窄谱中波紫外线联合阿维A治疗寻常型银屑病的效果观察

Effects of narrow-band ultraviolet combined with acitretin in the treatment of psoriasis vulgaris

目的探讨窄谱中波紫外线(NB-UVB)联合阿维A治疗寻常型银屑病的效果。方法抽取鹤壁市人民医院2015年6月至2019年6月收治的80例寻常型银屑病患者,按随机数字表法分为对照组与联合组,每组40例。对照组口服阿维A治疗,联合组在对照组治疗基础上联合NB-UVB照射治疗。比较两组疗效、皮损与瘙痒症状、免疫功能及不良反应发生情况。结果治疗后,联合组患者治疗总有效率[95.00%(38/40)]高于对照组[77.50%(31/40)],P<0.05。治疗后,两组患者银屑病皮损面积和严重程度指数、视觉模拟评分法瘙痒评分均较治疗前降低(P均<0.05),且联合组变化幅度低于对照组(P<0.05)。治疗后,两组患者免疫功能指标(CD3^+、CD4^+、CD4^+/CD8^+)水平较治疗前升高(P<0.05),CD8^+水平较治疗前降低(P<0.05),且联合组治疗后的CD3^+、CD4^+、CD4^+/CD8^+水平高于对照组(P<0.05),CD8^+水平低于对照组(P<0.05)。治疗期间,两组患者不良反应发生率比较差异未见统计学意义(P>0.05);治疗后,联合组患者皮肤病生活质量指数评分低于对照组(P<0.05)。结论NB-UVB联合阿维A治疗寻常型银屑病疗效显著,在减轻患者症状、提高免疫功能方面具有明显优势,且安全性高。

Objective To investigate the efficacy of narrow-band ultraviolet (NB-UVB) combined with acitretin in the treatment of psoriasis vulgaris.Methods Eighty patients with psoriasis vulgaris admitted to Hebi People’s Hsopital from June 2015 to June 2019 were selected and divided into control group and combined group according to the random number table method, with 40 cases in each group. Patients in the control group were treated with acitretin orally, and patients in the combined group were given NB-UVB irradiation treatment based on the treatment of the control group. The efficacy, skin lesions, itching symptoms, immune function and incidence of adverse reactions were compared between the two groups.Results After treatment, the total effective rate of treatment in combined group was 95.00% (38/40), significantly higher than the 77.50% (31/40) in control group (P<0.05). After treatment, the psoriasis area and severity index and itching score assessed by visual analogue scale (VAS) in the two groups were significantly decreased compared with those before treatment (P<0.05), and change of scores in combined group were significantly lower than those in control group (P<0.05). After treatment, the levels of immune function indexes, including cluster of differentiation (CD) 3^+ , CD4^+ , CD4^+ /CD8^+ in the two groups were significantly elevated, compared with those before treatment (P<0.05), while the CD8^+ level was significantly decreased, compared with that before treatment (P<0.05). And the levels of CD3^+ , CD4^+ and CD4^+ /CD8^+ in combined group were significantly higher than those in control group after treatment (P<0.05), while the CD8^+ level was significantly lower than that in control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups during treatment (P>0.05). After treatment, the dermatological life quality index scale score in combined group was significantly lower than that in control group (P<0.05).Conclusions NB-UVB combined with acitretin has significant efficacy in the treatment of psoriasis vulgaris. It has obvious advantages in reducing symptoms and improving immune function, with high safety.