糖皮质激索与他克莫司软膏治疗成人特应性皮炎的不良反应对比分析［摘要］目的：比较糖皮质激素与他克莫司软膏治疗成人特应性皮炎(AD)发生不良反应的情况，评价二者治疗成人AD的安全性。方法：将100例成人AD患者随机分为糖皮质激素组和他克莫司软膏组，每组50例，分别给予外用糖皮质激索及他克莫司软膏治疗，观察并比较两组治疗成人AD的疗效及不良反应发生情况。结果：他克莫司软膏组总有效率高于糖皮质激素组(94.0%对78.0%,P<0.05),药物相关不良反应的发生率明显低于糖皮质激素组(24.0%对40.0%,PV0.01),主要不良反应为局部瘙痒、刺痛，程度轻，多可自行缓解；糖皮质激素纟fl不良反应多，程度重，主要是局部皮肤萎缩、类固醇性痙疮、多毛、激素性潮红、局部皮肤刺痛、烧灼感等，多需给予对症治疗。结论：他克莫司软膏治疗AD疗效好，不良反应少且轻，用药安全，值得临床推广使用。［关键词］特应性皮炎成人他克莫司软膏不良反应［中图分类号］R751［文献标识码］B［文章编号］1673-7210(2011)02(c)-104-03ComparativeanalysisofadversedrugreactionscausedbyGlucocorticoidandTacrolimusOintmentinthetreatmentofatopicdermatitisHUANGXiaolingl,LAIYonghuil,LINDudil,QlUZil,YANGChunyanl,DENGShiqing2,HUANGFuxinB仃・ShenzhenChronicDiseasePreventionandCureCenter,GuangdongProvince,Shenzhcn518020,China;2.GuangzhouPanyuTraditionalChineseMedicalHospital,GuangdongProvince,Guangzhou511400,China;3.FutianPeople'sHospitalofShenzhenCity,GuangdongProvince,Shenzhen518033,China)［Abstract］Objective:Tocomparetheadversedrugreactions(ADR)causedbyGlucocorticoid(GC)andTacrolimusOintmentinthetreatmentofatopicdermatitis(AD),andevaluatethesafetyofthetwodrugsinthetreatmentofADinclinic.Methods:Atotalof100patientswithadultADwererandomlydividedintoGCgroupandTacrolimusOintmentgroup,with50patientsineachgroup.PatientsinthetwogroupswererespectivelygivenGCandTacrolimusOintmentforexternaluse,andtheefficacyaswellastheoccurrenceofADRinthetwogroupswereobservedandcompared・Results:ThetotaleffectiverateofTacrolimusOintmentgroupwassignificantlyhigherthanthatoftheGCgroup(94.0%vs7&0%,P<0.05),theincidenceofdrug-relatedADRwasobviouslylowerthanthatofGCgroup(24.0%vs40.0%,PV0.01),andthemainADRwerelocalskinpruritusandprickingpain,alltheclinicalmanifesta/tionsofADRweremildandcouldberelievedwithoutspecialtreatment.GCgrouphadmoreandsevereclinicalmaniFestationsofADRthanthoseofTacrolimusOintmentgroup,themainADRwerelocaldermatrophia,steroiclacne,crinosity,steroid-inducedflush,localskinprickingpain,burningsensationandsoon,ondneededsymptomatictreatment.Conclusion:TacrolimusOintinenthasabetterefficacyinthetreatment,ofAD,theADRarelessandmild,themedicationissafeandisworthyofapplicationinclinic.［Keywords］Atopicdermatitis;AduIts;TacrolimusOintment;Adversedrugreaction特应性皮炎(alopicdermatitis,AD)又称为异位性皮炎或遗传过敏性皮炎，是一种以瘙痒为特征的慢性复发性、炎症性皮肤病［1］,可严重影响患者及其家庭的生活质量。目前AD的发病机制尚未完全明确，但具发病率在世界范围内有升高趋势⑵。忖前，夕卜用糖皮质激素是治疗AD最常用的有效方法Z—［3］,可快速有效地缓解症状和体征。然而，长期使用糖皮质激素可导致多种不良反应(adversedrugreaction,ADR),使得糖皮质激素治疗AD受到一定的限制。近来研究报道，新型免疫抑制剂他克莫司(Tacrolimus)治疗AD收到较好的疗效，且不良反应少［4］。木文旨在通过比较糖皮质激素与他克莫司软膏治疗成人AD发生不良反应的情况，评价二者治疗成人AD的安全性。1资料与方法1.1一般资料按入选标准选择100例成人AD患者，均表现为瘙痒、湿疹等而经临床确诊为AD。入选标准：①符合《中国特应性皮炎诊断和治疗指南》［1］中的诊断标准。②根据Rajka等［5］...