阿维A不同给药时间对寻常性银屑病疗效的影响  

The Influence of Different Drug Administration Time of Acitretin in Treating Psoriasis Vulgaris

作　　者：张大维[1] 路永红[1] 刘艳[1] 吴波[1] 周沂[1] 谢莉[2] 吕艳[2] 刘延友[3] 

机构地区：[1]成都市第二人民医院皮肤科,四川成都610017 [2]成都市第二人民医院检验科,四川成都610017 [3]四川大学时间生物学实验室,四川成都610041

出　　处：《中国皮肤性病学杂志》2013年第5期465-468,共4页The Chinese Journal of Dermatovenereology

基　　金：四川省卫生厅科研项目(090028)

摘　　要：目的探讨阿维A治疗寻常性银屑病的最佳服药时间。方法选择90例寻常性银屑病患者随机分为早餐、中餐、晚餐3组。每组均以0.6mg/kg量予阿维A口服,同时予凡士林软膏外搽。共观察4周,分别于治疗前、治疗2周、治疗4周计算PASI评分并抽外周血检查TNF-α浓度,于治疗前后检查血常规及生化指标。同时记录不良反应。结果治疗后4周PASI评分比较,中餐组与早餐组和晚餐组比较差异均有统计学意义(P均<0.05)。治疗后4周TNF-α浓度比较,中餐组与早餐组和晚餐组比较差异均有统计学意义(P均<0.01)。不良反应方面,3组大部分病例均出现不同程度唇炎、口干、眼干、皮肤干燥脱屑等症状,均有肝酶及血脂升高。中餐组发生副作用的时间晚于其他组,且其他副作用的发生率低于另外两组。结论午餐服用阿维A治疗泛发性寻常性银屑病总体疗效优于早餐和晚餐,且不良反应发生率更低,发生时间更晚。Objective To evaluate the best time of drug administration of acitretin in treating universal psoriasis vulgar-is. Methods Totally, 90 patients suffering from universal psoriasis vulgaris were consecutively enrolled in this study, and randomly assigned into the breakfast, noon and dinner three groups. All patients were given o-ral acitretin 0.6mg/kg once a day, and each was additionally topical vaseline ointment twice a day for 4 weeks. The observation time include pretherapy ,2 weeks later and 4 weeks later. The outcome parameters in-elude PASI score, concentration of TNF-α, other experimental index and side-effect. Results Regarding the PASI score after 4 weeks, significant difference was observed （ P 〈 0.01 ） between the noon group and the breakfast group, the dinner group. Regarding concentration of TNF-α after 4 weeks, significant difference was observed（P 〈0. 01 ）between the noon group and the breakfast group, the dinner group. As to the side-effect, the synptoms of cheilitis, dry mouth, dry eye, dry skin and scaling were happened in the majority of the pa-tients of the three groups. About the experimental index, raising of transaminase and blood fat were observed in all groups. In a word,the side-effect happened later in the noon group than that in the other two groups, and the incidence of the side-effect was lower than the other two groups. Conclusion The response rate of the noon group is better than that in the other two groups in treating the universal psoriasis vulgaris, other-wise, the side-effect incidence is less, and the time is later.

关 键 词：银屑病 阿维A 时间生物学 PASI评分 TNF—α 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]