【目的】观察凉血除湿止痒散 （由大青叶、菊花、苦参、荆芥穗、花椒等组成） 外用治疗面部皮炎的临床疗效，分析其对患者皮肤屏障功能的影响。 【方法】将72例面部皮炎患者随机分为对照组和观察组，每组各36例。对照组给予外用氟芬那酸丁酯软膏和口服依巴斯汀片治疗，观察组在对照组的基础上联合凉血除湿止痒散外用冷湿敷治疗，疗程均为3周。观察2组患者治疗前后主、客观症状积分以及皮肤屏障功能指标的变化情况，评估2组患者的临床疗效和不良反应发生情况。【结果】（1） 疗效方面，治疗3周后，观察组的总有效率为75.00% （27/36） ，对照组为47.22% （17/36） ，组间比较，观察组的疗效明显优于对照组 （χ2 = 5.844，P＜0.05） 。 （2） 客观症状积分方面，治疗后，2组患者的红斑、炎性丘疹、脱屑、肿胀、皮损面积等各项客观症状积分均较治疗前明显降低 （P＜0.05） ，且观察组对红斑、炎性丘疹、皮损面积积分的降低幅度均明显优于对照组 （P＜0.05） ，而2组治疗后的脱屑、肿胀积分比较，差异均无统计学意义 （P＞0.05） 。 （3） 主观症状积分方面，治疗后，2组患者的瘙痒、灼热、刺痛、干燥/紧绷等各项主观症状积分均较治疗前明显降低 （P＜0.05） ，且观察组对各项主观症状积分的降低幅度均明显优于对照组 （P＜0.05） 。 （4） 皮肤屏障功能指标方面，治疗后，2组患者的经皮水分丢失量 （TEWL） 、pH值均较治疗前明显降低 （P＜0.05） ，皮肤角质层含水量 （SCH） 、角质层油脂量 （SEB） 均较治疗前明显升高 （P＜0.05） ，且观察组对TEWL、pH值的降低幅度及对SCH、SEB的升高幅度均明显优于对照组 （P＜0.05） 。 （5） 不良反应方面，治疗期间，2组患者均未发生严重不良反应，观察组的不良反应发生率为8.33% （3/36） ，对照组为5.66% （2/36） ，组间比较，差异无统计学意义 （χ2 = 0.215，P＞0.05） 。 【结论】凉血除湿止痒散外用冷湿敷治疗面部皮炎疗效确切，患者的主、客观症状均得到显著减轻，皮肤屏障功能得到显著改善，且不良反应少而轻。

Objective To observe the clinical efficacy of external application of Liangxue Chushi Zhiyang Powder （composed of Isatidis Folium，Chrysanthemi Flos，Sophorae Flavescentis Radix，Schizonepetae Spica，and Zanthoxyli Pericarpium，etc.） in the treatment of facial dermatitis，and to analyze its effect on skin barrier function of the patients. Methods Seventy-two patients with facial dermatitis were randomly divided into the control group and the observation group，with 36 cases in each group. The control group was treated with Butyl Flufenamic Ointment for external use and Ebastine Tablets orally， while the observation group was given cold and wet compress of Liangxue Chushi Zhiyang Powder on the basis of treatment for the control group. The course of treatment of both groups covered three weeks. Before and after the treatment，the changes of subjective and objective symptom scores as well as skin barrier function indicators of the two groups were observed. After treatment， the clinical efficacy and incidence of adverse reactions of the two groups were assessed. Results（1） After three weeks of treatment，the total effective rate of the observation group was 75.00% （27/36） ，and that of the control group was 47.22%（17/36）；the intergroup comparison showed that the therapeutic efficacy of the observation group was significantly superior to that of the control group （χ2 = 5.844，P＜0.05） . （2） After treatment，the scores of objective symptoms such as erythema，inflammatory papules，desquamation，swelling，and lesion area in the two groups were significantly decreased when compared with those before treatment （P＜0.05） ，and the decrease of the scores of erythema，inflammatory papules and lesion area in the observation group was significantly superior to that in the control group （P＜0.05） . The differences in the scores of desquamation and swelling between the two groups were not statistically significant （P＞0.05） . （3） After treatment，the scores of subjective symptoms such as itching， burning， stabbing pain， dryness/tightness of the skin in the two groups were significantly decreased when compared with those before treatment （P＜0.05） ，and the decrease of the scores of each subjective symptom in the observation group was significantly superior to that in the control group （P＜0.05） . （4） After treatment，the skin barrier function indicators such as trans-epidermal water loss （TEWL） and skin pH value of the two groups were significantly lowered（P＜0.05），and stratum corneum hydration （SCH） and sebum （SEB） content were significantly increased when compared with those before treatment （P＜0.05） . The decrease of TEWL and pH value as well as the increase of SCH and SEB content in the observation group was significantly superior to that in the control group （P＜0.05） . （5） During the treatment，no serious adverse reactions occurred in the two groups of patients. The incidence of adverse reactions in the observation group was 8.33% （3/36） ，and that in the control group was 5.66% （2/36），and the difference was not statistically significant （χ2 = 0.215，P＞0.05） . Conclusion The cold and wet compress of Liangxue Chushi Zhiyang Powder exerts certain efficacy in the treatment of facial dermatitis，which is effective on markedly relieving the subjective and objective symptoms of the patients，and improving the skin barrier function，with few and mild adverse reaction.

R275.9

深圳市“医疗卫生三名工程”广东省中医院禤国维国医大师皮肤研究团队资助项目 （编号：SZZYSM202106008）