| Hand Eczema(HE), as a common limitation of eczema, the incidence rate is increasing. The majority of patients of work-related, etiology and speci ficity of clinical manifestations, made it easy to recur, and hard to be cu red. The treatment is still a difficulty, currently, so more and more schola rs concerned about this disease as a relatively independent disease. Topic al corticosteroids are the most important treatment options together with optimized personal protection and skin care measures in long-term therap y. However, corticosteroids might induce side effects, such as atrophy, T herefore new treatment options for Hand Eczema are highly appreciated, bo th by patients and by physicians. Treatment of Chinese Medicine (especiall y topical drugs) for eczema has been had a long history,and gotten a good effect, with the development of modern medicine, there have been many mor e formulations.ObjectiveThis study (by observed changes in clinical symptoms) was to evaluat e the curative efficacy and the safety of Topicaling Bletila Striata Comp ound ointment combined with Triamcinolone Acetonide and Econazole Nitrate Cream in patients suffering from hand eczema keratosis. It was to provide the basis for further improvement of Chinese medicine formula, and to all eviate the symptoms of hand eczema keratosis and improve the quality of 1 ife of patients, to explore better methods of preventive measures and trea tment methods.Methods In this prospective randomized controlled single-blind study, we collected admissions of patients with Hand eczema keratosis of predominantly mild-to-moderate severity from June 2009 to February 2010 in the Dermatology of The Second Chinese Medicine Hospital of Guangdong Provincel. According to inclusion and exclusion criteria,80 selected patients were randomly divided into two groups,40 patients in treatment group and 40 patients in control group.The treatment group was conducted with the method of topicaling Triamcinolone Acetonide and Econazole Nitrate Cream combinded with Bletila Striata Compound Ointment after cleaning the hands twice a day. The control group was conducted with the method of topicaling Triamcinolone Acetonide and Econazole Nitrate Cream after cleaning the hands twice a day. Both groups were instructed the patients to pay attention to the hand skin care, and avoid contact with alkaline detergent and chemical products and any other items easily sensitized. All the patients need to Referral once a week a month for a course of treatment. The severity of Hand Eczema Keratosis was evaluated using the Hand Eczema Severity Index(HESCI),which is a scoring system for clinical assessment at the first visit and 4 weeks later after treatment, by which efficacy was evaluated.Meanwhile the adverse events were recorded for safety evaluation. All data were analysised by SPSS17.0 statistical software.Results38 cases in treatment group completed the whole course of treatment, while it were 39 cases in control group.1. After treatment, Comprehensive efficacy in the treatment group, compared with the control group, the cure rate of treatment group was 44.7%, and total effective rate was 92.1%, while the cure rate of control group was 17.9%, and total effective rate was 79.5%, which shows that the comprehensive efficacy of treatment group was higher than that of the control group. After statistical analysis, the difference was significant(P=0.005,<0.05).2. After treatment, Effect of reducing the area of lesion, compared with the control group,the cure rate of treatment group was 21.1%, and total effective rate was 78.9%, the cure rate of control group was 7.7%, and total effective rate was 46.2%, which shows that effect of reducing the area of lesion of treatment group was higher than that of the control group. After statistical analysis,the difference was significant(P=0.001,<0.05).3. Effect of relieve itching, after treatment of 4 weeks, both the treatment group and the control group were reduced significantly, the difference was significant (P<0.01)by statistical analysis, while the extent of decline in the treatment group is better than the control group, the difference was significant by the statistical analysis. (p=0.007, p<0.01)4. For the level of the clinical symptoms, the area of lesion, and the HESCI score, after treatment, both the treatment group and the control group, had a notable decreased, the statistical analysis showed that difference was significant (P<0.01), while the extents of decline were not the same, which the treatment group were all better than that of the control group, the differences were all significant by the statistical analysis(P<0.05). Adverse reactions:There were 2 patients in control group who had a partial mild burning sensation after 1 week's treatment.The symptom was transient and was disappeared soon without any treatment. Continuing medication, there was no similar adverse reactions of recur;There was no adverse reactions in the treatment group and none of the two groups had systemic adverse reactions.ConclusionsThe treatment of topicaling Bletila Striata Compound Ointment combined with Triamcinolone Acetonide and Econazole Nitrate Cream could obviously decreased the hand eczema severity index(HESCI) of patients with hand eczema keratosis, and could significantly relieve itching and reduce lesion area. The effects of the treatment group and the clinical indicators were all better than that of the control group topicaling Triamcinolone Acetonide and Econazole Nitrate Cream only. There was no obvious side effects in the study, and showed a good tolerability, So it was worthy to recommended in clinical application.
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