甲氨喋呤与阿维A治疗头部牛皮癣疗效观察

Effect of methotrexate and avermectin A on head psoriasis

目的探讨甲氨喋呤与阿维A在治疗头部牛皮癣疗效比较。方法 126例患者随机分为两组,甲氨喋呤组72例,阿维A组54例。甲氨喋呤组用量每次100～200mg静滴;阿维A初始剂量为20～40mg/d,起效后减至维持量10～30mg/d,疗程12周;外用药两组均以去炎松尿素霜为主。结果甲氨喋呤组有效66例,有效率91.6%,阿维A组有效42例,有效率77.8%,但组间差异无显著性(χ2=1.62,P>0.05);治疗4周和8周后甲氨喋呤组PASI评分明显低于阿维A组,组间差异有极显著性(P<0.001);治疗12周后PASI评分组间差异有显著性(P<0.05)。甲氨喋呤组总体疗效优于阿维A组。阿维A组副作用明显大于甲氨喋呤组。结论甲氨喋呤治疗头部牛皮癣疗效显著,副作用小,价格低廉,值得推广。

Aim To ovserve the effect of methotrexate and avermectin A on head psoriasis. Methods There 126 patients were randomly divided into two groups, the methotrexate group consisted of 72 cases and the avermectin A group consisted of 54 eases. Methotrexate with doses of 100-200rag was intravenously given to patients in methotrexate group; Avey with an initial dosage of 20-40mg/d and then increased to a maintenance dose of 10-30mg/d after therapeutic effect was observed,the treatment course 12 weeks. In addition,External drugs,mairdy triameinolone were also given to both groups. Results The effective rates in methotrexate and avermectin group were 91.6%（66/72）and 77.8%（42/54）without showing significant differences between the two groups（χ2=1.62,P〉0.05）. But the PASI grading in methotrexate group 4 and 8 weeks after treatment was significantly lower than that of the avermectin group （P〈0.001）. There significant differences were also noticed in PASI grading between the two groups 12 weeks after treatment （P〈0.05）. The side effects in methotrexate group was lighter than that of the avermectin group. Conclusion Methotrexate is worthy to be used for clinical treatment of psoriasis with high efllcacy,light side effects and low price.