不同剂量308 nm准分子光联合多烯磷脂酰胆碱注射液治疗寻常型银屑病的疗效观察

Therapeutic efficacy of different doses of 308 nm excimer laser combined with injections of Polyene Phosphatidylcholine for psoriasis vulgaris

目的:探讨不同剂量308 nm准分子光联合多烯磷脂酰胆碱注射液治疗寻常型银屑病的疗效。方法:将2016年6月至2017年12月本院确诊的192例寻常型银屑病患者按随机数字表法分为4组,均接受多烯磷脂酰胆碱注射液治疗,在此基础上,A组、B组、C组分别以1倍最小红斑量(MED)、3倍MED、6倍MED为初始剂量实施308 nm准分子光治疗,D组不照射,连续治疗8周后,比较4组患者银屑病面积和严重程度指数(PASI)评分、皮肤病生活质量指数(DLQI)评分、临床疗效、照射次数、照射剂量和不良反应发生情况。结果:治疗后4组患者PASI和DLQI评分与治疗前相比均明显降低,差异均具有统计学意义(P值均<0. 05); PASI和DLQI评分方面,D组> A组> B组> C组,两两比较,差异具有统计学意义(P <0. 05)。A组、B组、C组和D组治疗总有效率分别为58. 33%、77. 08%、91. 67%、37. 50%,差异具有统计学意义(P <0. 05);在平均照射次数、照射剂量方面,A组> B组> C组,两两比较,差异具有统计学意义(P值均<0. 01);采用不同剂量308 nm准分子光治疗的3组中,A组不良反应发生率最低,C组不良反应发生率最高,4组综合比较,差异具有统计学意义(P值均<0. 05)。结论:大剂量308 nm准分子光联合多烯磷脂酰胆碱注射液治疗寻常型银屑病效果较佳,能减轻患者疾病严重程度,提高临床疗效与皮肤生活质量,但其不良反应发生率较高,临床应加以注意。

Objective:To evaluate the efficacy of different doses of 308 nm excimer laser combined with injections of Polyene Phosphatidylcholine for psoriasis vulgaris(PV).Methods:The random number table was used to assign 192 inpatients with PV to 4 groups between June 2016 and December 2017.In addition to the injections of Polyene Phosphatidylcholine,groups A,B and C were also treated with 1,3,6 MED of 308 excimer laser,respectively.Group D was left unirradiated.After 8 weeks of treatments,psoriasis area and severity index(PASI),dermatology life quality index(DLQI),clinical efficacy,number of treatment,radiation dose and incidence of adverse reactions were compared among groups.Results:All treatments significantly reduced both PASI and DLQI(P<0.05 vs.pretreatment).Moreover,both PASI and DLQI in groups A to C were lower than that in group D(P<0.05).Furthermore,both PASI and DLQI arranged in descending arder were groups D,A,B and C(P<0.05).The total effective rates in groups A,B,C and D were 58.33%,77.08%,91.67%,37.50%,respectively(P<0.05).Both total number and dosage of laser radiation arranged in descending order were groups A,B and C(P<0.01).In 3 groups treated with different doses of 308 nm excimer laser,the incidence of adverse reactions was the lowest in group A,while the highest in group C(P<0.05).Conclusion:High dose of 308 nm excimer laser combined with injections of Polyene Phosphatidyl choline is superior in improving both PASI and DLQI,but attention should be paid to its higher incidence of adverse reactions.