Effect of umbilical patch of traditional Chinese medicine on atopic dermatitis in children and its influence on skin barrier function
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摘要:
目的 特应性皮炎(AD)目前尚缺乏特效治疗手段，常规治疗的效果有限。本研究探讨中药脐疗贴治疗儿童AD的效果及对皮肤屏障功能的影响。 方法 连续性选取2021年10月—2023年9月温州市中西医结合医院皮肤科收治的89例AD患儿，采用随机数表法分为治疗组(45例)和对照组(44例)。对照组给予吡美莫司乳膏和润肤剂常规治疗，治疗组在常规治疗基础上给予中药脐疗贴治疗，治疗4周后通过特应性皮炎积分指数(SCORAD)并计算症状积分下降指数(SSRI)评估疗效，并比较实验室指标[血清免疫球蛋白E(IgE)、外周血嗜酸性粒细胞计数(EOS)]、皮肤屏障功能[皮损角质层含水量、皮脂含量和经皮水分丢失(TEWL)]变化情况。 结果 治疗后2组SCORAD评分均较治疗前下降(P＜0.05)，且治疗组[(11.27±2.64)分vs.(14.01±3.45)分]低于对照组，SSRI[(53.92±12.79)% vs.(41.23±10.25)%]、总有效率[95.56%(43/45) vs. 79.55%(35/44)]均高于对照组，差异有统计学意义(P＜0.05)。治疗后2组血清IgE、外周血EOS和TEWL均较治疗前下降，皮损处角质层含水量、皮脂含量较治疗前升高(P＜0.05)，且治疗组血清IgE、外周血EOS和TEWL低于对照组，皮损处角质层含水量、皮脂含量高于对照组，差异有统计学意义(P＜0.05)。 结论 中药脐疗贴能有效缓解患儿AD症状和下调血清IgE、外周血EOS水平，改善皮肤屏障功能，增益临床疗效。 Abstract:Objective Atopic dermatitis (AD) currently lacks specific therapeutic means, and the effect of conventional treatment is limited. This study was to investigate the effect of umbilical patch on children with AD and its effect on skin barrier function. Methods A total of 89 children with AD admitted to the dermatology department of Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from October 2021 to September 2023 were randomly divided into treatment group and control group, 45 cases and 44 cases, respectively. The control group was given conventional treatment with pimeclimus cream and emollient, and the treatment group was given traditional Chinese medicine (TCM) umbilical patch on the basis of conventional treatment. After 4 weeks of treatment, the therapeutic effect was evaluated by SCORing atopic dermatitis (SCORAD) and symptom score reduction index (SSRI). The changes in laboratory indexes serum immunoglobulin E (IgE), peripheral blood eosinophil count (EOS), skin barrier function [cuticle water content, sebum content, and transcutaneous water loss (TEWL)] were compared. Results After treatment, the SCORAD score of both groups decreased compared with that before treatment (P < 0.05), and the treatment group [(11.27±2.64) points vs. (14.01±3.45) points] was lower than that of the control group. SSRI [(53.92±12.79) % vs. (41.23±10.25) %] and total effective rate [95.56% (43/45) vs. 79.55% (35/44)] were higher than those of the control group, the difference was statistically significant (P < 0.05). After treatment, serum IgE, peripheral blood EOS, and TEWL in both groups were decreased compared with that before treatment, and the corneum water content and sebum content in the skin lesions were increased compared with that before treatment (P < 0.05). Serum IgE, peripheral blood EOS, and TEWL in the skin lesions were lower than those in the control group, while the corneum water content and sebum content in the skin lesions were higher than those in the control group. The difference was statistically significant (P < 0.05). Conclusion TCM umbilical patch can effectively relieve the symptoms of AD, reduce the level of serum IgE and peripheral blood EOS, improve the skin barrier function, and enhance the clinical effect. -
表 1 2组AD患儿一般资料比较
Table 1. Comparison of general data between two groups of children with AD
组别 例数 性别
(男/女, 例)年龄
(x±s，岁)病程
(x±s，年)AD家族史
[例(%)]对照组 44 26/18 4.73±1.28 1.26±0.39 6(13.64) 治疗组 45 29/16 4.44±1.31 1.25±0.36 8(17.78) 统计量 0.270a 1.030b 0.126b 0.288a P值 0.603 0.306 0.900 0.592 注：a为χ2值，b为t值。 
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表 2 2组AD患儿SCORAD评分、SSRI比较(x±s)
Table 2. Comparison of SCORAD score and SSRI between two groups of children with AD (x±s)
组别 例数 SCORAD评分(分) SSRI(%) 治疗前 治疗后 对照组 44 23.84±4.49 14.01±3.45b 41.23±10.25 治疗组 45 24.46±5.06 11.27±2.64b 53.92±12.79 统计量 0.539a 4.273c 5.138a P值 0.617 0.002 ＜0.001 注：a为t值，c为F值; 与同组治疗前比较，bP＜0.05。
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表 3 2组AD患儿总有效率比较
Table 3. Comparison of total effective rates between two groups of children with AD
组别 例数 治愈
(例)显效
(例)好转
(例)无效
(例)总有效
[例(%)]对照组 44 1 12 22 9 35(79.55) 治疗组 45 5 18 20 2 43(95.56) 注：2组总有效率比较，χ2=5.265，P=0.022。
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表 4 2组AD患儿血清IgE、外周血EOS比较(x±s)
Table 4. Comparison of serum IgE and peripheral blood EOS between two groups of children with AD (x±s)
组别 例数 血清IgE(IU/mL) 外周血EOS(×106/L) 治疗前 治疗后 治疗前 治疗后 对照组 44 170.47±31.59 143.50±25.18b 387.02±82.01 331.54±66.12b 治疗组 45 172.13±34.60 124.65±20.37b 391.43±84.20 302.18±57.43b 统计量 0.236a 11.902c 0.250a 8.738c P值 0.814 ＜0.001 0.803 ＜0.001 注：a为t值，c为F值; 与同组治疗前比较，bP＜0.05。
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表 5 2组AD患儿皮损处角质层含水量、皮脂含量和TEWL比较(x±s)
Table 5. Comparison of cuticle water content, sebum content, and TEWL between two groups of children with AD (x±s)
组别 例数 角质层含水量(%) 皮脂含量(μg/cm2) TEWL(g/h·m2) 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 对照组 44 10.23±2.56 20.46±4.10b 76.40±5.85 94.21±7.30b 28.46±4.07 17.25±3.61b 治疗组 45 10.51±2.63 27.08±4.36b 76.29±6.02 102.46±7.95b 28.52±4.30 12.36±3.28b 统计量 0.509a 7.283c 0.087a 4.673c 0.068a 6.574c P值 0.612 ＜0.001 0.931 0.004 0.946 ＜0.001 注：a为t值，c为F值; 与同组治疗前比较，bP＜0.05。
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