目的:观察干支耳位贴敷联合疏肝健脾化斑汤治疗女性肝郁脾虚型黄褐斑的疗效。方法:将80例女性患者采用随机数字表法随机分为治疗组和对照组。对照组中途退出1例,入组39例;治疗组失访脱落1例、未遵医嘱用药1例,入组38例。对照组给予疏肝...目的:观察干支耳位贴敷联合疏肝健脾化斑汤治疗女性肝郁脾虚型黄褐斑的疗效。方法:将80例女性患者采用随机数字表法随机分为治疗组和对照组。对照组中途退出1例,入组39例;治疗组失访脱落1例、未遵医嘱用药1例,入组38例。对照组给予疏肝健脾化斑汤治疗(药物组成:柴胡、白芍、白术、茯苓、当归、川芎、枳壳、泽泻、白蒺藜、菟丝子、僵蚕、甘草片),1剂/d,200 mL/次,早晚温服。治疗组在对照组治疗基础上加用干支耳位贴敷。采用王不留行籽贴于耳穴丑时位、巳时位、辰时位、子时位和寅时位,按压,5 min/次,3次/d,1周更换1次耳穴贴。两组均以4周为1个疗程,治疗3个疗程判定疗效。观察两组治疗前后的临床疗效、黄褐斑面积和严重程度指数(melasma area and severity index,MASI)评分、中医证候积分、黄褐斑生活质量评分(melasma quality of life score,MELASQOL)、VISIA皮肤图像检测仪评分、皮肤镜评分及患者满意度。结果:治疗组基本治愈5例,显效23例,有效7例,无效3例,有效率为92.11%(35/38);对照组基本治愈2例,显效10例,有效16例,无效11例,有效率为71.79%(28/39)。两组疗效对比,差异有统计学意义(P<0.01)。治疗后,两组MASI评分、中医证候积分、MELASQOL评分、面部VISIA皮肤图像检测仪评分、皮肤镜评分较治疗前均下降(P<0.01),且治疗组低于对照组(P<0.01),治疗组患者满意度高于对照组(P<0.05)。结论:干支耳位贴敷联合疏肝健脾化斑汤治疗女性肝郁脾虚型黄褐斑能提高临床疗效,提升患者生活质量。展开更多
目的:研究口服氨甲环酸联合皮内注射氨甲环酸治疗黄褐斑的临床疗效。方法:选取2019年1月-2022年1月于笔者医院皮肤科就诊的黄褐斑患者168例,随机数字法分为对照组和实验组,每组84例;对照组采用口服氨甲环酸治疗,实验组采用口服氨甲环酸...目的:研究口服氨甲环酸联合皮内注射氨甲环酸治疗黄褐斑的临床疗效。方法:选取2019年1月-2022年1月于笔者医院皮肤科就诊的黄褐斑患者168例,随机数字法分为对照组和实验组,每组84例;对照组采用口服氨甲环酸治疗,实验组采用口服氨甲环酸联合皮内注射氨甲环酸治疗,比较两组治疗前后的临床疗效、皮肤颜色评分、皮损面积评分、症状总分、黄褐斑面积及严重程度(Melasma area severity index,MASI)评分,及治疗1个月、3个月后整体评价(Physician's global assessment,PGA)评分。结果:两组治疗后疗效等级比较差异有统计学意义(P<0.05),实验组的总有效率为97.62%高于对照组的总有效率84.52%(P<0.05);两组治疗后皮肤颜色评分、皮损面积评分及症状总分显著低于治疗前,且实验组治疗后皮肤颜色评分、皮损面积评分及症状总分显著低于对照组(P<0.05);两组治疗3个月后PGA评分较治疗1个月后PGA评分显著下降,且实验组PGA评分显著低于对照组(P<0.05);两组治疗后MASI评分较治疗前显著下降,且实验组MASI评分显著低于对照组(P<0.05);观察组不良反应发生率为2.38%,与对照组的1.19%比较无统计学意义(P>0.05)。结论:口服氨甲环酸联合皮内注射氨甲环酸治疗黄褐斑疗效显著。展开更多
目的:探讨六味地黄汤加减联合超皮秒激光治疗稳定期黄褐斑临床效果观察。方法:将笔者医院2021年2月-2022年1月收治的86例稳定期肝肾阴虚型黄褐斑患者,按数字表法随机分为对照组42例和研究组44例。对照组给予口服维生素C、E和Q开关Nd∶YA...目的:探讨六味地黄汤加减联合超皮秒激光治疗稳定期黄褐斑临床效果观察。方法:将笔者医院2021年2月-2022年1月收治的86例稳定期肝肾阴虚型黄褐斑患者,按数字表法随机分为对照组42例和研究组44例。对照组给予口服维生素C、E和Q开关Nd∶YAG激光治疗,观察组给予六味地黄汤加减联合超皮秒激光治疗,比较两组治疗3个月后的治疗有效率、黄褐斑面积和严重指数评分(Melasma area severity index,MASI)、中医证候积分、生活质量及安全性。结果:治疗3个月后,研究组治疗有效率86.36%,显著高于对照组的66.67%(P<0.05);治疗1个月后、治疗3个月后,两组MASI评分均较治疗前明显降低,且研究组MASI评分均显著低于对照组(P<0.05);治疗3个月后,两组各项中医证候积分均较治疗前明显降低,且研究组各项中医证候积分均显著低于对照组(P<0.05);治疗3个月后,两组黄褐斑生活质量评分(MELA-subjective quality of life,MELA-SQOL)、皮肤病生活质量指数(Dermatology life quality index,DLQI)均较治疗前明显降低,且研究组MELASQOL、DLQI评分均显著低于对照组(P<0.05);两组不良反应发生情况差异无统计学意义。结论:六味地黄汤加减联合超皮秒激光治疗稳定期黄褐斑疗效显著,该联合疗法能有效改善患者的皮损程度和生活质量,安全性高,值得临床推广应用。展开更多
