Al-Ghnaniem R, Short K, Pullen A, Fuller L C, Rennie J A, Leather A J M
Department of Surgery, King's College Hospital, Denmark Hill, London, SE5 9RS, UK.
Department of Dermatology, King's College Hospital, London, UK.
Int J Colorectal Dis. 2007 Dec;22(12):1463. doi: 10.1007/s00384-007-0325-8. Epub 2007 May 30.
Pruritus ani (PA) is a common condition which is difficult to treat in the absence of obvious predisposing factors. There is paucity of evidence-based guidelines on the treatment of this condition. We examined whether 1% hydrocortisone ointment is an effective treatment for PA.
A pilot randomized, double-blind, placebo-controlled, crossover trial was carried out. Eleven patients consented to take part in the trial and ten completed the study. After a 2-week run-in period, patients with primary PA were randomly allocated to receive 1% hydrocortisone ointment or placebo for 2 weeks followed by the opposite treatment for a further 2-week period. There was a washout period of 2 weeks between treatments. The primary outcome measure was reduction in itch using a visual analogue score (VAS). The secondary outcome measures were improvement in quality of life measured using a validated questionnaire (Dermatology Life Quality Index, DLQI) and improvement in clinical appearance of the perianal skin using the Eczema Area and Severity Index (EASI) score.
Treatment with 1% hydrocortisone ointment resulted in a 68% reduction in VAS compared with placebo (P=0.019), a 75% reduction in DLQI score (P=0.067), and 81% reduction in EASI score (P=0.01).
A short course of mild steroid ointment is an effective treatment for PA.
肛门瘙痒症（PA）是一种常见病症，在缺乏明显诱发因素的情况下难以治疗。关于该病症的治疗，循证指南较少。我们研究了1%氢化可的松软膏是否是治疗PA的有效方法。
开展了一项先导性随机、双盲、安慰剂对照、交叉试验。11名患者同意参加试验，10名完成了研究。在为期2周的导入期后，原发性PA患者被随机分配接受1%氢化可的松软膏或安慰剂治疗2周，随后接受相反治疗再持续2周。治疗之间有2周的洗脱期。主要结局指标是使用视觉模拟评分（VAS）评估瘙痒程度的降低情况。次要结局指标是使用经过验证的问卷（皮肤病生活质量指数，DLQI）评估生活质量的改善情况，以及使用湿疹面积和严重程度指数（EASI）评分评估肛周皮肤外观的改善情况。
与安慰剂相比，1%氢化可的松软膏治疗使VAS降低了68%（P = 0.019），DLQI评分降低了75%（P = 0.067），EASI评分降低了81%（P = 0.01）。
短期使用轻度类固醇软膏是治疗PA的有效方法。
