复方青黛胶囊联合紫外线照射治疗老年银屑病的临床研究

Qingdai Compound Capsule Combined with Ultraviolet Irradiation on the Elderly with Psoriasis

目的探讨复方青黛胶囊联合紫外线照射治疗老年银屑病疗效和对免疫指标的影响,为治疗老年银屑病提供方法。方法选取2017年11月—2018年11月来四川省遂宁市中心医院皮肤科就诊的老年银屑病患者116例,根据随机数字表法分为观察组和对照组,每组58例。对照组只给予紫外线照射治疗,观察组在与对照组相同治疗基础上加复方青黛胶囊治疗,疗程均为8周。观察并比较2组疗效;对2组进行银屑病面积和严重程度指数(psoriasis area and severity index,PASI)评分和比较;分别使用流式细胞仪和酶联免疫法测定并比较2组外周血T细胞亚群水平和炎症相关指标水平变化。结果观察组治疗总有效率显著高于对照组(98.28%vs79.3%,P<0.05)。治疗前2组PASI评分差异无统计学意义(P>0.05),治疗4周和8周后观察组PASI评分均显著低于对照组(P<0.05)。治疗前2组CD3+、CD4+、CD8+和CD4+/CD8+水平差异均无统计学意义(P>0.05),治疗8周后观察组CD3+CD4+和CD4+/CD8+水平均显著高于对照组(P<0.05),而CD8+水平显著低于对照组(P<0.05)。治疗前2组TNF-α、IL-6、IL-17和IL-23水平差异均无统计学意义(P>0.05),治疗8周后观察组TNF-α、IL-6、IL-17和L-23水平均显著低于对照组(P<0.05)。观察组和对照组治疗不良反应发生率差异无统计学意义(13.79%vs12.07%,P>0.05)。结论复方青黛胶囊联合紫外线照射治疗老年银屑病能显著改善患者的免疫状态,疗效显著,且安全性较高,具有一定的临床应用价值。

Objective To investigate the curative effect of Qingdai compound capsule combined with ultraviolet irradiation on the elderly with psoriasis and the impact on immune index.Mehtods 116 elderly with psoriasis selected during the period from November,2017 to November,2018 were randomly divided into 2 groups:observation group and control group,58 in each;ultraviolet irradiation was given to all the elderly in the 2 groups while Qingdai compound capsule was added to the elderly in observation group;the course lasted for 8 weeks;a comparative observation was made in curative effect between the 2 groups;were detected by flowcytometry and enzyme-linked immunosorbent assay(ELISA)were applied in detecting the variations of the levels of peripheral blood T cell subset and the inflammation-related index.Results The clinical effective rate in observation group(98.28%,57/58)was much higher than that in control group(79.3%,46/58)(P<0.05);before treatment,the PASI scores in observation group was of no statistical difference from those in control group(P>0.05)while 4 and 8 weeks after treatment,the PASI scores in observation group were much lower than those in control group(P<0.05);there were no significant differences in the levels of CD3+,CD4+,CD8+and CD4+/CD8+between the 2 groups before treatment(P>0.05)while the levels of CD3+,CD4+and CD4+/CD8+were significantly higher and the level of CD8+was significantly lower in observation group than those in control group after treatment(P<0.05);the levels of TNF-α,IL-6,IL-17 and IL-23 in the 2 groups were of no statistical differences before treatment(P>0.05)while after treatment,the levels in observation group were significantly lower than those in control group(P<0.05);no statistical difference was found in the incidence of adverse reactions between the 2 group[13.79%vs(8/58)12.07%(7/58)](P>0.05).Conclusion Qingdai compound capsule combined with ultraviolet irradiation can obviously improve the immunity of the elderly with psoriasis,it is safer and worthy of certain clinical application value.