阿维A联合白芍总苷治疗中重度斑块状银屑病的疗效

Clinical efficacy of acitretin combined with total glucosides of white paeony for the treatment of plaque psoriasis

目的:评价阿维A联合白芍总苷(TGP)治疗中、重度斑块状银屑病的有效性及安全性。方法:采用多中心、随机、双盲、平行对照的研究设计,共纳入符合入选标准的108例中、重度斑块状银屑病患者,随机分为试验组和对照组。试验组予口服阿维A联合TGP,对照组仅口服阿维A。两组疗程均为12周,分别于治疗后第2、4、8及12周进行疗效及不良反应的判定。结果:与治疗前比较,治疗12周后试验组达到银屑病皮损面积和严重程度指数(PASI)50改善的患者为90%,对照组为70.5%,两组间比较差异有统计学意义(P<0.05);同时,试验组丙氨酸氨基转移酶(ALT)升高的患者比例为6.8%,对照组为22.2%,两组间比较差异有统计学意义(P<0.05)。结论:TGP联合阿维A治疗中、重度斑块状银屑病患者,不仅达到PASI 50的疗效优于单用阿维A,且可降低单用阿维A引起的肝损害发生率。

Objective： To investigate the efficacy and safety of acitretin combined With total glucosides＇ of white paeony （TGP） for the treatment of severe plaque psoriasis. Methods： A randomized, double blind, placebo parallel-controlled, multi- center clinical trial was conducted. Totally, 108 patients with moderate and severe plaque psoriasis were randomly divided in- to the experiment group and control group. The experiment group was treated with TGP combined with acitretin, while the control group was treated with acitrein alone. The treatment course was 12 weeks. The efficacy and safety were evaluated at the baseline, as well as 2, 4, 8 and 12 weeks after the treatment. Results： After 12-week treatment, the proportion of pa- tients achieving a 50% reduction in psoriasis area and severity index 50（PASI 50） was 90% in the experiment group, and 70.5% in the control group, the difference between the 2 groups was statistical significant（P〈0.05）. At the same time, the incidence of elevated ALT in the experiment group was 6.8%, and the control group was 22.2%, the difference was signifi- cant （P〈0.05）. Conclusion： The effeacy of acitretin combined with TGP for the treatment of plaque psoriasis is better than that of acitretin alone, and also can reduce the incidence of liver damage caused by single use of acitretin.