复方甘草酸苷联合甲氨蝶呤治疗红皮病型银屑病疗效及其对患者血清IL-17、IL-23水平的影响

Efficacy of compound glycyrrhizin combined with methotrexate in the treatment of erythroderma psoriaticum and influence on serum IL-17 and IL-23

目的观察复方甘草酸苷联合甲氨蝶呤(MTX)治疗红皮病型银屑病的疗效及其对患者血清白细胞介素-17(IL-17)及白细胞介素-23(IL-23)水平的影响。方法选取2012年2月至2015年2月在我院皮肤科门诊及住院部治疗的红皮病型银屑病患者80例,按入院时间顺序,以2012年2月至2013年8月收治的患者为对照组,以2013年9月至2015年2月收治的患者为观察组,各40例。对照组给予甲氨蝶呤片口服,观察组口服甲氨蝶呤的同时给予复方甘草酸苷片口服,8周后评价两组患者的治疗效果,并测定患者血清中IL-17、IL-23水平的变化,比较药物不良反应。结果治疗8周后,观察组的治疗有效率为82.5%(33/40),明显高于对照组的65.0%(26/40),两组比较差异有统计学意义(P<0.05);两组患者治疗前的血清IL-17、IL-23水平比较差异均无统计学意义(P>0.05),治疗后对照组患者的血清IL-17、IL-23水平分别为(1.42±1.15)ng/L和(254.7±152.6)ng/L,观察组分别为(0.95±0.81)ng/L和(184.2±105.4)ng/L,分别与同组治疗前比较均明显降低,差异均有统计学意义(P<0.05),且观察组下降更明显,与对照组比较差异均具有统计学意义(P<0.05);观察组不良反应发生率为72.5%(29/40),明显低于对照组的100.0%(40/40),差异有统计学意义(P<0.05)。结论复方甘草酸苷联合甲氨蝶呤治疗红皮病型银屑病疗效好,两者具有协同作用,可减少药物不良反应,减少血清中炎症因子IL-17及IL-23的水平。

Objective To observe the clinical effect of compound glycyrrhizin combined with methotrexate(MTX) in treating erythroderma psoriaticum and the influence on serum interleukin-17(IL-17) and interleukin-23(IL-23) levels. Methods Eighty patients of erythroderma psoriaticum in our hospital from February 2012 to February2015 were randomly divided into treatment group(Sep. 2013 to Feb. 2015) and control group(Feb. 2012 to Aug. 2013)according to admission time, with 40 patients in each group. The control group was treated with MTX, while the treatment group was treated with MTX and compound glycyrrhizin. The curative effect of the two groups after two months of treatment was compared and the serum IL-17 and IL-23 levels before and after treatment were investigated. The adverse drug reactions were observed after treatment. Results After two months of treatment, the total effective rate was82.5%(33/40) in treatment group and 65.0%(26/40) in control group, with statistically significant difference(P<0.05).The serum IL-17 and IL-23 levels had no statistically significant difference between the two groups(P>0.05). The levels in the two groups after treatment [control group:(1.42±1.15) ng/L,(254.7±152.6) ng/L; treatment group:(0.95±0.81)ng/L,(184.2±105.4) ng/L] were all significantly decreased compared with those before treatment(P<0.05), and the decrease in the treatment group was more significant(P<0.05). The incidence of adverse reactions of treatment group[72.5%(29/40)] was significantly lower than that of the control group [100.0%(40/40)], and the difference was statistically significant(P<0.05). Conclusion Compound glycyrrhizin combined with MTX is effective in treating erythroderma psoriaticum in a synergic manner. It could reduce the adverse reactions and decrease IL-17 and IL-23 levels.