Abstract:

Objective　To explore the effect of human-like collagen repair dressings combined with dupilumab for children with moderate to severe atopic dermatitis. Methods　One hundred and sixteen children with moderate to severe atopic dermatitis treated at Northwest Women's and Children's Hospital from February 2021 to August 2023 were selected for the randomized controlled trial, and were divided into a control group and an experimental group by lottery, with 58 cases in each group. There were 29 males and 29 females in the control group; they were (5.78±2.34) years old. There were 29 males and 29 females in the experimental group; they were (5.82±2.28) years old. The control group were treated with dupilumab, while the experimental group with human-like collagen repair dressings and dupilumab. The treatment efficacies, symptom improvement (skin dryness, itching, and skin lesions), skin barrier function [sebum content, moisture content, and transepidermal water loss (TEWL)], scores of Scoring Atopic Dermatitis (SCORAD), scores of Investigator's Global Assessment (IGA), scores of Eczema Area and Severity Index (EASI), and quality of life [Children's Dermatology Life Quality Index (CDLQI) and Infant Dermatitis Quality of Life Index (IDQOL)] were compared between the two groups using t and χ² tests. Results　The overall treatment efficacy in the experimental group was higher than that in the control group [96.55% (56/58) vs. 81.03% (47/58)], with a statistical difference (χ²=7.017; P=0.008). The improvement times for skin dryness, itchiness, and lesions in the experimental group were shorter than those in the control group [(5.56±1.77) d vs. (7.06±2.16) d, (10.56±2.73) d vs. (12.09±2.16) d, and (7.58±2.06) d vs. (10.73±2.27) d], with statistical differences (t=4.091, 3.347, and 7.826; all P<0.05).After the treatment, the sebum content, hydration level, and TEWL in the experimental group were better than those in the control group [(84.22±12.24) μg/cm² vs. (65.47±10.31) μg/cm², (46.35±8.17)% vs. (37.40±7.75)%, (15.87±2.14) g/(h·cm²) vs. (19.76±2.94) g/(h·cm²)], with statistical differences (t=8.923, 6.053, and 8.147; all P<0.05). After the treatment, the scores of SCORAD, IGA, EASI, CDLQI, and IDQOL in the experimental group were lower than those in the control group (18.52±7.98 vs. 23.12±8.49, 1.53±0.74 vs. 2.02±0.61, 5.75±0.94 vs. 7.92±1.26, 3.92±0.53 vs. 9.19±1.31, and 4.68±0.37 vs. 8.83±1.26), with statistical differences (t=3.007, 3.891, 10.513, 28.401, and 24.067; all P<0.05). Conclusion　Human-like collagen repair dressings combined with dupilumab for children with moderate to severe atopic dermatitis can improve their skin symptoms, barrier function, and life quality, and reduce relevant scores.

Key words:

Atopic dermatitis, Human-like collagen repair dressings, Dupilumab, Effect

摘要：

目的　探讨类人胶原蛋白修复敷料联合度普利尤单抗治疗中重度特应性皮炎患儿的效果。方法　选取2021年2月至2023年8月西北妇女儿童医院收治的116例中重度特应性皮炎患儿进行随机对照试验。采用抽签法将其分为对照组和试验组，各58例。对照组男29例，女29例，年龄（5.78±2.34）岁。试验组男29例，女29例，年龄（5.82±2.28）岁。对照组度普利尤单抗治疗，试验组类人胶原蛋白修复敷料联合度普利尤单抗治疗。比较两组疗效、症状改善状况（皮肤干燥、皮肤瘙痒、皮损）、皮肤屏障状况［皮脂含量、含水量、经表皮水份丢失（transepidermal water loss，TEWL）］、特应性皮炎量表（Scoring Atopic Dermatitis，SCORAD）评分、研究者整体（Investigator's Global Assessment，IGA）评分、湿疹面积及严重度指数（Eczema Area and Severity Index，EASI）评分、生活质量［儿童皮肤病生活质量指数（Children's Dermatology Life Quality Index，CDLQI）、婴儿皮炎生活质量指数（Infant Dermatitis Quality of Life Index，IDQOL）］。采用t检验、χ²检验进行统计分析。结果　试验组总有效率高于对照组［96.55%（56/58）比81.03%（47/58）］，差异有统计学意义（χ²=7.017，P=0.008）。试验组皮肤干燥、皮肤瘙痒、皮损改善时间均短于对照组［（5.56±1.77）d比（7.06±2.16）d、（10.56±2.73）d比（12.09±2.16）d、（7.58±2.06）d比（10.73±2.27）d］，差异均有统计学意义（t=4.091、3.347、7.826，均P<0.05）。治疗后，试验组皮脂含量、含水量均高于对照组［（84.22±12.24）μg/cm²比（65.47±10.31）μg/cm²、（46.35±8.17）%比（37.40±7.75）%］，TEWL低于对照组［（15.87±2.14）g/（h·cm²）比（19.76±2.94）g/（h·cm²）］，差异均有统计学意义（t=8.923、6.053、8.147，均P<0.05）。治疗后，试验组SCORAD、IGA、EASI评分均低于对照组［（18.52±7.98）分比（23.12±8.49）分、（1.53±0.74）分比（2.02±0.61）分、（5.75±0.94）分比（7.92±1.26）分］，差异均有统计学意义（t=3.007、3.891、10.513，均P<0.05）。治疗后，试验组CDLQI、IDQOL评分均低于对照组［（3.92±0.53）分比（9.19±1.31）分、（4.68±0.37）分比（8.83±1.26）分］，差异均有统计学意义（t=28.401、24.067，均P<0.05）。结论　类人胶原蛋白修复敷料联合度普利尤单抗治疗中重度特应性皮炎患儿能改善其皮肤症状和皮肤屏障功能，降低相关评分，并提高患儿生活质量。

关键词:

特应性皮炎, 类人胶原蛋白修复敷料, 度普利尤单抗, 效果