复方甘草酸苷片联合丙酸氟替卡松治疗寻常型银屑病疗效观察

目的探讨复方甘草酸苷片联合丙酸氟替卡松治疗寻常型银屑病的临床疗效。方法选取2016年1月至2017年12月寻常型银屑病患者130例,随机分为对照组和观察组,每组各65例。对照组患者给予丙酸氣替卡松乳膏外抹,2次/d;观察组在对照组治疗基础上给予复方甘草酸苷片,2片/次,3次/d。两组患者均治疗6周。评价两组患者临床疗效,同时比较两组患者治疗2、4、6周后的银屑病皮损面积和严重程度指数(PASI)评分,两组治疗前后血清炎症因子(IL-6、IL-2、TNF-α、INF-7)、单核细胞趋化因子(RANTES、MIP-1、MIP-1α)、调节性T细胞(Th17、Treg、Th17/Treg)水平及其安全性。结果观察组治疗后总有效率(92.31%)明显高于对照组(78.46%)(P<0.05).观察组治疗4、6周后PASI评分明显低于对照组,差异有统计学意义(P<0.05)。观察组治疗后IL-6、IL-2、TNF-α、INF-7水平明显低于对照组,差异有统计学意义(P<0.05).观察组治疗后Th17、Th17/Treg较对照组降低更明显,Treg上升更明显,差异均有统计学意义(P<0.05)。观察组RANTES、MIP-1、MIP-1α水平下降程度高于对照组,两组比较差异有统计学意义(P<0.05)。两组均未出现严重不良反应。结论复方甘草酸苷片联合丙酸氟替卡松可通过降低炎症因子、单核细胞趋化因子水平,调节Th17/Treg失衡,提高寻常型银屑病的治疗效果。

Objective To explore the clinical efiects of fluticasone propionate ointment combined with compound glycyrrhizin tablet in treatment of psoriasis and the efiects on the PASI score, the level of inflammatory factors, regulatory T cells, monocyte chemotactic factors. Methods 130 cases of psoriasis who were divided into control group and observational group from Jan. 2016 to Dec. 2017, each group of 65 cases. The control group was given fluticasone propionate ointment, 2 times/d. The observational group was given compound glycyrrhin tablet based on the treatment of the control group, 2 pieces/time, 3 times/d. The course of treatment was 6 weeks. The clinical effect, the PASI score after treatment of 2, 4, 6 weeks, the level of inflammatory cytokines (IL-6, IL-2, TNF-α, INF-γ), monocyte chemotactic factors ( RANTES, MIP-1, MIP-1α), regulatory T cells (Th17, Treg and Th17/Treg ) were observed before and after treatment. The safety of the two groups were observed. Results The total effective rate of the control group and the observational group were 78.46% and 92.31% respectively, there were statistically significant of two groups ( P<0.05 ). The PASI score after treatment of 4, 6 weeks of the observational group were lower than the control group. The level of inflammatory cytokines IL-6, IL-2, TNF-α, INF-γ, RANTES, MIP-1, MIP-1α after treatment were lower than the control group, and the differences between the two groups were statistically significant ( P<0.05 ). The level of Th17, Th17/Treg of the observational group were decreased obviously, the level of Treg increased more obvious than the control group, the differences between the two groups were statistically significant ( P<0.05 ).There were not serious adverse reactions occurred in either group. Conclusion The clinical effect of fluticasone propionate ointment combined with compound glycyrrhizin tablet can lower the level of inflammatory factors and monocyte chemotactic factors, regulate the Th17/Treg imbalance, thus improve the effect of psoriasis.