中华皮肤科杂志 ›› 2011, Vol. 44 ›› Issue (12): 885-887.

• 研究报道 • 上一篇    下一篇

0.1%他克莫司软膏不同疗程治疗面部糖皮质激素依赖性皮炎的临床观察

徐贤挺1,林小敏2,许洁1,金永真1,李秉煦3   

  1. 1. 浙江省温州市第二人民医院皮肤科
    2. 温州市第二人民医院皮肤科
    3. 温州医学院附属第一医院皮肤科
  • 收稿日期:2011-03-03 修回日期:2011-08-02 出版日期:2011-12-15 发布日期:2011-12-02
  • 通讯作者: 李秉煦 E-mail:Libinxu@126.com

Different courses of topical tacrolimus 0.1% ointment for facial corticosteroid-dependent dermatitis: a clinical observation

  • Received:2011-03-03 Revised:2011-08-02 Online:2011-12-15 Published:2011-12-02

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摘要：

目的 观察0.1%他克莫司软膏不同疗程治疗面部糖皮质激素依赖性皮炎的临床疗效、安全性以及治疗结束后的病情反跳情况。方法 将104例面部糖皮质激素依赖性皮炎患者随机分为3组，均给予0.1%他克莫司软膏外涂，每日2次，疗程分别为4周、8周、16周，比较3组的疗效。疗程结束后4周随访比较3组的反跳情况。结果 共90例患者完成临床研究，其中疗程4周组32例、疗程8周组29例、疗程16周组29例，总有效率分别为75.00%、82.76%及86.21%，3组间有效率差异无统计学意义。3组的反跳率分别为46.88%、41.38%及20.69%，疗程16周组与疗程4周组、疗程8周组比较，差异均有统计学意义；疗程4周组与疗程8周组比较，差异无统计学意义。31.73%患者局部有刺激反应，均发生在治疗第1周。结论 0.1%他克莫司软膏治疗面部糖皮质激素依赖性皮炎安全、有效，疗程延长，总有效率上升不明显，疗程4周即能获得明显而稳定的疗效。但疗程越长，治疗结束后的反跳率越低。

关键词: 他克莫司

Abstract:

Objective To evaluate the clinical efficacy and safety of different courses of topical tacrolimus 0.1% ointment in facial corticosteroid-dependent dermatitis and to observe the rebound in patients after treatment with these regimens. Methods A total of 104 patients with facial corticosteroid-dependent dermatitis were randomly divided into 3 groups to be treated with topical tacrolimus 0.1% ointment twice daily for 4, 8 and 16 weeks respectively. The patients were followed up every 2 weeks within the early 4 weeks of treatment and every 4 weeks thereafter. The rebound phenomena was observed in patients on week 4 after the withdrawal of tacrolimus. Results Finally, 90 patients completed this trial, including 32 patients in the 4-week group, 29 patients in the 8-week group and 29 patients in the 16-week group. No significant differences were observed between the 4-, 8- and 16-week groups in the total reponse rate （75.00%, 82.76%, 86.21%, respectively, ?字2 =1.35, P > 0.05）. The rebound rate in the 16-week group significantly differed from that in the 4- and 8-week group （20.69% vs. 46.88% and 41.38%, both P < 0.05）, while no statistical difference was noted between the 4- and 8-week groups. Local burning and itching were reported in 31.73% of these patients, and all of these irritant reactions occurred within the first week of treatment. Conclusions Topical tacrolimus 0.1% ointment is safe and effective for the treatment of facial corticosteroid-dependent dermatitis. The total response rate does not increase with the extended treatment course, and 4 weeks of treatment is enough for the marked and stable improvement of facial corticosteroid-dependent dermatitis, but the rebound rate is likely to be reduced by extended treatment course.

Key words: Tacrolimus