Taheri Arash, Cantrell Jacob, Feldman Steven R
Department of Dermatology, Wake Forest School of Medicine, 4618 Country Club Road, Winston-Salem, NC 27104, USA.
Dermatol Online J. 2013 Jul 14;19(7):18954.
Common belief holds that as topical glucocorticoids are used over time the less effective they become, a phenomenon called tolerance or tachyphylaxis.
To determine what evidence supports the concept of tachyphylaxis to glucocorticoids.
We searched Medline and Google Scholar for articles on tachyphylaxis to glucocorticoids published through October 2012.
Rapid tolerance, tachyphylaxis, to non-clinical effects of glucocorticoids has been reported in literature. However, clinically significant tolerance to topical glucocorticoids has not been identified in clinical trials. We did not identify any evidence that clinical efficacy of glucocorticoids in inflammatory skin diseases significantly diminishes during long term continuous use.
Tachyphylaxis or tolerance to clinical effects of topical glucocorticoids in inflammatory skin diseases is not fully characterized or well studied.
Based on available data in literature, there is no clinical trial supporting the concept that topical glucocorticoids lose effectiveness over time, nor that intermittent use of topical glucocorticoids is more effective than continuous use.
普遍认为，随着局部糖皮质激素使用时间的延长，其效果会越来越差，这种现象称为耐受或快速耐受。
确定有哪些证据支持糖皮质激素快速耐受的概念。
我们检索了Medline和谷歌学术，查找截至2012年10月发表的关于糖皮质激素快速耐受的文章。
文献报道了糖皮质激素非临床效应的快速耐受，即快速耐受。然而，临床试验中尚未发现对局部糖皮质激素有临床意义的耐受。我们未找到任何证据表明糖皮质激素在炎症性皮肤病中的临床疗效在长期连续使用期间会显著降低。
炎症性皮肤病中局部糖皮质激素临床效应的快速耐受或耐受尚未得到充分表征或深入研究。
根据文献中的现有数据，没有临床试验支持局部糖皮质激素会随着时间推移而失去效力这一概念，也没有支持局部糖皮质激素间歇使用比连续使用更有效的观点。