Background: The Psoriasis Area and Severity Index (PASI) is the most frequently used clinical severity scale in clinical trials. Drug approval often depends on a 75%improvement in the baseline PASI score, also known a...Background: The Psoriasis Area and Severity Index (PASI) is the most frequently used clinical severity scale in clinical trials. Drug approval often depends on a 75%improvement in the baseline PASI score, also known as a PASI 75 or Delta PASI 75. This benchmark may be an overly stringent way to determine the success of psoriasis treatments as Delta PASIs appear to under-represent true clinical improvement. This discrepancy may relate to the way numerical values are assigned to the degree of body surface area (BSA) involvement. Objectives: To assesswhether altering the BSA component of the PASI formula so that it is weighted more heavily will result in a calculated change in psoriasis severity that more closely reflects patient assessment of improvement. Models developed included the Psoriasis Log-based Area and Severity Index (PLASI), which assigns values to the BSA score based on a linear scale using logarithms to define the intervals, and the Psoriasis Exact Area and Severity Index (PEASI), which uses the actual BSA as the multiplicative factor in the area score. Methods: Data were abstracted retrospectively fromtwo clinical trials involving psoriasis treatments that used the PASI. The same trained psoriasis graders were involved in both trials. In these trials, baseline and end-point PASI worksheets were completed that included the actual clinician-estimated BSA involvement (0-100%) for each of the four areas (head, upper extremities, trunk and lower extremities). In one of the trials, patients were asked to assess the percentage improvement in their psoriasis at the end of the treatment window. PASIs and Delta PASIs were recalculated based on the newmodels and all scoring systemswere validated by analysing their relationship to patients’self-assessments. Results: Clinical improvements under the new grading systems translated into greater percentage changes than calculated using the Delta PASI formula. Specifically, the Delta PASI 50 translated to a Delta PLASI 57.2 and Delta PEASI 61.1; Delta PASI 75 was equivalent to Delta PLASI 85.7 and Delta PEASI 91.7. Importantly,Delta PASI tended to be systematically lower than patients’self-assessment, while Delta PLASI and Delta PEASI better matched patients’self-assessments using a best-fit model. Conclusions: These results suggest that the Delta PASI underestimates percentage improvement when compared with measures of patient’s self-assessment, while Delta PLASI and Delta PEASI correlate better. Prospective studies will have to be performed to confirm these relationships, but weighting BSA more heavily in the severity score may result in a more accurate reflection of clinical status.展开更多
