中药药浴联合窄谱中波紫外线治疗寻常型银屑病血热证的疗效及对血清25羟维生素D的影响

Efficacy of traditional Chinese medicine bath combined with narrow-band ultraviolet B and its relation with serum 25-hydroxyvitamin D in psoriasis vulgaris of blood heat syndrome

目的观察中药药浴联合窄谱中波紫外线(NB-UVB)治疗寻常型银屑病血热证的疗效及对血清25羟维生素D[25(OH)D]的影响。方法将90例寻常型银屑病血热证患者按照随机数字表法分为3组,光疗组30例予NB-UVB治疗,药浴组30例予白疕1号药浴治疗,联合组30例予白疕1号药浴联合NB-UVB治疗,3组疗程均为8周。比较3组疗效;观察3组治疗前后银屑病皮损面积和严重程度指数(PASI)评分及红斑指数(EI)变化;检测3组治疗前后血清25(OH)D水平变化。结果联合组总有效率86.7%(26/30),光疗组总有效率60.0%(18/30),药浴组总有效率50.0%(15/30),联合组疗效优于光疗组、药浴组(P<0.05)。3组治疗后PASI评分、EI均较本组治疗前降低(P<0.05),且联合组治疗后PASI评分、EI均低于药浴组、光疗组(P<0.05)。联合组、光疗组治疗后血清25(OH)D水平均较本组治疗前升高(P<0.05),且联合组治疗后血清25(OH)D水平高于光疗组、药浴组(P<0.05)。结论中药药浴联合NB-UVB能有效减轻寻常型银屑病血热证患者免疫炎性反应,改善皮损,提高血清25(OH)D水平。

Objective To observe the efficacy of traditional Chinese medicine(TCM)bath combined with narrow-band ultraviolet B(NB-UVB)and its relation with serum 25-hydroxyvitamin D[25(OH)D]in psoriasis vulgaris(PV)of blood heat syndrome.Methods Totally 90 patients with PV(blood heat syndrome)were randomly assigned to three groups:phototherapy group(n=30)received NB-UVB,TCM bath group(n=30)received TCM bath(Baibi-1),and combination group(n=30)received NB-UVB+TCM bath.A 8-week treatment were performed,psoriasis area and severity index(PASI),erythema index(EI),serum 25-(OH)D were included as comparators;the curative effect was counted.Results The overall effective rate was better in the combination group than in the phototherapy group and the TCM bath group[86.7%(26/30)vs 60.0%(18/30),50.0%(15/30),(P<0.05),respectively].After treatment,PASI and EI in groups were lower(P<0.05),and the effect was better in the combination group(P<0.05);serum 25-(OH)D was increased in the combination group and the phototherapy group(P<0.05),and the effect was better in the combination group(P<0.05).Conclusion For patients with PV(blood heat syndrome),TCM bath combined with NB-UVB can relieve immune inflammatory,improve skin lesions and serum 25(OH)D level.