中国麻风皮肤病杂志 ›› 2025, Vol. 41 ›› Issue (12): 876-881.doi: 10.12144/zgmfskin202512876

• 论著 • 上一篇    下一篇

甘肃省特应性皮炎诊疗现状研究

卢艳芳1,摆荟1,石春蕊2   

  1. 1兰州大学第一临床医学院，甘肃兰州，730000；2兰州大学第一医院皮肤科，甘肃兰州，730000
  • 出版日期:2025-12-15 发布日期:2025-11-28

Current situation of atopic dermatitis diagnosis and treatment in Gansu Province

LU Yanfang1, BAI Hui1, SHI Chunrui2   

  1. 1 The First Clinical Medical College of Lanzhou University, Lanzhou 730000, China; 2 Department of Dermatology, The First Hospital of Lanzhou University, Lanzhou 730000, China
  • Online:2025-12-15 Published:2025-11-28

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摘要： 目的：调查分析甘肃省特应性皮炎（atopic dermatitis,AD）的诊疗现状。方法：线上向甘肃省内十四个地州市的皮肤科医生发放调查问卷，采用 SPSS 29.0统计软件进行数据分析。结果：共308名皮肤科医生参与问卷调查。青年/成人AD最常用的诊断标准为张氏标准（52.9%），婴儿/儿童AD最常用的为姚氏标准（57.5%）；22.7%的医生认为AD与湿疹是同一疾病；治疗前未进行严重程度评估的医生占20.8%；24%的医生不了解治疗AD的新型药物（磷酸二酯酶-4抑制剂、生物制剂、JAK抑制剂）；56.8%、47.4%、31.2%的医生所在地区分别无法获取外用磷酸二酯酶4（PDE-4）抑制剂、口服JAK抑制剂及生物制剂，19.2%的医生所在地区以上药物均不能获取；婴儿、儿童/特殊部位（如褶皱和面颈部等薄嫩部位）轻中度AD最常用的外用药物为钙调磷酸酶抑制剂（TCI，40.6%/53.2%）；青年、成人/老年人轻中度AD最常用的外用药物为糖皮质激素（TCS，56.2%/54.9%）；系统治疗方面，轻中度AD最常用抗组胺药（79.9%）；中重度AD急性期最常用糖皮质激素（71.1%），非急性期最常用生物制剂（37.3%）。结论：我省大部分皮肤科医生对AD诊断标准的选择符合国内指南推荐，但存在湿疹与特应性皮炎鉴别困难、治疗前未进行严重程度评估及新型药物可及性较差与治疗欠规范等问题。

关键词: 特应性皮炎, 诊疗现状, 甘肃省

Abstract: Objective: To investigate and analyze the diagnosis and treatment status of atopic dermatitis in Gansu Province. Methods: An online survey questionnaire was distributed to dermatologists within the province, and data analysis was conducted using SPSS 29.0. Results: A total of 308 dermatologists participated in the survey. The most commonly used diagnostic criteria for adult/young adult AD were the Zhang criteria, while the Yao criteria were most frequently applied for infantile/childhood AD. 22.7% of the physicians considered AD to be the same disease as eczema. 20.8% of the doctors did not perform severity assessment before treatment. 24% of the respondents were unaware of the new types of drugs for AD treatment (PDE-4 inhibitors, biologics, and JAK inhibitors). In terms of drug availability, 56.8%, 47.4%, and 31.2% of the physicians reported that topical PDE-4 inhibitors, oral JAK inhibitors, and biologics, respectively, were not accessible in their regions. 19.2% of the doctors stated that none of the aforementioned new drugs were available in their areas. Regarding topical medication selection, calcineurin inhibitors (TCIs) were the most commonly used topical agents for mild-to-moderate AD in infants (40.6%) and in children/special sites (such as flexures and thin-skinned areas like the face and neck) (53.2%). For mild-to-moderate AD in young adults, adults, and the elderly, topical corticosteroids (TCS) were the most frequently used (56.2% and 54.9%, respectively). In systemic treatment, antihistamines were the most commonly used for mild-to-moderate AD (79.9%). For moderate-to-severe AD, corticosteroids were the most frequently used during acute phases (71.1%), while biologics were the most commonly used during non-acute phases (37.3%). Conclusion: The majority of dermatologists in our province comply with the domestic guidelines in the selection of diagnostic criteria for AD. However, there are issues such as difficulty in differentiating eczema from AD, lack of severity assessment before treatment, and poor accessibility and standardized use of new drugs.

Key words: atopic dermatitis, current situation of diagnosis and treatment, Gansu Province