Research On Bacteriology Of Eczema And The Clinical Efficacy Of Triamcinolone Acetonide Econazole Cream On Eczema

Part one Research on bacteriology of eczemaObjective:Through the identification and culture of bacteria from the skin lesions,edges of eczema skin lesions,and the skin of healthy people,to identify the distribution of bacteria in eczema of different stages,to provide theoretical basis for the rational use of antibiotics for eczema.We also took the drug sensitivity test for detected bacteria for guiding medicine use clinically.Methods:According to the clinical manifestations,360 patients with eczema were divided into three groups:acute,subacute and chronic,there are 120 patients in each group.Another 120 patients without skin disease were selected as healthy control group.Wiped each area with a sterile cotton swab(wetted with sterile saline solution)of each selected patient,then wiped the affected area and the edges with a dry sterile swab.Secretions,exudates and other substances were inoculated into the goat blood culture dishes under aseptic conditions.Finally,drug sensitivity test were taken by automately assay.Results:1.Results of bacteria culture:Among these bacteria,219 strains of Staphylococcus aureus,38 Staphylococcus epidermidis,8 Staphylococcus haemolytica,2 staphylococcus schleiferi,7 Acinetobacter,8 Klebsiella pneumoniae,8 E.coli,mainly Staphylococcus aureus.the main bacteria are Staphylococcus aureus.2.Bacteria distribution in the drawn area:The total bacteria detection rate in the skin lesion of acute eczema was 82.50%,which was higher than that in subacute phase 68.33%and chronic phase 35%.There was statistical significance between three phases(P<0.05),the bacteria detection rates in skin lesions were higher than those of the edges lesions and the healthy skin(P<0.05).The rate of Staphylococcus aureus in acute phase was 68.33%,which was higher than that in subacute phase 54.17%,chronic phase 26.67%,there was no statistical significance(P>0.05).3.Drug sensitivity test results:S.aureus was very sensitive to vancomycin,rifampicin and nitrofurantoin,the rate was 100%.Staphylococcus epidermidis was also sensitive to rifampicin,it was also 100%,they were not sensitive to erythromycin,the rate were 25.57%and 47.37%,respectively.Conclusion:There were bacteria in acute,subacute and chronic eczema.The bacteria in acute eczema was higher than that in subacute and chronic phase.The bacteria were mainly S.aureus,and it was most sensitive to vancomycin,rifampicin and nitrofurantoin.Part two The clinical efficacy of triamcinolone acetonide econazole cream on eczemaObjective:To observe the distribution of bacteria before and after treatment of acute,subacute and chronic eczema with triamcinolone acetonide econazole cream(Pevisone);the improvement of the clinical severity,the efficiency and the incidence of adverse reactions.Methods:Acute eczema patients were randomly divided into experimental group A(Pevisone plus Bactroban,mupirocin ointment),experimental B group(Pevisone),experimental C group(Bactroban)and control group(saline);subacute eczema patients were divided into experimental group A(Pevisone plus Bactroban),experimental B group(Pevisone),experimental group C(Bactroban)and control group(Yuze skin barrier repair body lotion);chronic eczema patients were divided into experimental group A(Compound Flumetasone Ointment,Orsalin Ointment),experimental group B(Pevisone),experimental C group(Bactroban)and control group(Yuze body lotion).each group have 30 patients.We observed and recorded the bacteria distribution,clinical severity,clinical efficacy and side effects after treatment 1 week and 2 weeks respectively.Results:1.Distribution of bacteria before and after treatment:The rate of bacteria in each stage was decreased after one week and two weeks treatment,the rates of bacteria in three experimental groups was significantly lower than that in control group,and the differences were statistically significant.(P all<0.05).2.Clinical severity before and after treatment:After 1 week,the clinical severity in the acute,subacute eczema were all improved in Pevisone plus Bactroban group and Pevisone group after treatment,there was no statistical significance between these two groups(P>0.05).The clinical severity in chronic eczema were improved in the Pevisone group and the Orsalin Ointment group after treatment,the difference of efficacy was no statistical significance(P>0.05).After 2 weeks,the clinical severity in acute,subacute eczema decreased further in Pevisone combined with Bactroban group and Pevisone group,but there was no significant difference between these two groups(P>0.05);in chronic eczema group,the clinical severity were further decreased in the Pevisone group and the Orsalin Ointment group,there was no significant difference between these two groups(P>0.05).In control group(Yuze body lotion group),the clinical severity in the subacute and chronic eczema were improved after treatment.and have statistical significance(P=0.029,P=0.028,all<0.05).3.Treatment efficiency:The results showed that after 2 weeks,the efficiency of each group was higher than 1 week.After 2 weeks,the efficiency of the acute and subacute phases were 96.67%in Pevisone plus Bactroban group,which was higher than that in the Pevisone group(the efficiency were both 86.67%),there was no significant difference between them(P>0.05).The efficiency of chronic phase in Orsalin Ointment group was 90.00%,higher than that in Pevisone group(the efficiency was 83.33%),and there was no significant difference between these groups(P>0.05).4.Adverse reactions:There was no obvious adverse reactions in each group.Conclusion:In acute and subacute eczema,Pevisone combined with Bactroban and Pevisone can reduce the bacteria significantly;both methods can improve efficiency,they all have higher efficiency;in chronic eczema,both Pevisone and Orsalin Ointment can reduce the bacteria,and they have the similar efficacy.