紫丹银屑颗粒联合阿维A胶囊和复方氟米松软膏治疗寻常型银屑病的临床观察  

Clinical Observation of Zidan Yinxie Granules Combined with Acitretin Capsule and Compound Flumetasone Ointment in the Treatment of Psoriasis Vulgaris

作　　者：毛荣超 唐美 邓仁远 蒙小兵 莫光亮 MAO Rongchao, TANG Mei, DENG Renyuan, MENG Xiaobing, MO Guangliang(Dept. of Dermatology, Qiannan Buyi and Miao Autonomous Prefecture People＇s Hospital, Guizhou Duyun 558000, Chin)

机构地区：[1]黔南布依族苗族自治州人民医院皮肤科,贵州都匀558000

出　　处：《中国药房》2018年第6期800-804,共5页China Pharmacy

基　　金：贵州省中医药;民族医药科学技术研究课题(No.QZYY2014017);贵州省黔南州科技计划项目(No.黔南科合社字[2015]019号)

摘　　要：目的:观察紫丹银屑颗粒联合阿维A胶囊和复方氟米松软膏治疗寻常型银屑病的临床效果与安全性。方法:将97例寻常型银屑病患者按随机数字表法分为对照组(48例)和观察组(49例)。对照组患者口服阿维A胶囊10 mg,tid,连用8周,后改为10 mg,bid,连用4周;并外涂复方氟米松软膏适量,bid。观察组患者在对照组治疗的基础上口服紫丹银屑颗粒4 g,tid。两组患者疗程均为12周。观察两组患者的临床疗效,治疗前后皮损面积和严重程度指数(PASI)评分、视觉模拟疼痛(VAS)评分、皮肤病生活质量指数(DLQI)评分、血清和皮损组织液中中性粒细胞蛋白酶(NE)、Trappin-2、胎盘型钙黏蛋白(P-cad)含量;随访治疗总有效患者6个月内的复发情况;观察患者不良反应发生情况。结果:观察组有2例患者脱落,47例患者完成研究;对照组有3例患者脱落,45例患者完成研究。观察组患者总有效率为97.87%,显著高于对照组的84.44%,差异有统计学意义(P<0.05)。治疗后,两组患者PASI、VAS、DLQI评分,血清和皮损组织液中NE、Trappin-2和P-cad含量均显著低于同组治疗前,且观察组显著低于对照组,差异均有统计学意义(P<0.05)。随访6个月,观察组治疗总有效患者复发率(28.26%)显著低于对照组(47.36%),且平均复发时间[(17.91±3.10)周]显著长于对照组[(9.80±3.41)周],差异均有统计学意义(P<0.05)。两组患者不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:紫丹银屑颗粒联合阿维A胶囊和复方氟米松软膏治疗寻常型银屑病可通过降低患者血清和皮损组织液中NE、Trappin-2和P-cad表达水平发挥疗效,且安全性较好。OBJECTIVE：To observe the clinical efficacy and safety of Zidan yinxie granules combined with Acitretin capsule and Compound flumetasone ointment in the treatment of psoriasis vulgaris. METHODS：A total of 97 patients with psoriasis vulgaris were divided into control group（48 cases） and observation group（49 cases） according to number random method. Control group was given Acitretin capsule 10 mg, tid, for consecutive 8 weeks, and then 10 mg, bid, for consecutive 4 weeks and Compound flumetasone ointment for external use,bid. Observation group was given Zidan yinxie granule 4 g,tid,on the basis of control group. Treatment courses of 2 groups lasted for 12 weeks. Clinical efficacy was observed in 2 groups. Psoriasis area and severity index（PASI） score,VAS score,dermatology life quality index（DLQI）score,the expression of neutrophil elastase（NE）,Trappin-2 and placental calcadin（P-cad）in serum and tissue fluid of skin lesion were observed before and after treatment. Recurrence followed up for 6 months in total effective patients and the occurrence of ADR were observed. RESULTS：Two patients of observation group withdrew from the study,and 47 patients completed the study;three patients of control group withdrew from the study,and 45 patients completed the study. Total response rate of observation group was 97.87%,which was significantly higher than 84.44% of control group,with statistical significance（P〈0.05）. After treatment,PASI,VAS and DLQI scores,the content of NE,Trappin-2 and P-cad in serum and tissue liquid of skin lesion were significantly lower than before treatment;the observation group was significantly lower than the control group. After 6-month follow-up,recurrence rate of total effective patients in observation group（28.26%） was significantly lower than control group（47.36%）, and average recurrence time of observation group [（17.91 ±3.10）weeks] was longer than that of control group [（9.80±3.41）weeks],with statistical significance（P〈0.05）. There was

关 键 词：寻常型银屑病 紫丹银屑颗粒 阿维A胶囊 复方氟米松软膏 中性粒细胞蛋白酶 Trappin-2 胎盘型钙黏蛋白 

分 类 号：R275.9[医药卫生—中西医结合]