窄谱中波紫外线联合阿维A胶囊治疗斑块状银屑病疗效分析

Clinical Efficacy of Narrow⁃spectrum Medium⁃wave Ultraviolet Light Combined with Acitretin Capsules in the Treatment of Plaque Psoriasis

目的分析窄谱中波紫外线联合阿维A胶囊治疗斑块状银屑病的临床疗效。方法选取2021年5月至2022年5月永城市人民医院收治的92例斑块状银屑病患者作为研究对象,按照不同治疗方法将其分为联合组(46例)和单一组(46例),联合组患者采用窄谱中波紫外线联合阿维A胶囊治疗,单一组患者单纯采用阿维A胶囊治疗,对比观察两组患者皮损情况、血清炎症因子水平、临床疗效及不良反应发生情况。结果治疗8周后,联合组患者银屑病皮损面积和严重程度指数(PASI)评分为(7.53±1.86)分、血清白细胞介素(IL)-17水平为(40.78±9.49)ng/ml、血清IL-22水平为(29.61±7.64)ng/ml,明显低于单一组患者的PASI评分(11.82±2.45)分、血清IL-17水平(54.23±11.62)ng/ml、血清IL-22水平(37.12±8.76)ng/ml(t=9.459、6.080、4.382,P均<0.001);治疗8周后,联合组患者治疗总有效率为91.30%,明显高于单一组患者的治疗总有效率71.74%(χ^(2)=5.845,P=0.016);治疗期间,联合组患者不良反应发生率为8.70%,与单一组患者的不良反应发生率15.22%无明显差异(χ^(2)=0.929,P=0.335)。结论与单纯应用阿维A胶囊相比,窄谱中波紫外线联合阿维A胶囊更有利于调节斑块状银屑病患者的血清IL-17、IL-22水平,减轻炎症细胞浸润程度,改善临床症状,且安全性较好。

Objective To analyze the clinical efficacy of narrow-spectrum medium-wave ultraviolet light combined with acitretin capsules in the treatment of plaque psoriasis.Methods 92 patients with plaque psoriasis,admitted to Yongcheng People’s Hospital from May 2021 to May 2022,were enrolled as research subjects and divided into the combina-tion group(n=46)and the single group(n=46)according to the different treatment methods they received.Patients in the combination group were treated with narrow-spectrum medium-wave ultraviolet light combined with acitretin capsules,whereas patients in the single group were given acitretin capsules alone for treatment.The skin lesion condition,serum inflammatory factor levels,clinical efficacy and the occurrence of adverse reactions were compared between the two groups.Results After 8 weeks of treatment,patients in the combination group had a psoriasis area and severity index(PASI)score of(753±186)points,serum interleukin(IL)-17 level of(4078±949)ng/ml,and serum IL-22 level of(2961±764)ng/ml,which were significantly lower than the corresponding(1182±245)points,(5423±1162)ng/ml,and(3712±876)ng/ml of patients in the single group(t=9459,6080 and 4382,all P<0001),and the total effective rate of patients was 9130%in the combination group,which was significantly higher than the corresponding 7174%in the single group(χ^(2)=5845,P=0016).During the treatment period,the incidence of adverse reactions of patients in the combination group was 870%,showing no significantly difference compared with the corresponding 1522%in the single group(χ^(2)=0929,P=0335).Conclusion Compared with the alone application of acitretin capsules,the combined application of narrow-spectrum medium-wave ultraviolet light and acitretin capsules is more effective in regulating serum IL-17 and IL-22 levels of patients with plaque psoriasis,and improving their inflammatory cell infiltration and clinical symptoms,and is safe to apply in clinical practice.