消银方联合钙泊三醇倍他米松软膏维持治疗寻常型银屑病45例

Xiaoyin Decoction Combined with Calcipotriol Betamethasone Ointment 45 Cases Psoriasis Vulgaris Maintenance Treatment

目的:观察消银方联合钙泊三醇倍他米松软膏维持治疗寻常型银屑病的近期疗效及对远期病情稳定的作用。方法:将90例寻常型银屑病随机按数字法分为对照组和观察组各45例。对照组采用钙泊三醇倍他米松软膏,适量外用,2次/d,疗程4周或至皮损面积和严重程度指数(PASI)评分为0分时停止使用;口服复方甘草酸苷片,3片/次,3次/d,疗程16周。观察组外用药物治疗同对照组,内服药物采用消银方,1剂/d。疗程16周。于治疗前及治疗后第4,16周末进行银屑病皮损面积和严重程度指数(PASI)评分,并计算PASI-50;于治疗前及治疗后第4,16周末进行瘙痒程度采用视觉模拟(VAS)评分及皮肤病生活质量指数(DLQI)评分;记录16周内复发情况,并计算复发时间。结果:治疗后4周,对照组总有效率为86.67%,观察组为88.89%,两组比较差异无统计学意义;PASI75两组平均为68.89%。治疗后16周,对照组总有效率为62.22%,观察组为82.22%,观察组优于对照组(P<0.05);PASI75分别为40.0%和57.78%,差异无统计学意义。治疗后4周,两组PASI评分均比治疗前显著下降(P<0.01),组间比较差异无统计学意义;治疗后16周,两组PASI评分较治疗后4周上升,但观察组PASI评分低于对照组(P<0.01);治疗后4,16周观察组瘙痒VAS和DLQI均低于对照组(P<0.01);对照组有20例患者曾经达到复发标准,观察组有13例,两组比较差异无统计学意义;对照组的平均复发时间(49±7)d短于观察组的(71±10)d(P<0.01)。结论:消银方维持治疗联合钙泊三醇倍他米松软膏治疗寻常型银屑病近期能减轻患者瘙痒,提高生活质量;持续维持治疗能提高总有效率,稳定病情,延长缓解期。

Objective： Observe recent curative effect of maintenance treatment of Xiaoyin decoction combined with calcipotriol betamethasone ointment in treating psoriasis vulgaris and effect to forward. Method： Ninety patients with psoriasis vulgaris were randomly divided into control group （45 cases） and observation group （45 cases） by random number table. Patients in control group received calcipotriol betamethasone ointment, appropriately external application, 2 times/day, course was 4 weeks or stopping when score of psoriasis area and severity index （PASI） was 0, and patients received compound glycyrrhizin tables, 3 tables/time, 3 times/day, taken orally, course of treatment were 16 weeks. Patients in observation group received the same external medicines as the control group and received Xiaoyin decoction taken orally, 1 dose/day, course of treatment were 16 weeks. Before treatment and at the end of the fourth and sixteenth week after treatment, PASI was measured and PASI-50 was calculated. And degree of pruritus was measured by visual analogue scale （VAS） and dermatology life quality index （DLQI）. During 16 weeks, condition of relapse was recorded and time of relapse was calculated. Result： At the fourth week after treatment, the total effective rate in control group was 86.67% and in observation group was 88.89% , which means no statistical significance from the differences between two groups. PASI75 in both groups were 68.89%. At the sixteenth week after treatment, the total effective rate in the observation group was 82.22% superior to 62.22% in the control group （P 〈 0.05）. PASI75 in two group were 40% and 57.78% , which means no statistical significance from the differences between two groups. At the fourth week after treatment, both groups＇ scores of PASI decreased which compared with the time before treatment （P 〈 0.01 ） , and there was no statistical significance from the differences between two groups. Compared with the fourth week after treatment, at the sixteenth week after treatment, both groups＇ scores of PASI increased but score of PASI in observation group was lower than the control group （P 〈 0.01 ）. At the fourth and sixteenth week after treatment, VAS and DLQI of pruritus in observation group were less than those in the control group （P 〈 0.01 ）. 20 cases in the control group got the standard of relapse and 13 cases in the observation group, which means no statistical significance from the differences between two groups, mean time of relapse in control group was （49±7） days longer than （71 ±10） days in the observation group （P 〈 0.01 ）. Conclusion： Treatment of Xiaoyin decoction combined with calcipotriol betamethasone ointment can reduce condition of pruritus in treating psoriasis vulgaris at recent and improve the quality of patients＇ lives. And continuing maintenance treatment can improve total effective rate, make disease stable and prolong remission.