NB-UVB联合卡泊三醇倍他米松治疗老年中重度银屑病患者的临床效果

Clinical effect of narrow-band ultraviolet B combined with calcipotriol betamethasone in the treatment of senile patients with moderate and severe psoriasis

目的探究窄谱中波紫外线(NB-UVB)联合卡泊三醇倍他米松治疗老年中重度银屑病患者的临床效果。方法选取150例年龄≥60岁的银屑病患者,采用随机数字法分为A、B、C组,每组50例,A组给予NB-UVB光疗联合卡泊三醇倍他米松软膏,B组单用NB-UVB光疗,C组单用卡泊三醇倍他米松软膏。比较三组治疗前、后的血清免疫指标、炎性指标水平、DLQI评分、PASI评分、临床疗效及用药期间的不良反应发生情况。结果治疗后,三组IL-6、IL-22、IL-23、IFN-γ、TNF-α水平均降低,且A组低于B、C组,差异具有统计学意义(P<0.05)。治疗后,三组DLQI评分和PASI评分均降低,且A组低于B、C组,差异具有统计学意义(P<0.05)。A组的临床治疗总有效率高于B、C组,差异具有统计学意义(P<0.05)。三组用药期间均未出现影响治疗的严重不良反应。结论 NB-UVB联合卡泊三醇倍他米松治疗老年患者银屑病患者可有效调节细胞免疫功能,降低效应免疫因子和炎症因子水平,改善症状,疗效较单一治疗有所提高,且不增加不良反应,有临床推广价值。

Objective To investigate the clinical effect of narrow-band ultraviolet B(NB-UVB) combined with calcipotriol betamethasone in the treatment of senile patients with moderate and severe psoriasis. Methods A total of 150 patients with psoriasis and aged ≥60 years were selected and divided into group A, B, C according to the random number method, with 50 cases in each group. The group A was given NB-UVB phototherapy combined with calcipotriol betamethasone ointment, the group B was given NB-UVB phototherapy alone, and the group C was given calcipotriol betamethasone ointment. The levels of serum immune indexes and inflammatory indexes, DLQI and PASI scores before and after treatment,clinical efficacy and the adverse reactions during medication were compared among the three groups. Results After treatment, levels of IL-6, IL-22, IL-23, IFN-γ and TNF-α in the three groups decreased, and those in the group A were lower than the group B and C, the differences were statistically significant(P<0.05). After treatment, DLQI and PASI scores in the three groups decreased, and those in the group A were lower than the group B and C, the differences were statistically significant(P<0.05). The total effective rate of clinical treatment of the group A were higher than that of group B and C, the differences were statistically significant(P <0.05). There were no serious adverse reactions affecting the treatment in the three groups during medication. Conclusion NB-UVB combined with calcipotriol betamethasone in the treatment of senile patients with psoriasis can effectively regulate the cellular immune function, reduce the levels of effector immune factors and inflammatory factors, improve symptoms, has higher curative effect than single treatment, without increasing adverse reactions, which has clinical popularization value.