目的观察不同分期斑块状银屑病患者血清白细胞介素-22(interleukin-22,IL-22)水平变化,探讨IL-22与银屑病面积和严重程度指数(psoriasis area and severity index,PASI)评分的相关性。方法斑块状银屑病患者45例,其中进展期15例为进展期...目的观察不同分期斑块状银屑病患者血清白细胞介素-22(interleukin-22,IL-22)水平变化,探讨IL-22与银屑病面积和严重程度指数(psoriasis area and severity index,PASI)评分的相关性。方法斑块状银屑病患者45例,其中进展期15例为进展期组,静止期15例为静止期组,退行期15例为退行期组;同期体检健康者15例为对照组。采用EILSA法检测各组血清IL-22水平;对银屑病患者行PASI评分;Pearson相关法分析银屑病患者PASI评分与血清IL-22的相关性。结果进展期组、静止期组、退行期组血清IL-22水平[(28.01±6.72)、(21.78±4.84)、(11.19±2.20)ng/L]均高于对照组[(9.33±2.17)ng/L](P<0.05),进展期组、静止期组、退行期组血清IL-22水平依次降低(P<0.05)。进展期组、静止期组、退行期组PASI评分[(20.96±5.42)、(14.72±3.13)、(6.48±1.70)分]依次降低(P<0.05)。Pearson相关分析结果显示,进展期组、静止期组、退行期组PASI评分与血清IL-22均呈正相关(r=0.810,P<0.001;r=0.589,P=0.021;r=0.772,P<0.001)。结论IL-22参与斑块状银屑病的发生、发展,与病情严重程度有关,不同分期患者的PASI评分与血清IL-22呈正相关。展开更多
目的:探讨白介素(IL)-18及IL-27在寻常性银屑病(PV)发病机制中的作用。方法:采用实时荧光定量聚合酶链式反应(PCR)检测54例PV患者和40例健康对照组外周血中IL-18及IL-27 m RNA的表达,分析42例PV患者应用白芍总苷(TGP)治疗4周后及23例患...目的:探讨白介素(IL)-18及IL-27在寻常性银屑病(PV)发病机制中的作用。方法:采用实时荧光定量聚合酶链式反应(PCR)检测54例PV患者和40例健康对照组外周血中IL-18及IL-27 m RNA的表达,分析42例PV患者应用白芍总苷(TGP)治疗4周后及23例患者治疗8周后外周血中IL-18及IL-27 m RNA的表达水平,并对患者进行银屑病皮损面积和严重程度指数(PASI)评分。结果:PV患者外周血中IL-18和IL-27 m RNA的表达水平明显高于健康对照组(P<0.01)。IL-18与IL-27的ΔCt值呈正相关(r=0.706,P<0.05)。PASI评分与IL-18 m RNA表达呈正相关(r=0.613,P<0.05),与IL-27 m RNA的表达无明显相关性(P>0.05);经TGP治疗4周后,患者外周血中IL-18和IL-27 m RNA的表达及PASI评分均明显降低(P<0.05)。与治疗4周后比较,治疗8周后患者IL-18 m RNA的表达及PASI评分也明显降低(P<0.05);而IL-27 m RNA的表达差异无统计学意义(P>0.05),但PASI评分降低(P<0.05)。结论:IL-18及IL-27可能与PV发病有关。展开更多
文摘目的:观察干支耳位贴敷联合疏肝健脾化斑汤治疗女性肝郁脾虚型黄褐斑的疗效。方法:将80例女性患者采用随机数字表法随机分为治疗组和对照组。对照组中途退出1例,入组39例;治疗组失访脱落1例、未遵医嘱用药1例,入组38例。对照组给予疏肝健脾化斑汤治疗(药物组成:柴胡、白芍、白术、茯苓、当归、川芎、枳壳、泽泻、白蒺藜、菟丝子、僵蚕、甘草片),1剂/d,200 mL/次,早晚温服。治疗组在对照组治疗基础上加用干支耳位贴敷。采用王不留行籽贴于耳穴丑时位、巳时位、辰时位、子时位和寅时位,按压,5 min/次,3次/d,1周更换1次耳穴贴。两组均以4周为1个疗程,治疗3个疗程判定疗效。观察两组治疗前后的临床疗效、黄褐斑面积和严重程度指数(melasma area and severity index,MASI)评分、中医证候积分、黄褐斑生活质量评分(melasma quality of life score,MELASQOL)、VISIA皮肤图像检测仪评分、皮肤镜评分及患者满意度。结果:治疗组基本治愈5例,显效23例,有效7例,无效3例,有效率为92.11%(35/38);对照组基本治愈2例,显效10例,有效16例,无效11例,有效率为71.79%(28/39)。两组疗效对比,差异有统计学意义(P<0.01)。治疗后,两组MASI评分、中医证候积分、MELASQOL评分、面部VISIA皮肤图像检测仪评分、皮肤镜评分较治疗前均下降(P<0.01),且治疗组低于对照组(P<0.01),治疗组患者满意度高于对照组(P<0.05)。结论:干支耳位贴敷联合疏肝健脾化斑汤治疗女性肝郁脾虚型黄褐斑能提高临床疗效,提升患者生活质量。
