复方甘草酸苷及阿维A联合NB-UVB治疗寻常型银屑病的疗效观察
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摘要
目的探讨复方甘草酸苷及阿维A联合窄谱中波紫外光(NB-UVB)治疗寻常型银屑病的临床疗效。方法 144例寻常型银屑病患者随机分为对照组和观察组,每组72例。2组患者均进行NB-UVB照射治疗,隔日1次。此外,对照组口服阿维A胶囊20～40 mg/d,观察组在对照组的基础上口服复方甘草酸苷片,3片/次,3次/d。2组患者均以8周为1个疗程。比较2组患者的临床疗效及不良反应情况。结果观察组临床疗效显著优于对照组(Z=2. 08,P <0. 05),总有效率显著高于对照组(χ~2=4. 21,P <0. 05)。2组患者PASI评分均显著下降(F时间=264. 17,P <0. 05),组间比较,观察组PASI评分显著低于对照组(F组别=31. 58,F时间×组别=7. 87,P <0. 05)。观察组丙氨酸氨基转移酶轻度升高患者显著少于对照组(χ~2=4. 14,P <0. 05),其他不良反应少于对照组,但差异无统计学意义(P <0. 05)。结论复方甘草酸苷及阿维A联合NB-UVB治疗寻常型银屑病安全有效,值得临床推广。
Objective To investigate the clinical efficacy of compound glycyrrhizin and acitretin A combined with narrow-spectrum midwave ultraviolet rays( NB-UVB) in treatment of psoriasis vulgaris. Methods A total of 144 patients with psoriasis vulgaris were randomly divided into control group( n = 72) and observation group( n = 72). The patients in both groups were treated by NB-UVB irradiation,once every other day. In addition the patients in control group were treated by oral acitretin A,20 ～ 40 mg/d,however,the patients in observation group,on the basis of control group,were treated by compound glycyrrhizin,3 tablets once,three times a day,with a treatment course of 8 weeks for both groups. The clinical efficacy and adverse reactions were observed and compared between the two groups. Results The therapeutic effects in observation group were superior to those in control group( P < 0. 05),and the effective rate was significantly higher than that in control group( P < 0. 05). The PASI scores in both groups were significantly decreased( P < 0. 05),moreover,the PASI scores in observation group were significantly lower than those in control group( P < 0. 05). The patients with mild elevation of GPT in observation group were significantly less than those in control group( P < 0. 05). In addition the other adverse reactions in observation group were less than those in control group,but there were no significant differences between two groups( P >0. 05). Conclusion The compound glycyrrhizin and acitretin A combined with NB-UVB are safe and effective in treating psoriasis vulgaris,thus,it is worthy of clinical promotion.
Objective To investigate the clinical efficacy of compound glycyrrhizin and acitretin A combined with narrow-spectrum midwave ultraviolet rays( NB-UVB) in treatment of psoriasis vulgaris. Methods A total of 144 patients with psoriasis vulgaris were randomly divided into control group( n = 72) and observation group( n = 72). The patients in both groups were treated by NB-UVB irradiation,once every other day. In addition the patients in control group were treated by oral acitretin A,20 ～ 40 mg/d,however,the patients in observation group,on the basis of control group,were treated by compound glycyrrhizin,3 tablets once,three times a day,with a treatment course of 8 weeks for both groups. The clinical efficacy and adverse reactions were observed and compared between the two groups. Results The therapeutic effects in observation group were superior to those in control group( P < 0. 05),and the effective rate was significantly higher than that in control group( P < 0. 05). The PASI scores in both groups were significantly decreased( P < 0. 05),moreover,the PASI scores in observation group were significantly lower than those in control group( P < 0. 05). The patients with mild elevation of GPT in observation group were significantly less than those in control group( P < 0. 05). In addition the other adverse reactions in observation group were less than those in control group,but there were no significant differences between two groups( P >0. 05). Conclusion The compound glycyrrhizin and acitretin A combined with NB-UVB are safe and effective in treating psoriasis vulgaris,thus,it is worthy of clinical promotion.
引文
1吕莉,陈敬.银屑病治疗的研究进展.河北医药,2017,39:3643-3647.
2侯文利,罗宝萍,曹文智.优质护理对红皮病型银屑病患者心理状态的影响.河北医药,2013,35:3509-3510.
3沈跃莉,叶俊儒.阿维A胶囊联合复方甘草酸苷片对寻常型银屑病患者症状的改善及安全性.医学综述,2016,22:3491-3493.
4罗丽敏,李军,刘劲松,等.复方甘草酸苷对寻常型银屑病患者血浆内皮素分泌的影响.检验医学与临床,2015,12:3542-3543.
5赵辨主编.中国临床皮肤病学.第1版.南京:江苏科学技术出版社,2010.1017.
6 Mattei PL,Corey KC,Kimball AB.Psoriasis Area Severity Index(PASI)and the Dermatology Life Quality Index(DLQI):the correlation between disease severity and psychological burden in patients treated with biological therapies.J Eur Acad Dermatol Venereol,2014,28:333-337.
