司库奇尤单抗联合紫草素对复发性中重度斑块型银屑病的疗效分析

Analysis on the curative effects of secukinumab combined with topical shikonin in the treatment of recurrent moderate-to-severe plaque psoriasis

目的分析司库奇尤单抗联合紫草素对复发性中重度斑块型银屑病患者免疫炎症指标及皮肤屏障功能的影响。方法选取我院2020年1月至2022年1月复发性中重度斑块型银屑病患者70例,根据随机数字表法分为观察组及对照组,每组35例。两组均接受常规治疗,对照组加用司库奇尤单抗,观察组加用司库奇尤单抗联合紫草素。两组持续治疗12周,评定疗效,记录不良反应发生情况,并分析治疗前后银屑病面积与严重程度指数(psoriasis area and severity index,PASI)、中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte ratio,NLR)、皮肤病生活质量指数(dermatological quality of life index,DLQI)、血清肿瘤坏死因子(tumor necrosis factor,TNF)-α、白介素(interleukin,IL)-17、IL-23水平、角质层含水量、皮脂含量变化。结果两组总有效率对比,观察组94.59%高于对照组74.29%(P<0.05);治疗后观察组PASI评分、DLQI评分及NLR低于对照组(P<0.05);与对照组比较,治疗后观察组角质层含水量、皮脂含量较高,血清TNF-α、IL-17、IL-23水平较低(P<0.05)。结论司库奇尤单抗联合外用紫草素治疗复发性中重度斑块型银屑病效果确切,能有效调节免疫炎症指标,改善皮肤屏障功能,缓解病情,提高患者生活质量,且安全性较高。

Objective To analyze the effects of secukinumab combined with topical shikonin on immune inflammatory indexes and skin barrier function in patients with recurrent moderate-to-severe plaque psoriasis.Methods A total of 70 patients with recurrent moderate-to-severe plaque psoriasis in our hospital from January 2020 to January 2022 were selected and divided into observation group and control group according to the random number table method,with 35 cases in each group.Both groups received conventional treatment,and the control group was added with secukinumab,and the observation group was added with secukinumab and shikonin.The two groups were treated continuously for 12 weeks,the curative effect was evaluated and the occurrence of adverse reactions were recorded.Changes in psoriasis area and severity index(PASI)score,neutrophil-to-lymphocyte ratio(NLR),dermatological quality of life index(DLQI)score,serum tumor necrosis factor(TNF)-α,interleukin(IL)-17,IL-23 levels,stratum corneum water content and sebum content before and after treatment were analyzed.Results The total effective rate of the observation group was 94.59%higher than that of the control group(74.29%),the difference was significant(P<0.05).After treatment,the PASI score,DLQI score and NLR of the observation group were lower than those of the control group(P<0.05).Compared with the control group,the water content and sebum content in the stratum corneum in the observation group were higher,and serum levels of TNF-α,IL-17 and IL-23 were lower(P<0.05).Conclusion Secukinumab combined with topical shikonin is effective in the treatment of recurrent moderate-to-severe plaque psoriasis.It can effectively regulate immune inflammatory indexes,improve skin barrier function,alleviate the disease condition,improve the quality of life of patients,and ensure the safety.