Clinical Study Of "analing Lotion" Combined With Minocycline In The Treatment Of EGFRIs-related Moderate/severe Acne-like Rash

This thesis consists of two parts:a literature review and a clinical observation.The first part is the literature review.It is made up of two parts:One introduced the basic knowledge of epidermal growth factor receptor inhibitors(EGFRIs),including its relationship with efficacy.The author emphasises on the mechanism,incidence,pattern of manifestation,occurrence regularity,assessment and classification,pathology,Western medicine treatment,prevention and nursing of the EGFRIs related dermatologic toxicities.The other discussed traditional Chinese medicine's understanding and treatment methods and other related aspects regarding to this side effect.The second part is a clinical research.Objective:To observe the clinical effects and the safety of Zhiyang Pingfu decoction combine with minocycline in treating EGFRIs associated grade 2-3 skin toxicities,and observe the dosage of minocycline.Methods:30 malignant tumors patients,confirmed by pathology or cytology diagnosis,had 2-3 degrees of papulopustular rash adverse reactions after using EGFRIs were randomly divided into the treatment group and the control group.The treatment group was treated externally with Zhiyang Pingfu decoction for 2 weeks,and given minocycline(100 mg twice per day);the control group was treated externally with urea decotion for 2 weeks,and given minocycline(100 mg twice per day).When the rash ease to mild or appears not tolerate side effects of minocycline(such as gastrointestinal side effects,liver and kidney impairment,vestibular toxicity,allergies,etc),minocycline can be discontinued.7 days was a course of treatment and each case was evaluated after that,each was observed for level changing of papulopustular rash and the other skin side effects after treatment,the dosage of minocycline,the relieving time and effective percentage as well.Moreover,compare the treatment group with the control group,all data was analyzed by paired Wilcoxon rank sum test and paired t-test of SPSS 20.0 statistical software.Results:The total effective percentage of "Zhiyang Pingfu decoction" combine with minocycline was 93.33%.The results showed that "Zhiyang Pingfu decoction" combine with minocycline had significant efficacy to grade 2-3 papulopustular rash,skin dryness,itching and paronychia(p<0.05).The shortest time of symptoms relieving was day and the longest was 9 days,and it has an average of 3.67±2.05 days and the mid-time is 3 days.It was obviously shorter than the control group(p<0.01),and can significantly reduce the dosage of miniocycline(p<0.001),at lease 100mg,and the most was 1400mg,and it has an average of 700±335mg and the mid-dose is 600mg.Its efficacy for treating grade 2-3 papulopustular rash,skin dryness,itching was better than urea cream(p<0.05),while efficacy for treating paronychia is no significantly different from the control group.Conclusion:"Zhiyang Pingfu decoction"combine with minocycline had much better effects on EGFRIs associated grade 2-3 papulopustular rash and effected significantly quicker than minocycline alone,and can significantly reduce the dosage of miniocycline.Allergic reactions and other adverse reactions in the clinical course of the study were not found.Furthermore,it is easy and convenient to use and has good patient compliance.Therefore,it is worthy of clinical application widely.