掌跖脓疱病临床相关因素及白芍总苷治疗作用的研究

发布时间：2018-02-22 21:56

本文关键词： 掌跖脓疱病斑贴试验白芍总苷雷公藤多苷　出处：《天津医科大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的：通过对掌跖脓疱病患者的临床资料进行综合分析,结合患者的斑贴试验检测结果,总结其发病的相关因素,同时观察白芍总苷治疗掌跖脓疱病的疗效,为预防和治疗掌跖脓疱病提供参考依据。方法： 1.采用调查问卷表的形式对2011年3月～2013年2月于天津市长征医院皮肤科治疗的197例掌跖脓疱病患者的临床资料进行登记。 2.对符合斑贴条件的患者进行斑贴试验,筛查每位患者最常见的过敏原。 3.将符合条件的90例掌跖脓疱病患者随机分为实验组和对照组,实验组给予白芍总苷胶囊口服,对照组给予雷公藤多苷片口服,同时均外用糠酸莫米松乳膏治疗。疗程均为8周。然后进行疗效比较,同时观察患者的不良反应。应用SPSS18.0完成全部统计分析。结果： 1.197例掌跖脓疱病中,男女比例为1：1.32,女性多于男性,发病年龄以41-50岁的比例最高；病程以5年以内居多,且以反复发作者最常见；职业中工人、农民占多数；发病的季节分布无明显差异；诱发或者加重病情的因素中以感染因素最常见；87例患者有吸烟不良嗜好；3例有寻常型银屑病病史；发病部位掌部以大鱼际最好发,足底以足弓最好发。 2.113例患者行斑贴试验发现有84例患者出现了一种甚至是多种的阳性反应,总阳性率为74.34%。阳性率较高的致敏原为重铬酸钾(32.74%)、硫酸镍(29.2%)。 3.治疗4周时实验组的有效率为40%；对照组的有效率为64.44%,两组之间比较差异有统计学意义(P0.05)；治疗8周时实验组的有效率为80%；对照组的有效率为88.89%,两组之间比较差异无统计学意义(P0.05)；实验组出现不良反应者5人,对照组出现不良反应者8人,两组之间比较差异无统计学意义(P0.05)。结论： 1.掌跖脓疱病女性发病率高于男性。 2.感染可能是掌跖脓疱病首要的发病因素。 3.吸烟可能在诱发或加重掌跖脓疱病中起一定的作用。 4.重铬酸钾、硫酸镍可能是诱发或加重掌跖脓疱病的潜在因素。 5.掌跖脓疱病可以认为是不同于银屑病的独立疾病。 6.白芍总苷治疗掌跖脓疱病安全有效。
[Abstract]:Objective: to analyze the clinical data of patients with palmoplantar pustulosis, combined with the results of patch test, to summarize the related factors and to observe the curative effect of total paeony glucoside on palmoplantar pustulosis. To provide a reference for the prevention and treatment of palmoplantar pustulosis. Methods:. 1. The clinical data of 197 cases of palmoplantar pustulosis treated in dermatology department of Tianjin Changzheng Hospital from March 2011 to February 2013 were registered by questionnaire. 2. The most common allergens of each patient were screened by patch test. 3. Ninety patients with palmoplantar pustulosis were randomly divided into experimental group and control group. The experimental group was administered with total paeony glucoside capsule and the control group was given tripterygium wilfordii polyglycoside tablets. The course of treatment was 8 weeks. Then the curative effect was compared and the adverse reactions of the patients were observed. The statistical analysis was done with SPSS18.0. Results:. 1. In 197 cases of palmoplantar pustulosis, the ratio of male and female was 1: 1.32, female was more than male, the age of onset was the highest in 41-50 years old, the course of disease was mostly within 5 years, and the recurrence was the most common. There was no significant difference in the seasonal distribution of the disease, among the factors that induced or aggravated the disease, the most common factor was infection. The most common factor was infection in 87 patients with bad habit of smoking and 3 patients had a history of psoriasis vulgaris, and the palmar region of the disease was the best in the thenar area. The sole of the foot is best served by the arch of the foot. 2.The spot patch test showed that 84 patients had one or more positive reaction, the total positive rate was 74.34. The allergen with higher positive rate was potassium dichromate 32.74g, nickel sulfate 29.2g. 3. The effective rate of the experimental group was 40 at the 4th week of treatment, the effective rate of the control group was 64.44, the difference between the two groups was statistically significant (P 0.05), the effective rate of the experimental group was 80 at the 8th week of treatment, and the effective rate of the control group was 88.89, the difference between the two groups was compared. There was no statistical significance (P 0.05), 5 patients in the experimental group had adverse reactions, There were 8 adverse reactions in the control group, and there was no significant difference between the two groups (P 0.05). Conclusion:. 1. The incidence of palmoplantar pustulosis was higher in women than in men. 2. Infection may be the primary cause of palmoplantar pustulosis. 3. Smoking may play a role in inducing or exacerbating palmoplantar pustulosis. 4. Potassium dichromate and nickel sulfate may be potential factors in inducing or exacerbating palmoplantar pustulosis. 5. Palmoplantar pustulosis can be considered as an independent disease different from psoriasis. 6. The total glucoside of paeony is safe and effective in the treatment of palmoplantar pustulosis.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R758.6

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