米诺环素和烟酰胺联合小剂量糖皮质激素治疗62例大疱性类天疱疮

Minocycline and nicotinamide combined with low-dose glucocorticoid for the treatment of 62 cases of bullous pemphigoid

目的：对北京大学第一医院2002--2012年间使用米诺环素和烟酰胺联合小剂量糖皮质激素治疗62例大疱性类天疱疮患者疗效进行临床总结。方法：62例患者（三联治疗组）初诊时均予米诺环素（200mg／d）、烟酰胺（600-1500mg/d）及泼尼松（20-30mg/d）治疗，另选取121例予米诺环素联合烟酰胺治疗的大疱性类天疱疮患者作为二联治疗组。随访观察48周并对两组疗效进行比较。结果：三联治疗组治疗2周和24周后有效率分别为82．3％和75．4％，与二联治疗组比较。差异均有统计学意义（χ2=11．33、35．81，P均〈0．01），而治疗48周后有效率为72．5％。三联治疗组疗效明显优于二联治疗组。且加用小剂量糖皮质激素并未增加严重不良反应。结论：米诺环素和烟酰胺联合小剂量糖皮质激素治疗大疱性类天疱疮安全有效。

Objective： To summarize the clinical efficacy of minocycline and nicotinamide combined with low-dose glucocor- ticoid for the treatment of 62 patients with bullous pemphigoid from 2002 to 2012 in Peking University First Hosipital. Methods： Sixty-two patients（treatment group） were given minocycline（200 mg/d）, nicotinamide（600-1 500 mg/d） combined with prednisone（20-30 mg/d）, 121 cases of bullous pemphigoid were treated with minocycline and nicotinamide as the control group. All the patients were followed-up for 48 weeks, and the efficacy of the two groups were also evaluated. Results： After 2 and 24-week treatment, the effective rates of the 2 groups were 82.3% and 75.4%, respectively, the difference between the two groups was statistical significant （χ2=11.33, 35.81, P〈0.01）; and after 48-week treatment, the effective rate of treatment group was 72.5%, the addition of low-dose corticosteroids did not increase the incidence serious adverse reactions. Conclu- sion： Minocycline, nicotinamide combined with low-dose glucocorticoid is effective and safe for the treatment of bullous pem- phigoid patients.