【摘要】：目的銀屑病存在易復(fù)發(fā)、難治愈的特點(diǎn),且采用聯(lián)合用藥治療銀屑病的研究較少。文中旨在研究白芍總苷膠囊(TGP)聯(lián)合阿維A、復(fù)方氟米松治療尋常性銀屑病(PV)的臨床效果及對(duì)患者外周血細(xì)胞因子水平的影響。方法選取2015年10月至2017年1月于蘇州大學(xué)附屬第一醫(yī)院皮膚科就診的126例PV患者,隨機(jī)數(shù)字表法分為聯(lián)合用藥組(阿維A+復(fù)方氟米松軟膏+TGP)和對(duì)照組(阿維A+復(fù)方氟米松軟膏),每組63例。通過(guò)對(duì)2組患者治療前后外周血白細(xì)胞介素IL-17、IL-18、IL-23等指標(biāo)水平綜合評(píng)價(jià)臨床治療效果。結(jié)果 2組銀屑病患者治療后IL-17、IL-18及IL-23濃度較治療前均明顯降低,聯(lián)合用藥組3項(xiàng)指標(biāo)下降幅度最大(P0.05);治療后聯(lián)合用藥組IL-17[(61.18±8.91)pg/m L]、IL-18[(68.56±17.95)pg/m L]及IL-23濃度[(70.13±12.16)pg/m L]均明顯低于對(duì)照組[(78.64±7.85)、(79.49±18.64)、(91.18±16.89)pg/m L],差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后聯(lián)合用藥組TNF-α[(14.47±7.53)ng/L]、PASI評(píng)分[(4.09±1.29)分]及皮損總面積百分比[(6.17±4.59)%]均明顯低于對(duì)照組[(23.49±8.12)ng/L、(7.29±5.13)分、(8.09±5.18)%],且較治療前顯著下降,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2組不良反應(yīng)發(fā)生率比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。聯(lián)合用藥組治療總有效率較對(duì)照組明顯升高(85.71%vs 65.08%,P0.05)。結(jié)論白芍總苷膠囊聯(lián)合阿維A、復(fù)方氟米松可有效調(diào)節(jié)IL-17、IL-18、IL-23及TNF-α水平,從而顯著提高銀屑病的臨床治療效果。
[Abstract]:Objective Psoriasis is easy to relapse and difficult to cure. The aim of this study was to study the clinical effect of total glucoside of paeony (TGP) combined with Avera and compound flutamethasone in the treatment of psoriasis vulgaris (PV) and the effect of TGP on peripheral blood cytokine levels in patients with psoriasis vulgaris. Methods 126 patients with PV were selected from October 2015 to January 2017 in the Department of Dermatology, the first affiliated Hospital of Suzhou University. The patients were randomly divided into two groups: Avera compound flutamethasone ointment (TGP) and control group (Avera compound flumisone ointment) with 63 cases in each group. The clinical therapeutic effect was evaluated by the level of IL-17, IL-18 and IL-23 in peripheral blood before and after treatment. Results the levels of IL-17, IL-18 and IL-23 in patients with psoriasis after treatment were significantly lower than those before treatment. The levels of IL-17 [(61.18 鹵8.91) pg/m L] and IL-23 [(68.56 鹵17.95) pg/m L] and IL-23 (70.13 鹵12.16 pg/m L) in the combined treatment group were significantly lower than those in the control group [(78.64 鹵7.85), (79.49 鹵18.64), (91.18 鹵16.89) pg/m L] after treatment (P0.05). After treatment, the TNF- 偽 [(14.47 鹵7.53) ng / L] PASI score [(4.09 鹵1.29) scores] and the percentage of total lesion area [(6.17 鹵4.59)%] were significantly lower in the combined group than in the control group [(23.49 鹵8.12) ng / L, (7.29 鹵5.13), (8.09 鹵5.18)%]. The total effective rate of the combined treatment group was significantly higher than that of the control group (85.71%vs 65.08 and P0.05). Conclusion Total glucoside capsule of paeony combined with Avera and compound flumisone can effectively regulate the levels of IL-17, IL-18, IL-23 and TNF- 偽, so as to improve the clinical therapeutic effect of psoriasis.
【作者單位】： 蘇州大學(xué)附屬第一醫(yī)院皮膚科;
【分類(lèi)號(hào)】：R758.63

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