窄谱中波紫外线联合愈银方药浴治疗寻常型银屑病疗效观察

Clinical Efficacy of Narrow Band Ultraviolet Bin Combined with Yuyin Recipe in Treating Psoriasis Vulgaris

目的观察窄谱中波紫外线(NB-UVB)联合中药愈银方药浴治疗寻常型银屑病的临床疗效。方法将119例寻常型银屑病患者,采用信封法随机分为两组,治疗组(62例)采用NB-UVB联合愈银方药浴治疗,对照组(57例)单纯采用NB-UVB治疗,疗程均为8周,于治疗前和治疗后第2、4、6、8周进行银屑病皮损面积和严重性指数(PASI)评分,依据PASI评分下降率判定两组治疗效果,并观察NB-UVB累积剂量及不良反应。结果两组PASI评分与初诊比较,治疗第2、4、6、8周均有统计学意义(P<0·05)。治疗组、对照组的痊愈率分别为69·35%、24·56%,总有效率分别为96·77%、71·93%,经统计学处理两组疗效比较有统计学意义(χ2=27·755,P<0·01)。从第2周起PASI评分下降率治疗组与对照组比较,差异有统计学意义(P<0·01)。NB-UVB照射总剂量(J/cm2)治疗组(9·95±4·76)少于对照组(12·77±5·05),经统计学处理,两组差异有统计学意义(t=3·141,P<0·01)。治疗组和对照组的不良反应发生率分别为4·84%(3/62例)、31·58%(18/57例),差异亦有统计学意义(χ2=119,P<0·01)。结论NB-UVB联合中药药浴治疗银屑病,可以提高疗效,减少紫外线累积量,减轻紫外线照射的不良反应。

Objective To observe the clinical efficacy of narrow band ultraviolet bin （NB-UVB）combined with Yuyin Recipe （YYR） in treating psoriasis vulgaris （PV）. Methods One hundred and nineteen patients with PV were randomly assigned to 2 groups by envelop method, the 62 patients in the treated group were treated with NB-UVB and YYR bathing, and the 57 in the control group were treated with NB-UVB alone. The course of treatment for both groups was 8 weeks. PASI scoring was performed before treatment and at the 2nd, 4th, 6th and 8th week of treatment respectively, and the treatment effect was evaluated depending on the decreasing rate of PASI score. The accumulated dose and side-effect of NB-UVB applied was observed. Results The PASI scores in the treated group measured at various time points after treatment were significantly different to that of baseline （P 〈 0. 05）. The cure rate in the treated group and the control group was 69.35% and 24. 56% while the total effective rate in them 96. 77% and 71.93%, respectively, showing significant difference between the two groups （X^2 = 27. 755 ,P 〈0. 01 ）. The difference of PASI decreasing rate between groups showed statistical significant from the 4th week （P 〈0. 01 ）. The total dose of NB-UVB applied in the treated group （9.95±4. 76） was less than that in the control group （12. 77 ±5.05） with the difference of statistical significance （t =3. 141 ,P 〈0. 01 ）. The adverse reaction occurrence in them was 4. 84% （3/62） and 31.58% （18/57） respectively, also showing significant difference （X^2 = 119,P 〈0. 01）. Conclusion The combined use of TCM medicated bath with NB-UVB can enhance the curative effect, reduce the accumulated dosage and lessen the adverse reactions of ultraviolet radiation.