针刺联合窄谱中波紫外线治疗静止期寻常型银屑病疗效观察

Observation on the Clinical Efficacy of Acupuncture plus Narrow-band Ultravile B for Static Psoriasis Vulgaris

目的观察针刺联合窄谱中波紫外线治疗静止期寻常型银屑病的临床疗效。方法将68例静止期寻常型银屑病患者按随机数字表法分为对照组和观察组,每组34例。对照组予窄谱中波紫外线照射治疗,观察组在对照组治疗基础上予针刺治疗。比较两组治疗前后银屑病皮损面积与严重程度指数(PASI)、皮肤病生活质量指数(DQLI)、角质层含水量、经表皮水分丢失量、血清高迁移率族蛋白B1(HMGB1)、白介素18(IL-18)的水平,并比较两组临床疗效。结果观察组总有效率高于对照组(P<0.05)。治疗后,两组PASI、DQLI评分均降低(P<0.05),且观察组PASI、DQLI评分低于对照组(P<0.05)。治疗后,两组角质层含水量均增高(P<0.05),经表皮水分丢失量均减少(P<0.05);且观察组角质层含水量、经表皮水分丢失量均优于对照组(P<0.05)。治疗后,观察组血清HMGB1、IL-18水平明显降低(P<0.05),且低于对照组(P<0.05)。结论针刺联合窄谱中波紫外线治疗静止期寻常型银屑病临床疗效优于单纯窄谱中波紫外线治疗,可缓解临床症状,提高生活质量,改善皮肤屏障功能,降低血清HMGB1和IL-18水平。

Objective To observe the clinical efficacy of acupuncture plus narrow-band ultravile B for static psoriasis vulgaris.Method Sixty-eight patients with static psoriasis vulgaris were allocated,using a random number table,to control and observation groups,34 cases each.The control group received narrow-band UVB irradiation and the observation group,acupuncture in addition.The psoriasis area and severity index(PASI)scores,the dermatology quality of life index(DQLI)scores,the water contents of the horny layer,transepidermal water losses and serum high-mobility group box-1 protein(HMGB1)and interleukin-18(IL-18)levels were compared between the two groups before and after treatment.The clinical therapeutic effects were also compared between the two groups.Result The total efficacy rate was higher in the observation group than in the control group(P<0.05).After treatment,the PASI score and the DQLI score decreased in both groups(P<0.05)and were lower in the observation group than in the control group(P<0.05).After treatment,the PASI score and the DQLI score decreased in both groups(P<0.05)and were lower in the observation group than in the control group(P<0.05).After treatment,the water content of the horny layer increased and transepidermal water loss decreased in both groups(P<0.05),and the water content of the horny layer was higher and transepidermal water loss was smaller in the observation group than in the control group(P<0.05).After treatment,serum HMGB1 and IL-18 levels decreased significantly in the observation group(P<0.05)and were lower than in the control group(P<0.05).Conclusion Acupuncture plus narrow-band ultravile B is clinically more effective than narrow-band ultravile B alone in treating static psoriasis vulgaris.It can relieve the clinical symptoms,improve the quality of life,ameliorate skin barrier function and decrease serum HMGB1 and IL-18 levels.