Observation Of The Therapeutic Effect Of Oral Tranilast On Multiple Keloids

Objective To investigate the efficacy and safety of oral tranilast in the treatment of multiple keloids and provide a reference for the systematic treatment of keloid.Methods 40 patients with keloids were screened according to the inclusion criteria and exclusion criteria in the Affiliated Hospital of Nantong University from September 2021 to June 2022.Tranilast Capsules were orally administered to all patients on the day of enrollment and treatment.Three observation time points were set during the whole treatment process,the start of treatment(T0),3 months of treatment(T3M)and 6 months of treatment(T6M),and the changes of evaluation indicators at each observation point before and after treatment were compared.The appearance of keloids and the patients ’feelings were evaluated with the Bidirectional Scar Subjective Assessment Scale(POSAS).The evaluation indexes of daily life quality included Pittsburgh Sleep Quality Index(PSQI)and Dermatology Life Quality Inventory(DLQI).Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)were used to evaluate the emotional status of patients.Meanwhile,the side effects occurred during the treatment were also recorded.Results 1.In the POSAS score scale,the item with the highest score in both PSAS(patient scar assessment scale)and OSAS(observer scar assessment scale)at baseline for scar appearance was color.The total scores of PSAS and OSAS and other indexes decreased significantly(P<0.05).During the treatment,the decrease rate of PSAS was more significant than that of OSAS.The mean PSAS score decreased by25.99% from T0 to T3M,12.20% from T3M to T6 M,and 35.02% from T0 to T6 M.The mean OSAS score decreased by 17.36% from T0 to T3M,7.47% from T3M to T6 M,and 23.54% from T0 to T6 M.In terms of patient ’s self-perception,the pruritus was slightly higher than the pain score at baseline.The scores of the pruritus and the pain also had a significant downward trend during the treatment(P<0.05).The percent reduction in the mean pruritus score was 44.77%for T3M and 57.56%for T6M.The mean percentage reduction in pain was 48.68%for T3M and 61.18%for T6M.Pruritus scores remained slightly higher than pain scores at the end point of observation.2.The PSQI and DLQI scores of daily life quality were significantly improved(P<0.05).The mean PQSI decline rate was 35.42% from T0 to T3M,33.33% from T3M to T6 M,and 56.94% from T0 to T6 M.The mean DLQI reduction was 33.64% from T0 to T3M,54.93% from T3M to T6 M,and 70.09% from T0 to T6 M.3.As for the aspect of mood status,the score of SAS and SDS had a tendency to decrease obviously,the decrease rate of SAS was 9.37% in the first 3 months and 16.05% in the sixth month.The rate of decrease in SDS score was 8.55% in the first 3months and 15.52% in the sixth month.The negative emotions such as anxiety and depression were improved during the treatment(P<0.05).4.In terms of adverse reactions,during the treatment period,2 patients had gastrointestinal discomfort symptoms at the initial stage of administration,1 patient had mild dizziness,and 1 patient had transient liver function abnormality.The symptoms were improved without treatment.Conclusion Tranilast can effectively improve the appearance of scars in patients with multiple keloids,and reduce the subjective symptoms of pain and itching.At the same time,it can indirectly improve the sleep quality of patients,and can actively improve the quality of life of patients.Tranilast treatment can give patients confidence,reduce psychological burden,and relieve negative emotions such as anxiety and depression.