, Beijing 100034, China Corresponding author: WU Yan, Email: adelewu@medmail.com.cn 【Abstract】 Objective To observe the suppressing effect of topical nonsteroidal anti-inflammatory drugs （NSAIDs） and corticosteroids on ultraviolet ray （UV）-induced erythema. Methods A solar simulator and an UV phototherapy device were used as light sources, respectively. Erythema reaction was induced on the back skin of 30 healthy volunteers by 1, 2 and 3 minimal erythema doses （MED） of irradiation. Five preparations including butyl flufenamate 2.5% ointment, butyl flufenamate 5% ointment, the base of butyl flufenamate ointment, halometasone ointment, and diclofenac 1% ointment, were applied to the irradiation sites respectively half an hour before or immediately after the irradiation. One irradiation site remained untreated and served as the control. The degree of erythema was evaluated by a chromameter at 4, 24, and 48 hours after the irradiation. Intragroup and intergroup comparisons were done by t test and analysis of variance, respectively. Results When applied half an hour before solar-simulated irradiation, both 2.5% and 5% butyl flufenamate ointment totally suppressed the erythema reaction induced by 1－3 MED of UV irradiation, with no significant increase in erythema index at all the three time points after irradiation （all P > 0.05）; diclofenac 1% only inhibited the erythema induced by 1 MED of UV irradiation at 4 and 48 hours, with no difference observed in erythema index between the baseline and these time points after irradiation; however, halometasone significantly aggravated the erythema reaction （P < 0.05）. Neither NSAIDs nor corticosteroids applied immediately after solar-simulated irradiation showed statistical effect on the degree of UV-induced erythema. When applied immediately after irradiation using the phototherapy device, butyl flufenamate 2.5% ointment, butyl flufenamate 5% ointment and halometasone ointment all induced a significant reduction in erythema reaction at 4 hours after 1 MED of irradiation （all P < 0.05）, and diclofenac caused a statistical decrease in erythema reaction at all the time points after 1－3 MED of irradiation （all P < 0.05）. Conclusions Topical use of butyl flufenamate before UV irradiation can effectively inhibit erythema reaction induced by 1－3 MED of irradiation. When applied immediately after irradiation, diclofenac shows the strongest erythema-suppressive effect, followed sequentially by butyl flufenamate and halometasone. 【Key words】 Flufenamic acid; Glucocorticoids; Ultraviolet rays; Erythema

刘慧贤孙楠郭建美吴艳. 非甾体类抗炎药和糖皮质激素对紫外线诱导红斑的影响[J]. 中华皮肤科杂志, 2013, 46(6): 415-418.

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