莪仙化斑汤联合阿达木单抗治疗斑块型银屑病临床研究  

Clinical Study on Exian Huaban Decoction Combined with Adalimumab for Plaque Psoriasis

作　　者：吴满平 吴大兴 郭波 WU Manping;WU Daxing;GUO Bo(Department of Dermatology,Tongxiang Dermatology Prevention and Treatment Hospital,Tongxiang Zhejiang 314500,China)

机构地区：[1]桐乡市皮肤病防治院皮肤科,浙江桐乡314500

出　　处：《新中医》2024年第9期145-149,共5页New Chinese Medicine

摘　　要：目的:观察莪仙化斑汤联合阿达木单抗治疗斑块型银屑病的疗效及对患者症状缓解时间、经表皮水分丢失情况、血清人β-防御素-2(hBD-2)水平的影响。方法:选取86例斑块型银屑病患者,按随机数字表法分为联合组及对照组各43例,治疗期间2组各脱落2例,最终每组各41例。对照组给予阿达木单抗注射液治疗,联合组在对照组基础上加用莪仙化斑汤治疗。比较2组临床疗效及症状缓解时间,比较2组治疗前后皮肤屏障功能相关指标值、血清hBD-2水平的变化。结果:联合组临床疗效总有效率为95.12%,对照组为73.17%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组银屑病面积与严重性指数(PASI)评分均较治疗前下降(P<0.05),联合组PASI评分低于对照组(P<0.05)。治疗后,联合组红斑、鳞屑、瘙痒、面积及浸润症状缓解时间均较对照组短(P<0.05)。治疗后,2组皮质含量、角质层水分含量均较治疗前提升(P<0.05),经表皮水分丢失均较治疗前下降(P<0.05);联合组皮质含量、角质层水分含量均高于对照组(P<0.05),经表皮水分丢失低于对照组(P<0.05)。治疗后,2组血清hBD-2水平均较治疗前下降(P<0.05),联合组血清hBD-2水平低于对照组(P<0.05)。结论:莪仙化斑汤联合阿达木单抗治疗斑块型银屑病能有效缓解患者临床症状,降低瘙痒程度,减小银屑病面积,提高生活质量。Objective:To observe the curative effect of Exian Huaban Decoction combined with Adalimumab for plaque psoriasis,and its effect on symptom relief time,transepidermal water loss,and levels of human beta-defensin-2(hBD-2)in serum.Methods:A total of 86 patients with plaque psoriasis were selected and divided into the combination group and the control group according to the random number table method,with 43 cases in each group.During this period,2 cases were lost in each group,and finally 41 cases were obtained in each group.The control group was treated with Adalimumab Injection,and the combination group was treated with Exian Huaban Decoction based on the treatment of the control group.The clinical effects and symptom relief time were compared between two groups,and the changes in skin barrier function related indexes and serum hBD-2 levels were compared before and after treatment.Results:The total clinical effective rate was 95.12%in the combination group,and 73.17%in the control group,the difference being significant(P<0.05).After treatment,the psoriasis area and severity index(PASl)scores in the two groups were decreased when compared with those before treatment(P<0.05),and the PASl score in the combination group was lower than that in the control group(P<0.05).After treatment,the areas and infiltration relief time of symptoms including erythema,scales,and itching in the combination group were shorter than those in the control group(P<0.05).After treatment,the cortical content and stratum corneum moisture content in the two groups were increased when compared with those before treatment(P<0.05),and the loss of epidermal moisture was decreased when compared with that before treatment(P<0.05);the cortical content and stratum corneum moisture content in the combination group were higher than those in the control group(P<0.05),and the loss of epidermal moisture was lower than that in the control group(P<0.05).After treatment,the hBD-2 levels in serum in the two groups were decreased when compared with those before

关 键 词：斑块型银屑病 莪仙化斑汤 阿达木单抗 皮肤屏障功能 血清人β-防御素-2 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]