本文關(guān)鍵詞： 掌跖膿皰病 斑貼試驗(yàn) 白芍總苷 雷公藤多苷　出處：《天津醫(yī)科大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：通過對掌跖膿皰病患者的臨床資料進(jìn)行綜合分析,結(jié)合患者的斑貼試驗(yàn)檢測結(jié)果,總結(jié)其發(fā)病的相關(guān)因素,同時(shí)觀察白芍總苷治療掌跖膿皰病的療效,為預(yù)防和治療掌跖膿皰病提供參考依據(jù)。 方法： 1.采用調(diào)查問卷表的形式對2011年3月～2013年2月于天津市長征醫(yī)院皮膚科治療的197例掌跖膿皰病患者的臨床資料進(jìn)行登記。 2.對符合斑貼條件的患者進(jìn)行斑貼試驗(yàn),篩查每位患者最常見的過敏原。 3.將符合條件的90例掌跖膿皰病患者隨機(jī)分為實(shí)驗(yàn)組和對照組,實(shí)驗(yàn)組給予白芍總苷膠囊口服,對照組給予雷公藤多苷片口服,同時(shí)均外用糠酸莫米松乳膏治療。療程均為8周。然后進(jìn)行療效比較,同時(shí)觀察患者的不良反應(yīng)。應(yīng)用SPSS18.0完成全部統(tǒng)計(jì)分析。 結(jié)果： 1.197例掌跖膿皰病中,男女比例為1：1.32,女性多于男性,發(fā)病年齡以41-50歲的比例最高；病程以5年以內(nèi)居多,且以反復(fù)發(fā)作者最常見；職業(yè)中工人、農(nóng)民占多數(shù)；發(fā)病的季節(jié)分布無明顯差異；誘發(fā)或者加重病情的因素中以感染因素最常見；87例患者有吸煙不良嗜好；3例有尋常型銀屑病病史；發(fā)病部位掌部以大魚際最好發(fā),足底以足弓最好發(fā)。 2.113例患者行斑貼試驗(yàn)發(fā)現(xiàn)有84例患者出現(xiàn)了一種甚至是多種的陽性反應(yīng),總陽性率為74.34%。陽性率較高的致敏原為重鉻酸鉀(32.74%)、硫酸鎳(29.2%)。 3.治療4周時(shí)實(shí)驗(yàn)組的有效率為40%；對照組的有效率為64.44%,兩組之間比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)；治療8周時(shí)實(shí)驗(yàn)組的有效率為80%；對照組的有效率為88.89%,兩組之間比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)；實(shí)驗(yàn)組出現(xiàn)不良反應(yīng)者5人,對照組出現(xiàn)不良反應(yīng)者8人,兩組之間比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論： 1.掌跖膿皰病女性發(fā)病率高于男性。 2.感染可能是掌跖膿皰病首要的發(fā)病因素。 3.吸煙可能在誘發(fā)或加重掌跖膿皰病中起一定的作用。 4.重鉻酸鉀、硫酸鎳可能是誘發(fā)或加重掌跖膿皰病的潛在因素。 5.掌跖膿皰病可以認(rèn)為是不同于銀屑病的獨(dú)立疾病。 6.白芍總苷治療掌跖膿皰病安全有效。
[Abstract]:Objective: to analyze the clinical data of patients with palmoplantar pustulosis, combined with the results of patch test, to summarize the related factors and to observe the curative effect of total paeony glucoside on palmoplantar pustulosis. To provide a reference for the prevention and treatment of palmoplantar pustulosis. Methods:. 1. The clinical data of 197 cases of palmoplantar pustulosis treated in dermatology department of Tianjin Changzheng Hospital from March 2011 to February 2013 were registered by questionnaire. 2. The most common allergens of each patient were screened by patch test. 3. Ninety patients with palmoplantar pustulosis were randomly divided into experimental group and control group. The experimental group was administered with total paeony glucoside capsule and the control group was given tripterygium wilfordii polyglycoside tablets. The course of treatment was 8 weeks. Then the curative effect was compared and the adverse reactions of the patients were observed. The statistical analysis was done with SPSS18.0. Results:. 1. In 197 cases of palmoplantar pustulosis, the ratio of male and female was 1: 1.32, female was more than male, the age of onset was the highest in 41-50 years old, the course of disease was mostly within 5 years, and the recurrence was the most common. There was no significant difference in the seasonal distribution of the disease, among the factors that induced or aggravated the disease, the most common factor was infection. The most common factor was infection in 87 patients with bad habit of smoking and 3 patients had a history of psoriasis vulgaris, and the palmar region of the disease was the best in the thenar area. The sole of the foot is best served by the arch of the foot. 2.The spot patch test showed that 84 patients had one or more positive reaction, the total positive rate was 74.34. The allergen with higher positive rate was potassium dichromate 32.74g, nickel sulfate 29.2g. 3. The effective rate of the experimental group was 40 at the 4th week of treatment, the effective rate of the control group was 64.44, the difference between the two groups was statistically significant (P 0.05), the effective rate of the experimental group was 80 at the 8th week of treatment, and the effective rate of the control group was 88.89, the difference between the two groups was compared. There was no statistical significance (P 0.05), 5 patients in the experimental group had adverse reactions, There were 8 adverse reactions in the control group, and there was no significant difference between the two groups (P 0.05). Conclusion:. 1. The incidence of palmoplantar pustulosis was higher in women than in men. 2. Infection may be the primary cause of palmoplantar pustulosis. 3. Smoking may play a role in inducing or exacerbating palmoplantar pustulosis. 4. Potassium dichromate and nickel sulfate may be potential factors in inducing or exacerbating palmoplantar pustulosis. 5. Palmoplantar pustulosis can be considered as an independent disease different from psoriasis. 6. The total glucoside of paeony is safe and effective in the treatment of palmoplantar pustulosis.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R758.6

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