7付曼妮,解翠林.复方甘草酸苷对寻常型银屑病的免疫调节作用以及临床疗效分析.中国中西医结合皮肤性病学杂志,2017,16:138-140.
8全国银屑病流行调查组.全国1984年银屑病流行调查报告.皮肤病与性病,1989,11:60-72.
9肖易,赵爽,赵越,等.942例早发与晚发银屑病患者的人口学与临床特征分析.中国医师杂志,2016,18:544-547,551.
10 Das S,Stuart PE,Ding J,et al.Fine mapping of eight psoriasis susceptibility loci.Eur J Hum Genet.2015,23:844-853.
11 Mitsui A,Tada Y,Shibata S,et al.Deficiency of both L-selectin and ICAM-1 exacerbates imiquimod-induced psoriasis-like skin inflammation through increased infiltration of antigen presenting cells.Clin Immunol,2015,157:43-55.
12 G9men Jülide Sedef,Sahiner N,Ko9ak M,et al.PCR investigation of panton-valentine leukocidin,enterotoxin,exfoliative toxin,and agr genes in Staphylococcus aureus strains isolated from psoriasis patients.Turk JMed Sci,2015,45:1345-1352.
13周宇,杨名,白新平,等.NB-UVB光疗联合自拟凉血止痒方剂煎煮药浴治疗寻常型银屑病疗效及对血液流变学的影响.现代中西医结合杂志,2017,26:3023-3026.
14中华医学会皮肤性病学分会.阿维A治疗银屑病专家共识(2017版).中华皮肤科杂志,2017,50:397-399.
15 Carretero G.Ribera M.Guidelines for the useof aeitretin in psoriasis.Psoriasis Group of the Spanish Academyof Dermatology and Venereology l Jj.Actas Dermosifiliogr,2013,104:598-616.
16 Milaniuk S,Pietrzak A,Mosiewicz B,et al.Influence of psoriasis on circulatory system function assessed in echocardiography.Arch Dermatol Res,2015,307:855-861.
2侯文利,罗宝萍,曹文智.优质护理对红皮病型银屑病患者心理状态的影响.河北医药,2013,35:3509-3510.
3沈跃莉,叶俊儒.阿维A胶囊联合复方甘草酸苷片对寻常型银屑病患者症状的改善及安全性.医学综述,2016,22:3491-3493.
4罗丽敏,李军,刘劲松,等.复方甘草酸苷对寻常型银屑病患者血浆内皮素分泌的影响.检验医学与临床,2015,12:3542-3543.
5赵辨主编.中国临床皮肤病学.第1版.南京:江苏科学技术出版社,2010.1017.
6 Mattei PL,Corey KC,Kimball AB.Psoriasis Area Severity Index(PASI)and the Dermatology Life Quality Index(DLQI):the correlation between disease severity and psychological burden in patients treated with biological therapies.J Eur Acad Dermatol Venereol,2014,28:333-337.
7付曼妮,解翠林.复方甘草酸苷对寻常型银屑病的免疫调节作用以及临床疗效分析.中国中西医结合皮肤性病学杂志,2017,16:138-140.
8全国银屑病流行调查组.全国1984年银屑病流行调查报告.皮肤病与性病,1989,11:60-72.
9肖易,赵爽,赵越,等.942例早发与晚发银屑病患者的人口学与临床特征分析.中国医师杂志,2016,18:544-547,551.
10 Das S,Stuart PE,Ding J,et al.Fine mapping of eight psoriasis susceptibility loci.Eur J Hum Genet.2015,23:844-853.
11 Mitsui A,Tada Y,Shibata S,et al.Deficiency of both L-selectin and ICAM-1 exacerbates imiquimod-induced psoriasis-like skin inflammation through increased infiltration of antigen presenting cells.Clin Immunol,2015,157:43-55.
12 G9men Jülide Sedef,Sahiner N,Ko9ak M,et al.PCR investigation of panton-valentine leukocidin,enterotoxin,exfoliative toxin,and agr genes in Staphylococcus aureus strains isolated from psoriasis patients.Turk JMed Sci,2015,45:1345-1352.
13周宇,杨名,白新平,等.NB-UVB光疗联合自拟凉血止痒方剂煎煮药浴治疗寻常型银屑病疗效及对血液流变学的影响.现代中西医结合杂志,2017,26:3023-3026.
14中华医学会皮肤性病学分会.阿维A治疗银屑病专家共识(2017版).中华皮肤科杂志,2017,50:397-399.
15 Carretero G.Ribera M.Guidelines for the useof aeitretin in psoriasis.Psoriasis Group of the Spanish Academyof Dermatology and Venereology l Jj.Actas Dermosifiliogr,2013,104:598-616.
16 Milaniuk S,Pietrzak A,Mosiewicz B,et al.Influence of psoriasis on circulatory system function assessed in echocardiography.Arch Dermatol Res,2015,307:855-861.