白芍总苷胶囊与复方甘草酸苷胶囊联合卡泊三醇软膏及窄谱中波紫外线治疗银屑病

Total Glucosides of Paeony Capsules and Compound Glycyrrhizin Capsules Combined with Calcipotriol Ointments and Narrow-band UVB in the Treatment of Psoriasis

目的:探讨白芍总苷胶囊与复方甘草酸苷胶囊联合卡泊三醉软膏及窄谱中波紫外线治疗寻常型斑块状银屑病的近期疗效。方法:采用随机、开发、平行对照试验。采用随机数字法,将163例寻常型斑块状银屑病患者分为观察组(81例)和对照组(82例)。两组患者均给予卡泊三醇软膏外用bid,窄谱中波紫外线(NB-UVB)照射3 d 1次,复方甘草酸苷胶囊50 mg,po,tid。在此基础上,观察组予白芍总苷胶囊0.6 g,po,tid,对照组予阿维A胶囊10 mg,po,qd。两组均4周为1个疗程。治疗前及治疗开始后每2周评估患者的症状积分,计算症状积分下降指数(SSRI),评价治疗效果,比较两组不良反应发生率。结果:共有150例患者完成试验,其中观察组74例,对照组76例。观察组第2、第4周时SSRI分别为(0.73±0.27)与(0.86±0.17),痊愈率分别为41.89%和56.76%,总有效率分别为89.19%和93.24%,上述指标与对照组比较,差异均无统计学意义(P>0.05)。两组不良反应比较,消化道不适发生率观察组略高于对照组(P<0.05),头痛、皮损加重等不良反应发生率观察组显著低于对照组(P<0.001)。结论:联合口服白芍总苷胶囊与复方甘草酸苷胶囊治疗斑块状银屑病的近期临床疗效与联合口服阿维A胶囊与复方甘草酸苷胶囊相似,而不良反应较少,可以作为临床治疗银屑病的备选方案之一。

Objective ： To observe the short-term efficacy of total glucosides of paeony capsules and compound glycyrrhizin capsules combined with calcipotriol ointments and narrow-band UVB in the treatment of chronic plaque psoriasis. Methods： A randomized, opened and paralleled trial was administered in 163 subjects with chronic plaque psoriasis. Randomized number method was used to di- vide the patients into the observation group（ 81 cases） which was orally received total glucosides of paeony capsules and compound gly- cyrrhizin capsules, and the control group （82 cases） which was orally received acitretin capsules and compound glycyrrhizin capsules. Meanwhile, all the patients were topically administrated calcipotriol ointments, twice a day, and narrow-band ultraviolet radiation, once every three days with 4-week treatment course. Symptom score reducing index（SSRI）was evaluated in each group before the treatment and every 2 weeks after the treatment. Results： Totally 150 subjects completed the trial, including 74 cases in the observation group and 76 cases in the control group. SSRI in the observation group on the 14lh and 28th day was （0.73 ±0.27） and （0.86 ±0.17） , re- spectively, which showed no statistically significance compared with that in the control group（0.81 ± 0.25 ） and （0.91 ± 0.31 ）, re- spectively, P 〉 0.05）. The cure rate in the observation group was 41.89% on the 14th day and 56.76% on the 28th day, which were similar with those in the control group（46.05% and 64.47% , P 〉 0.05 ）. Total effective rate in the observation group was 89.19% on the 14th day and 93.24% on the 28th day, which were also without statistic significance compared with those in the control group （90.79% and 94.74% , P 〉 0.05 ）. Conclusion： Total glucosides of paeony capsules combined with compound glycyrrhizin capsules in the treatment of chlonic plaque psoriasis shows similar efficacy with acitretin capsules combined with compound glycyrrhizin capsules with fewer adverse reactions, suggesting total glucosides of paeony capsules can be used as one of the options for clinical treatment of psoriasis.