阿维A胶囊联合灵龟八法治疗银屑病失眠的临床研究

Clinical observation of acitretin combined with Linggui Bafa in the treatment of insomnia of psoriasis patients

目的:探讨阿维A胶囊联合灵龟八法治疗银屑病失眠的临床疗效及安全性。方法:将166例患者随机分为治疗组85例和对照组81例,治疗组:口服阿维A胶囊,30mg/次,与午餐同服1次/日,同时予灵龟八法针灸治疗。根据患者的来诊时间查询开穴作为主穴,相应的八脉交会穴为客穴。主客相配:公孙-内关;外关-足临泣;后溪-申脉;列缺-照海,均为双侧取穴。针刺方法:列缺向肘部平刺约0.5寸,余穴均直刺约0.5寸,行提插捻转平补平泻手法,留针30分钟,每10分钟行针1次。隔日治疗1次,1周3次,共治疗4周。对照组:口服阿维A胶囊,用量用法同治疗组。连续用药4周,无其它伴随治疗。治疗前、治疗结束、随访1月时对各观察指标、不良反应予以记录,尤其注意患者有无脱皮及血脂升高,治疗结束后进行疗效评估。结果:两组临床疗效观察治疗期间治疗组脱落1例,对照组脱落2例,余病例均完成治疗及随访,全部纳入统计分析。总疗程结束后,治疗组痊愈率为51.2%,对照组为44.3%;总有效率治疗组为90.5%,对照组为72.2%,两组总有效率比较,差异有统计学意义(χ2=11.70,P=0.004 <0.05)。两组PSQI评分比较采用重复测量方差分析,对两组患者各观察时点PSQI评分进行比较提示具有统计学意义(P <0.05),组间比较具有主效应(P <0.05)。组内各时点两两比较,治疗组疗后4周PSQI评分均优于疗前及随访1月(P <0.05),随访1月PSQI评分低于治疗组,但无统计学意义(P> 0.05);对照组亦呈现相关变化趋势。结论:阿维A胶囊联合灵龟八法针灸治疗可有效改善银屑病失眠患者睡眠质量及生存质量。

Objective To evaluate the curative efect and security of acitretin combined with Lingui Bafa（灵龟八法）in treating insomnia of patients with psoriasis. Methods： The 166 cases were randomly divided into two groups： The treatment group （n=85） and the control group（n=81）. Patients of the treatment group were treated by acitretin capsule combined with Lingui Bafa, and the control group received acitretin capsule only. The course of treatment in the two groups lasted 4 weeks and 1 month follow up. The curative efect and adverse reactions were recorded after the therapy. Results： 1 case dropped in the treatment group and 2 cases dropped in the control group during the treatment of the two groups. All the remaining cases were treated and followed up, all of which were included in the statistical analysis. The healing rate of the treatment group was 51.2%, and that of the control group was 44.3%. The total efective rate was 96.4% in the treatment group and 87.3% in the control group. Compared the two groups, the diference of the total efective rate of the two groups was statistically signifcant （χ2=11.70,P=0.004 〈 0.05）. PSQI score of two groups was compared with repetitive measure analysis of variance, at each observation point in patients with two groups, the PSQI score comparison suggested statistically signifcance （P 〈0.05） , the main efect between groups was compared （P 〈 0.05）. At each point in the set of pairwise comparison, PSQI score 4 weeks after treatment of treatment group was better than before treatment and follow-up 1 month（P 〈 0.05）, PSQI score during the following up of 1 month was lower than that before treatment, but the diference was of no statistical signifcance（P 〉 0.05）; The control group also showed a trend of change. Conclusion： This study demonstrated that the efcacy and safety of acitretin combined with Lingui Bafa was signifcant in the treatment of insomnia of patients with psoriasis.