文摘目的:研究口服氨甲环酸联合皮内注射氨甲环酸治疗黄褐斑的临床疗效。方法:选取2019年1月-2022年1月于笔者医院皮肤科就诊的黄褐斑患者168例,随机数字法分为对照组和实验组,每组84例;对照组采用口服氨甲环酸治疗,实验组采用口服氨甲环酸联合皮内注射氨甲环酸治疗,比较两组治疗前后的临床疗效、皮肤颜色评分、皮损面积评分、症状总分、黄褐斑面积及严重程度(Melasma area severity index,MASI)评分,及治疗1个月、3个月后整体评价(Physician's global assessment,PGA)评分。结果:两组治疗后疗效等级比较差异有统计学意义(P<0.05),实验组的总有效率为97.62%高于对照组的总有效率84.52%(P<0.05);两组治疗后皮肤颜色评分、皮损面积评分及症状总分显著低于治疗前,且实验组治疗后皮肤颜色评分、皮损面积评分及症状总分显著低于对照组(P<0.05);两组治疗3个月后PGA评分较治疗1个月后PGA评分显著下降,且实验组PGA评分显著低于对照组(P<0.05);两组治疗后MASI评分较治疗前显著下降,且实验组MASI评分显著低于对照组(P<0.05);观察组不良反应发生率为2.38%,与对照组的1.19%比较无统计学意义(P>0.05)。结论:口服氨甲环酸联合皮内注射氨甲环酸治疗黄褐斑疗效显著。
文摘目的:探讨六味地黄汤加减联合超皮秒激光治疗稳定期黄褐斑临床效果观察。方法:将笔者医院2021年2月-2022年1月收治的86例稳定期肝肾阴虚型黄褐斑患者,按数字表法随机分为对照组42例和研究组44例。对照组给予口服维生素C、E和Q开关Nd∶YAG激光治疗,观察组给予六味地黄汤加减联合超皮秒激光治疗,比较两组治疗3个月后的治疗有效率、黄褐斑面积和严重指数评分(Melasma area severity index,MASI)、中医证候积分、生活质量及安全性。结果:治疗3个月后,研究组治疗有效率86.36%,显著高于对照组的66.67%(P<0.05);治疗1个月后、治疗3个月后,两组MASI评分均较治疗前明显降低,且研究组MASI评分均显著低于对照组(P<0.05);治疗3个月后,两组各项中医证候积分均较治疗前明显降低,且研究组各项中医证候积分均显著低于对照组(P<0.05);治疗3个月后,两组黄褐斑生活质量评分(MELA-subjective quality of life,MELA-SQOL)、皮肤病生活质量指数(Dermatology life quality index,DLQI)均较治疗前明显降低,且研究组MELASQOL、DLQI评分均显著低于对照组(P<0.05);两组不良反应发生情况差异无统计学意义。结论:六味地黄汤加减联合超皮秒激光治疗稳定期黄褐斑疗效显著,该联合疗法能有效改善患者的皮损程度和生活质量,安全性高,值得临床推广应用。
文摘Background: The Psoriasis Area and Severity Index (PASI) is the most frequently used clinical severity scale in clinical trials. Drug approval often depends on a 75%improvement in the baseline PASI score, also known as a PASI 75 or Delta PASI 75. This benchmark may be an overly stringent way to determine the success of psoriasis treatments as Delta PASIs appear to under-represent true clinical improvement. This discrepancy may relate to the way numerical values are assigned to the degree of body surface area (BSA) involvement. Objectives: To assesswhether altering the BSA component of the PASI formula so that it is weighted more heavily will result in a calculated change in psoriasis severity that more closely reflects patient assessment of improvement. Models developed included the Psoriasis Log-based Area and Severity Index (PLASI), which assigns values to the BSA score based on a linear scale using logarithms to define the intervals, and the Psoriasis Exact Area and Severity Index (PEASI), which uses the actual BSA as the multiplicative factor in the area score. Methods: Data were abstracted retrospectively fromtwo clinical trials involving psoriasis treatments that used the PASI. The same trained psoriasis graders were involved in both trials. In these trials, baseline and end-point PASI worksheets were completed that included the