311nm窄谱中波紫外线照射治疗寻常性银屑病疗效观察

Observation of the efficacy of 311 nm narrow-band ultraviolet B phototherapyin psoriasis vulgaris

目的观察311nm窄谱中波紫外线(NB-UVB)照射治疗寻常性银屑病的疗效及其影响因素。方法单独采用NB-UVB照射或联合糠馏油硼酸氧化锌软膏(PBZS)封包治疗寻常性银屑病87例,并以银屑病面积和严重度指数(PASI)评价疗效,分析性别、皮肤类型、临床分型及临床分期对疗效的影响,同时对采用其他方法治疗的30例寻常性银屑病患者进行回顾性的评价。结果在(17.60±4.42)d、(16.90±5.80)d、(25.80±6.67)d治疗后,NB-UVB组、NB-UVB+PBZS组及回顾分析组治疗前后PASI评分改善率分别为(76.3±24.6)%、(88.1±28.7)%、(76.5±26.2)%;与回顾分析组比较,NB-UVB组与其疗效相当(P>0.05),但治疗时间显著缩短(P<0.05),而NB-UVB+PBZS组则在更短的治疗时间(P<0.05)取得了更好的疗效(P<0.05);疗效相关因素分析表明,点滴状略优于斑块状、进行期略优于静止期(0.01<P<0.05)。结论NB-UVB照射治疗寻常性银屑病疗效好、不良反应小,NB-UVB与PBZS联合使用能显著增加疗效,其疗效可能与寻常性银屑病的亚型及分期有关。

Objective: To observe the efficacy and its correlated factors of 311 nm narrow-band ultraviolet B (NB-UVB) in the treatment of patients with psoriasis vulgaris. Methods: A total of 87 patients were treated by 311 nm NB-UVB radiation only or combined with topical therapy of pityroli-boracic acid-zinc oxide salve (PBZS), and 30 cases of psoriasis vulgaris treated previously with other methods were also reviewed. Results: The efficacy was evaluated by psoriasis area and severity index(PASI) and the correlated factors such as sex, age, skin type, clinical typing and staging were analyzed. Results: After (17.60±4.42)d,(16.90±5.80)d and (25.80±6.67)d treatment, the improved rates of PASI of NB-UVB group, NB-UVB +PBZS group and review group were (76.3±24.6)%,(88.1±28.7)% and (76.5±26.2)%, respectively. When compared with review group, the efficacy of NB-UVB group had no difference (P > 0.05), but the treatment time was significantly shorter(P < 0.05), while NB-UVB +PBZS group got better efficacy (P < 0.05)in shorter time(P < 0.05). Analysis of correlated factors showed that the efficacy in psoriasis guttata was better than in plaque type, and in progress stage was better than in quiescent stage(0.01 < P < 0.05), respectively. Conclusions: Radiation of 311 nm NB-UVB was safe and effective for psoriasis vulgaris. Combination with topical PBZS could improve the efficacy significantly. The effectiveness may also be correlated to the clinical type and stage of the disease.