消银颗粒联合阿维A治疗寻常性银屑病的临床研究

Clinical study on Xiaoying Granules combined with acitretin in treatment of psoriasis vulgaris

目的观察消银颗粒联合阿维A治疗寻常性银屑病的临床疗效。方法选取2013年1月—2015年7月鄂东医疗集团黄石市中心医院皮肤科收治的寻常型银屑病患者104例,随机分为对照组和治疗组,每组各52例。对照组口服阿维A胶囊,初始剂量25～30 mg/d,有效后,维持剂量25～50 mg/d。治疗组在对照组基础上口服消银颗粒,3.5 g/次,3次/d。两组患者均治疗4周。观察两组的临床疗效,比较两组IL-17、IL-10和复发率。结果治疗后,对照组和治疗组的总有效率分别为78.8%、92.3%,两组比较差异有统计学意义（P〈0.05）。治疗后,两组白细胞介素-17（IL-17）和严重程度指数评分（PASI评分）均显著下降,而白细胞介素-10（IL-10）均显著上升,同组治疗前后比较差异有统计学意义（P〈0.05）;且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义（P〈0.05）。治疗后随访6个月,对照组和治疗组的复发率分别为35.0%、17.4%,两组比较差异有统计学意义（P〈0.05）。结论消银颗粒联合阿维A治疗寻常型银屑病具有较好的临床疗效,可显著减低IL-17水平,升高IL-10水平,调节Th17/Treg细胞平衡,降低复发率,具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Xiaoying Granules combined with acitretin in treatment of psoriasis vulgaris. Methods Patients（104 cases） with psoriasis vulgaris in Department of Dermatology of Huangshi Central Hospital of Edong Medical Group from January 2013 to July 2015 were randomly divided into control and treatment groups, and each group had 52 cases. Patients in the control group were po administered with Acitretin Capsules, starting dosage was 25 — 30 mg/d, maintenance dose was 25 — 50 mg/d after effective. Patients in the treatment group were po administered with Xiaoying Granules on the basis of the control group, 3.5 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and IL-17, IL-10, and recurrence rate in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 78.8% and 92.3%, respectively, and there was difference between two groups（P〈0.05）. After treatment, IL-17 levels and PASI scores in two groups were significantly decreased, but the IL-10 levels in two groups were significantly increased, and the difference was statistically significant in the same group（P〈0.05）. And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups（P〈0.05）. Follow up for 6 months after treatment, the recurrence rates in the control and treatment groups were 35.0% and 17.4%, respectively, and there was difference between two groups（P〈0.05）. Conclusion Xiaoying Granules combined with acitretin has clinical curative effect in treatment of psoriasis vulgaris, significantly decreases IL-17 level, increases IL-10 level, regulates Th17/Treg cell balance, reduce relapse rate, which has a certain clinical application value.