骨化三醇联合复方氟米松治疗寻常型银屑病患者的效果及对血清中白细胞介素6、17、23水平的影响

Effect of calcitriol combined with compound Flumethasone in treatment of psoriasis vulgaris patients and influences on serum levels of interleukin 6, 17 and 23

目的探讨骨化三醇联合复方氟米松治疗寻常型银屑病(PV)患者的临床效果及对血清白细胞介素6、17、23(IL-6、IL-17、IL-23)水平的影响。方法选取2015年3月~2016年11月揭阳市人民医院皮肤与性病科收治的寻常型银屑病患者80例,按照随机数字表法将其分为单药组及联合组,每组各40例。单药组给予复方氟米松治疗,联合组在单药组给药基础上给予骨化三醇治疗。比较两组治疗前后的严重性指数(PASI)、皮损总面积百分比及临床效果,检测及对比治疗前后血清IL-6、IL-17及IL-23水平,并比较安全性及复发情况。结果两组治疗后PASI评分及皮损总面积百分比均明显低于治疗前,且联合组治疗后均明显低于单药组,差异有统计学意义(P<0.05);联合组总有效率明显高于单药组,差异有统计学意义(P<0.05)。两组治疗后血清IL-6、IL-17及IL-23水平均明显低于治疗前,且联合组均明显低于单药组,差异有统计学意义(P<0.05)。联合组治疗期间总不良反应发生率与单药组比较,差异无统计学意义(P>0.05),联合组治疗后1年内复发率明显低于单药组,差异有统计学意义(P<0.05)。结论 骨化三醇联合复方氟米松治疗PV患者可明显提高临床疗效,显著降低血清IL-6、IL-17及IL-23水平,并可减少复发情况,且不良反应无明显增加,具有推广价值。

Objective To investigate the clinical effect of Calcitriol combined with compound Flumethasone in the treatment of psoriasis vulgaris（PV） patients and the influences on the serum levels of interleukin 6, 17 and 23（IL-6,IL-17, IL-23）. Methods From March 2015 to November 2016, in Department of Dermatology and Venereal Diseases,Jieyang People＇s Hospital, 80 PV patients were selected, they were divided into single drug group and combined group by random digital table method, with 40 cases in each group. The single drug group was treated with compound Flumetasone, while the combined group was given Calcitriol on the base of the single drug group. The severity index（PASI） and the total area percentage of skin lesions before and after treatment and the clinical efficacy in the two groups were compared, and the levels of serum IL-6, IL-17 and IL-23 were detected and compared before and after treatment, then the safety and recurrences were compared. Results After treatment, the PASI scores and total area percentage of skin of two groups were significantly lower than those before treatment, and these of the combined group were significantly lower than those of the single drug group, the differences were statistically significant（P〈0.05）. The total effective rate of the combined group was significantly higher than that of the single drug group, the differences were statistically significant（P〈0.05）. After treatment, the levels of serum IL-6, IL-17 and IL-23 in the two groups were significantly lower than those before treatment, these of combined group were significantly lower than those of the single drug group, the differences were statistically significant（P〈0.05）. There was no significant difference in the incidence rates of total adverse reactions between the combined group and the single drug group during the treatment（P〉0.05）, and the recurrence rate of the combined group within 1 year after treatment was significantly lower than that of the single drug group, the difference was statistically significant（P〈0.05）. Conclusion Calcitriol combined with compound Flumethasone for the treatment of PV can significantly improve the clinical efficacy, significantly reduce the serum levels of IL-6, IL-17 and IL-23, reduce the recurrence, and there is no obvious increase in adverse reactions,which has the value of popularization.