窄谱中波紫外线联合白芍总苷胶囊和尿素乳膏治疗寻常型银屑病的临床观察

Clinical Observation of NB-UVB Combined with Total Glucosides of White Paeony Capsules and Urea Cream in the Treatment of Psoriasis Vulgaris

目的:观察窄谱中波紫外线联合白芍总苷胶囊和尿素乳膏治疗寻常型银屑病的疗效和安全性。方法:选择2015年1月-2016年12月我院皮肤科收治的75例寻常型银屑病患者,按随机数字表法分为对照组(37例)和观察组(38例)。对照组患者口服白芍总苷胶囊0.6 g,每日3次,若服药后出现腹泻或大便明显增多,则将剂量减少至0.3 g,每日3次+尿素乳膏适量,每日早晚1次涂抹于皮损处,连用12周。观察组患者在对照组治疗的基础上予窄谱中波紫外线光疗,首次剂量0.36 J/cm^2,照射时间2 min/次,隔日照射1次,按皮肤反应调整剂量,连用8周。观察两组患者的临床疗效,治疗前后银屑病面积与严重性指数(PASI)评分及不良反应发生情况。结果:观察组有1例患者因照射后出现明显水肿性红斑伴疼痛后退出治疗;对照组患者均完成治疗。观察组患者总有效率(86.49%)显著高于对照组(56.76%),差异有统计学意义(P<0.05)。治疗前,两组患者PASI评分比较,差异均无统计学意义(P>0.05);治疗后,两组患者PASI评分均显著低于同组治疗前,且观察组显著低于对照组,差异均有统计学意义(P<0.05)。两组患者不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:窄谱中波紫外线联合白芍总苷胶囊和尿素乳膏治疗寻常型银屑病的疗效和安全性均较好,可显著降低患者的PASI评分。

OBJECTIVE:To observe therapeutic efficacy and safety of NB-UVB combined with Total glucosides of white paeony(TGP)capsules and Urea cream in the treatment of psoriasis vulgaris.METHODS:A total of 75 patients with psoriasis vulgaris in dermatology department of our hospital during Jan.2015-Dec.2016 were divided into control group(37 cases)and observation group(38 cases)according to random number table.Control group was given TGP capsules 0.6 g orally,3 times a day,reducing to 0.3 g,3 times a day if diarrhea or stool increased significantly after taking the medicine+Urea cream,smearing on the skin,day and evening,for consecutive 12 weeks.Observation group was additionally given NB-UVB irradiation with initial dose of 0.36 J/cm2,2 min/time,every other day,adjusted according to skin reaction for consecutive 8 weeks,on the basis of control group.Clinical efficacies of 2 groups were observed,and PASI scores before and after treatment and the occurrence of ADR were observed.RESULTS:One patient of observation group withdrew from therapy after suffering from obvious edematous erythema with pain due to irradiation.All patients of control group completed treatment.Total response rate of observation group(86.49%)was significantly higher than that of control group(56.76%),with statistical significance(P<0.05).Before treatment,there was no statistical significance in PASI scores between 2 groups(P>0.05).After treatment,PASI scores of 2 groups were significantly lower than before treatment,and observation group was significantly lower than control group,with statistical significance(P<0.05).There was no statistical significance in total incidence of ADR between 2 groups(P>0.05).CONCLUSIONS:NB-UVB combined with TGP capsules and Urea cream show good therapeutic efficacy and safety for psoriasis vulgaris,and can significantly decrease PASI score of patients.