雷公藤多苷片联合他扎罗汀治疗寻常型银屑病58例

Effect of Tripterygium Wilfordii Tablets Combined Tazarotene in the Treatment of 58 Cases of Psoriasis Vulgaris

目的:观察雷公藤多苷片联合他扎罗汀治疗寻常型银屑病的的临床疗效。方法:将116例寻常性银屑病患者随机分为观察组、对照组,每组58例。两组均外用他卡西醇软膏,2次/d;0.05%他扎罗汀凝胶,每日1次,睡前外用。观察组在对照组治疗的基础上口服雷公藤多苷片30 mg,每日3次。两组均以治疗4周为1个疗程,治疗3个疗程后观察临床疗效及治疗前后肿瘤坏死因子-α(TNF-α)、促血管内皮生成素(VEGF)、白介素-18(IL-18)水平及皮肤干燥、瘙痒、红斑、灼痛等不良反应的发生情况。结果:观察组基本痊愈率为51.72%,总有效率94.83%;对照组基本痊愈率37.93%,总有效率82.76%。两组基本痊愈率、总有效率相比差异有统计学意义(P<0.05)。TNF-α,VEGF,IL-18治疗前后两组组内相比差异具有统计学意义(P<0.05),治疗后两组组间比较差异具有统计学意义(P<0.05)。观察组不良反应发生率10.34%,对照组不良反应发生率8.62%,两组相比差异无统计学意义。结论:雷公藤多苷片联合他扎罗汀治疗寻常型银屑病具有较好的临床疗效,可降低血清TNF-α,VEGF,IL-18的水平,使银屑病患者免疫调节趋向正常,从而达到治疗疾病的目的。

Objective： To observe the effect of tripterygium wilfordii tablets combined tazarotene in the treatment of psoriasis vulgaris in patients.Method： One hundred sixteen cases of psoriasis vulgaris patients were randomly divided into the observation group and the control group,58 cases in each group.Two groups were given topical tacalcitol ointment,bid;0.05% tazarotene gel,1 times a day,before going to bed externally.Observation group was treated with tripterygium wilfordii polyglycoside tablet 30 mg each time,tid.The 2 groups were treated for 4 weeks as 1 courses of treatment.After 3 courses of treatment clinical effect was observed for before and after treatment,including tumor necrosis factor-α（TNF-α）,expression of vascular endothelial growth factor（VEGF）,interleukin 18（IL-18） and dry skin,itching,erythema,burning and other adverse reaction.Result： In observation group basic recovery rate was 51.72%,total effective rate was 94.83%;in control group the basic recovery rate was 37.93%,the total efficiency of 82.76%.Two groups showed significant basic recovery rate and the total efficiency rate（P0.05）.TNF-α,VEGF,IL-18 before and after treatment in 2 groups both showed difference（P0.05）.After the treatment,the difference between two groups was significant（P0.05）.In observation group the incidence of adverse reactions was 10.34%,in control group the incidence was 8.62% without significant difference.Conclusion： The effect of Tripterygium wilfordii tablets combined tazarotene in the treatment of psoriasis vulgaris has good clinical curative effect,can reduce the level of serum TNF-α,VEGF,IL-18 levels,so that psoriasis patients immune regulation tends to normal,so as to achieve the purpose of treating disease.