联合白芍总苷治疗斑秃的临床疗效分析  

Clinical analysis of alopecia areata treatment effect combined with total glucosides of paeony

作　　者：袁丞达[1] 王小勇[1] 寇霄 王敏磊[1] 应航宇[1] 陶承军[1] 邬成霖[1] 

机构地区：[1]浙江省杭州市中医院皮肤科,310007 [2]浙江省中山医院皮肤科,杭州市310007

出　　处：《中华全科医学》2015年第5期826-828,共3页Chinese Journal of General Practice

基　　金：浙江省中医药科技计划项目(2012ZB115);杭州市卫生科技计划项目(2011A051)

摘　　要：目的比较复方甘草酸苷、胱氨酸、哈西奈德与联合白芍总苷治疗斑秃的临床疗效,观察白芍总苷对外周血CD4+、CD8+细胞亚群的影响。方法将147例斑秃患者随机分为2组,治疗组80例,对照组67例,对照组采用口服复方甘草酸苷、胱氨酸,外用哈西奈德治疗,治疗组在此基础上联合白芍总苷,治疗3个月后进行疗效比较;记录所有患者治疗中出现不良反应,分析不良反应发生原因;抽取治疗组患者治疗前后的血样,通过流式细胞仪检查外周血中CD4+、CD8+细胞亚群,比较治疗前后CD4+、CD8+细胞亚群变化,并对所有患者进行跟踪随访,比较2组的复发率。结果治疗组痊愈22例,显效46例,有效10例,无效2例,复发3例,对照组痊愈9例,显效39例,有效16例,无效3例,复发9例,治疗组痊愈率、有效率高于对照组(P<0.05),治疗组治疗后CD4+、CD8+细胞亚群低于治疗前(P<0.05),治疗组复发率低于对照组(P<0.05);治疗期间主要不良反应为低钾、水肿、血压升高,但均不影响治疗。结论白芍总苷能调节外周血CD4+、CD8+细胞亚群,与复方甘草酸苷、胱氨酸、哈西奈德联合治疗斑秃能提高疗效,减少复发率。Objective To observe the clinical effect of total glucosides of paeony（ TGP） combined with compound glycyrrhizin,cystine,halcinonide in the treatment of alopecia areata and observe the effects of total glucosides of paeony on peripheral blood CD4^＋,CD8^＋lymphocyte subsets. Methods One hundred and forty-seven cases of alopecia areata patients were randomly divided into two groups,80 cases in the treatment group,67 cases in the control group,the control group was treated with compound glycyrrhizin,cystine,topical halcinonide treatment,in addition to the above treatment in treatment group added with TGP. Record adverse reactions in the treatment of all patients,the occurrence of the cause analysis of adverse drug reaction; Extraction blood in the treatment group before and after treatment and analyzed peripheral blood CD4^＋,CD8^＋cell subsets by flow cytometry examination comparison. The therapeutic effect was compared after 3 months treatment,and all patients were followed up,compare the relapse rate of 2 groups. Results The treatment group cured 22 cases,markedly effective 46 cases,effective 10 cases,invalid 2 cases,3 cases of recurrence,the control group cured 9 cases,markedly effective 39 cases,effective 16 cases,invalid 3 cases,recurrence in 9 cases,the cure rate of the treatment group and curative effect judgment,efficiency is higher than the control group（ P〈0. 05）,the recurrence rate of treatment group is lower than that of the control group（ P〈0. 05）. After treatment,CD4^＋,CD8^＋cells were lower than those before therapy（ P〈0. 05） in the treatment group. The main adverse reaction during the treatment of hypokalemia,edema,elevated blood pressure,but does not affect the treatment. Conclusion TGP can regulate the peripheral blood CD4^＋,CD8^＋lymphocyte subsets. TGP combined with compound glycyrrhizin,cystine,halcinonide can improve the curative effect,reduce the recurrence rate in the treatment of alopecia areata.

关 键 词：斑秃 白芍总苷 复方甘草酸苷 

分 类 号：R758.71[医药卫生—皮肤病学与性病学] R986[医药卫生—临床医学]