actual clinician-estimated BSA involvement (0-100%) for each of the four areas (head, upper extremities, trunk and lower extremities). In one of the trials, patients were asked to assess the percentage improvement in their psoriasis at the end of the treatment window. PASIs and Delta PASIs were recalculated based on the newmodels and all scoring systemswere validated by analysing their relationship to patients’self-assessments. Results: Clinical improvements under the new grading systems translated into greater percentage changes than calculated using the Delta PASI formula. Specifically, the Delta PASI 50 translated to a Delta PLASI 57.2 and Delta PEASI 61.1; Delta PASI 75 was equivalent to Delta PLASI 85.7 and Delta PEASI 91.7. Importantly,Delta PASI tended to be systematically lower than patients’self-assessment, while Delta PLASI and Delta PEASI better matched patients’self-assessments using a best-fit model. Conclusions: These results suggest that the Delta PASI underestimates percentage improvement when compared with measures of patient’s self-assessment, while Delta PLASI and Delta PEASI correlate better. Prospective studies will have to be performed to confirm these relationships, but weighting BSA more heavily in the severity score may result in a more accurate reflection of clinical status.
文摘目的观察不同分期斑块状银屑病患者血清白细胞介素-22(interleukin-22,IL-22)水平变化,探讨IL-22与银屑病面积和严重程度指数(psoriasis area and severity index,PASI)评分的相关性。方法斑块状银屑病患者45例,其中进展期15例为进展期组,静止期15例为静止期组,退行期15例为退行期组;同期体检健康者15例为对照组。采用EILSA法检测各组血清IL-22水平;对银屑病患者行PASI评分;Pearson相关法分析银屑病患者PASI评分与血清IL-22的相关性。结果进展期组、静止期组、退行期组血清IL-22水平[(28.01±6.72)、(21.78±4.84)、(11.19±2.20)ng/L]均高于对照组[(9.33±2.17)ng/L](P<0.05),进展期组、静止期组、退行期组血清IL-22水平依次降低(P<0.05)。进展期组、静止期组、退行期组PASI评分[(20.96±5.42)、(14.72±3.13)、(6.48±1.70)分]依次降低(P<0.05)。Pearson相关分析结果显示,进展期组、静止期组、退行期组PASI评分与血清IL-22均呈正相关(r=0.810,P<0.001;r=0.589,P=0.021;r=0.772,P<0.001)。结论IL-22参与斑块状银屑病的发生、发展,与病情严重程度有关,不同分期患者的PASI评分与血清IL-22呈正相关。
文摘目的:探讨白介素(IL)-18及IL-27在寻常性银屑病(PV)发病机制中的作用。方法:采用实时荧光定量聚合酶链式反应(PCR)检测54例PV患者和40例健康对照组外周血中IL-18及IL-27 m RNA的表达,分析42例PV患者应用白芍总苷(TGP)治疗4周后及23例患者治疗8周后外周血中IL-18及IL-27 m RNA的表达水平,并对患者进行银屑病皮损面积和严重程度指数(PASI)评分。结果:PV患者外周血中IL-18和IL-27 m RNA的表达水平明显高于健康对照组(P<0.01)。IL-18与IL-27的ΔCt值呈正相关(r=0.706,P<0.05)。PASI评分与IL-18 m RNA表达呈正相关(r=0.613,P<0.05),与IL-27 m RNA的表达无明显相关性(P>0.05);经TGP治疗4周后,患者外周血中IL-18和IL-27 m RNA的表达及PASI评分均明显降低(P<0.05)。与治疗4周后比较,治疗8周后患者IL-18 m RNA的表达及PASI评分也明显降低(P<0.05);而IL-27 m RNA的表达差异无统计学意义(P>0.05),但PASI评分降低(P<0.05)。结论:IL-18及IL-27可能与PV发病有关。
