羟氯喹加用雷公藤多苷片对慢性光化性皮炎患者的治疗效果及与血药浓度的相关性研究

Study on the therapeutic effect of Hydroxychloroquine combined with Tripterygium Glycoside Tablet in patients with chronic actinic dermatitis and its correlation with blood concentration

目的研究羟氯喹联合雷公藤多苷片对慢性光化性皮炎(CAD)患者的治疗效果及与血药浓度的相关性。方法回顾性分析2020年1月至2023年7月江西省皮肤病专科医院收治的80例CAD患者临床资料,根据治疗方式的不同分为对照组(n=34)和观察组(n=46)。对照组患者接受羟氯喹治疗14 d,观察组采用羟氯喹治疗7 d后再加用雷公藤多苷片治疗7 d。比较治疗7、14 d时两组临床疗效、不良反应发生率以及两组患者羟氯喹血药浓度,分析羟氯喹治疗效果与血药浓度的相关性。结果两组治疗7 d时的临床疗效、不良反应发生率比较,差异无统计学意义(P>0.05)。观察组治疗14 d时的临床疗效高于对照组,不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。两组治疗7 d时羟氯喹血药浓度比较,差异无统计学意义(P>0.05),观察组治疗14 d时羟氯喹血药浓度高于对照组,差异有统计学意义(P<0.05)。CAD患者羟氯喹血药浓度与治疗效果呈正相关(r=0.517,P<0.05)。结论羟氯喹对CAD患者的治疗效果与血药浓度呈正相关,临床可以此为参考,预测CAD患者病情进展和治疗效果,对未达到有效血药浓度的患者,可联合使用免疫抑制剂使羟氯喹的血药浓度升高,从而产生相应的临床疗效。

Objective To study the therapeutic effect of Hydroxychloroquine combined with Tripterygium Glycoside Tablet in patients with chronic actinic dermatitis(CAD)and its correlation with blood concentration.Methods Clinical data of 80 CAD patients admitted to Dermatology Hospital of Jiangxi Province from January 2020 to July 2023 were retrospectively analyzed.According to different treatment methods,they were divided into control group(n=34)and observation group(n=46).Patients in the control group received Hydroxychloroquine treatment for 14 days.The observation group was treated with Hydroxychloroquine for 7 days and then treated with Tripterygium Glycoside Tablet for 7 days.The clinical efficacy,incidence of adverse reactions and blood concentration of Hydroxychloroquine in the two groups were compared at 7 and 14 days,and the correlation between the therapeutic effect of Hydroxychloroquine and blood concentration was analyzed.Results There were no significant differences in clinical efficacy and incidence of adverse reactions between the two groups after 7 days of treatment(P>0.05).After 14 days of treatment,the clinical efficacy of the observation group was higher than that of the control group,and the total incidence of adverse reactions was lower than that of the control group,with statistical significances(P<0.05).There was no statistical significance in the blood concentration of Hydroxychloroquine between the two groups at 7 days of treatment(P>0.05),but the blood concentration of Hydroxychloroquine in the observation group was higher than that in the control group at 14 days of treatment,and the difference was statistically significant(P<0.05).The serum concentration of Hydroxychloroquine in CAD patients was positively correlated with the therapeutic effect(r=0.517,P<0.05).Conclusion The therapeutic effect of Hydroxychloroquine on CAD patients is positively correlated with blood concentration,which can be used as a clinical reference to predict the disease progression and therapeutic effect of CAD patients.For patients who do not reach effective blood concentration,immunosuppressants can be combined to increase the blood concentration of Hydroxychloroquine,thus producing corresponding clinical efficacy.