白芍总苷胶囊和卡泊三醇联合窄谱紫外线照射治疗银屑病的疗效

Clinical Efficacy to Treat Psoriasis Jointly with Total Glucosides of Paeony Glucoside, Narrow-Spectrum Ultraviolet Irradiation and Calcipotriol

目的观察白芍总苷胶囊和卡泊三醇联合窄谱紫外线照射治疗银屑病的临床疗效。方法选取2018年1月至2020年12月银屑病患者100例,按照治疗方法不同分为观察组和对照组,每组患者各50例。对照组采用卡泊三醇联合窄谱紫外线照射治疗;观察组采用白芍总苷胶囊和卡泊三醇联合窄谱紫外线照射治疗,两组均行相同光剂量的窄谱紫外线照射,初始照射剂量0.4 J/cm^(2),根据患者皮肤反应逐次增加照射剂量0.05~0.1 J/cm^(2),每周治疗2~3次,连续治疗8周。照射治疗8周后即刻,比较两组患者的临床疗效、中医症状积分(皮肤瘙痒、皮疹暗红、皮损脱落鳞屑)。并进行血液检测(包括辅助性T细胞22、肿瘤坏死因子-α、可溶性E选择蛋白、可溶性细胞间黏附分子1),记录不良反应发生情况。结果治疗前两组实验室指标(辅助性T细胞22、肿瘤坏死因子-α、可溶性E选择蛋白、可溶性细胞间黏附分子1)、中医症状积分(皮肤瘙痒、皮疹暗红、皮损脱落鳞屑)相比较,差异无统计学意义(P>0.05)。治疗8周后,实验室指标、中医症状积分均低于治疗前,且观察组的实验室指标、中医症状积分均低于对照组,差异具有统计学意义(P<0.05);观察组总有效率为(92.0%)高于对照组的(80.0%),差异具有统计学意义(P<0.05)。观察组不良反应发生率为10.0%,与对照组(8.0%)比较,差异无统计学意义(P>0.05)。结论白芍总苷胶囊和卡泊三醇联合窄谱紫外线照射治疗银屑病较卡泊三醇联合窄谱紫外线照射效果更佳,更有助于改善患者不适症状,值得推广使用。

Objective To analyze the clinical effect to treat psoriasis jointly with total glucosides of paeonia lactiflora,narrow-spectrum ultraviolet irradiation and calcipotriol.Methods Totally 100 patients with psoriasis treated during the period from Jan.2018 to Dec.2020 were selected and divided by treating methods into an observation group and a control group,50 patients in each group.The patients in the control group were treated with narrow-spectrum ultraviolet radiation plus calcipotriol,and those in the observation group were given total glucosides of paeonia lactiflora in addition.Immediately after 8 weeks’ treatment,the clinical efficacy and TCM symptom scores(pruritus,rash and scaling) were compared between the two groups.Moreover,for both groups,blood tests(including helper T cells 22,tumor necrosis factor-α,soluble E-selectin and soluble intercellular adhesion molecule 1) were performed,and adverse reactions were recorded.Results There was no difference in laboratory indicators(helper T cell 22,tumor necrosis factor-α,soluble E-selectin and soluble intercellular adhesion molecule 1) and TCM symptom scores(pruritus,rash and scales) between the two groups before the treatment(P>0.05).Upon 8 weeks’ treatment,for both groups,the laboratory indexes and TCM symptom scores dropped and the laboratory indexes and TCM symptom scores of the observation group were apparently lower than those of the control group(P<0.05).The total effective rates of the observation group and control group were 92.0% and 80.0% respectively,indicating a difference that was statistically significant(P<0.05).The incidence of adverse reactions was 10.0% in the observation group and 8.0% in the control group(P>0.05).Conclusions Joint usage of paeoniflorin total glycosides capsules,narrow-spectrum ultraviolet irradiation and calcipotriol is worthy to be promoted for treatment of psoriasis as it is more effective and more helpful to relieve the discomfort symptoms of patients.