司库奇尤单抗联合卡泊三醇软膏治疗中重度银屑病的临床效果研究

A study of the clinical effect of secukinumab combined with calcipotriol ointment in the treatment of moderate-to-severe psoriasis

目的研究中重度银屑病患者采用司库奇尤单抗联合卡泊三醇软膏治疗的疗效。方法110例中重度银屑病患者,用数字表法随机划分成两组,即对照组(单用卡泊三醇软膏治疗,55例)和研究组(司库奇尤单抗联合卡泊三醇软膏治疗,55例)。对比两组疗效,症状改善时间,银屑病面积与严重性指数(PASI)评分,炎性因子[白细胞介素-17(IL-17)、肿瘤坏死因子-α(TNF-α)和白细胞介素-23(IL-23)]水平,不良反应发生情况。结果相较于对照组(81.82%),研究组治疗总有效率(96.36%)更高(P<0.05)。研究组患者的皮肤脱屑、鳞屑、红斑以及瘙痒改善时间分别为(9.66±1.77)、(10.44±1.72)、(11.15±1.22)、(10.35±1.40)d,短于对照组的(13.50±1.66)、(12.71±1.66)、(13.55±1.17)、(13.50±1.51)d(P<0.05)。治疗前两组的PASI评分无明显差异(P>0.05);治疗1、4周,研究组的PASI评分分别为(15.20±3.89)、(10.02±2.33)分,低于对照组的(23.50±5.44)、(15.60±2.47)分(P<0.05)。治疗后,研究组的IL-17水平为(96.44±11.82)pg/ml、TNF-α为(97.66±10.55)μg/L、IL-23为(189.66±15.00)pg/ml,对照组的IL-17水平为(103.55±14.28)pg/ml、TNF-α为(105.30±11.84)μg/L、IL-23为(201.33±20.28)pg/ml,经比较得知研究组炎性因子IL-17、TNF-α以及IL-23水平更低(t=2.8445、3.5729、3.4311,P=0.0053、0.0005、0.0009<0.05)。与对照组(20.00%)对比,研究组的不良反应发生率(3.64%)更低(P<0.05)。结论司库奇尤单抗与卡泊三醇软膏联合应用到中重度银屑病患者治疗中,取得的疗效确切,临床治疗安全性以及有效性较高,能加快患者症状的消退速度,降低人体炎性因子水平,改善患者的免疫功能,值得运用。

Objective To study the efficacy of secukinumab combined with calcipotriol ointment in the treatment of moderate-to-severe psoriasis.Methods A total of 110 patients with moderate-to-severe psoriasis were randomly divided into two groups by digital table method,namely the control group(treated with capotriol ointment alone,55 cases)and the study group(treated with secukinumab combined with capotriol ointment,55 cases).Both groups were compared in terms of efficacy,symptom improvement time,psoriasis area and severity index(PASI)score,levels of inflammatory cytokines[interleukin-17(IL-17),tumor necrosis factor-α(TNF-α)and interleukin-23(IL-23)],and occurrence of adverse reactions.Results Compared with the control group(81.82%),the total effective rate of the study group(96.36%)was higher(P<0.05).The improvement time of skin desquamation,scaling,erythema and pruritus in the study group were(9.66±1.77),(10.44±1.72),(11.15±1.22)and(10.35±1.40)d,which were shorter than(13.50±1.66),(12.71±1.66),(13.55±1.17)and(13.50±1.51)d in the control group(P<0.05).Before treatment,there was no significant difference in PASI scores between the two groups(P>0.05).After 1 and 4 weeks of treatment,the PASI scores of the study group were(15.20±3.89)and(10.02±2.33)points,which were lower than(23.50±5.44)and(15.60±2.47)points of the control group(P<0.05).After treatment,the study group had IL-17 of(96.44±11.82)pg/ml,TNF-αof(97.66±10.55)μg/L and IL-23 of(189.66±15.00)pg/ml,while the control group had IL-17 of(103.55±14.28)pg/ml,TNF-αof(105.30±11.84)μg/L,and IL-23 of(201.33±20.28)pg/ml.The levels of inflammatory cytokines of IL-17,TNF-αand IL-23 were lower in the study group(t=2.8445,3.5729,3.4311;P=0.0053,0.0005,0.0009<0.05).Compared with the control group(20.00%),the incidence of adverse reactions in the study group(3.64%)was lower(P<0.05).Conclusion The combination of secukinumab and calcipotriol ointment in the treatment of patients with moderate-to-severe psoriasis has achieved precise efficacy,high clinical safety and effectiveness,which can accelerated the recession of the patient's symptoms,reduce the level of inflammatory cytokines,and improved the patient's immune function.It is worthy of use.