阿维A联合中药复方治疗银屑病临床疗效观察

发布时间：2018-03-22 14:17

本文选题：银屑病　切入点：阿维A　出处：《湖北中医药大学》2010年硕士论文　论文类型：学位论文

【摘要】： 目的：本研究旨在通过临床观察来比较阿维A、中药复方及两种药物联合应用这三种治疗方法治疗银屑病的临床疗效；从而对比分析评价三种治疗方法的治疗作用；在此基础上探讨中西药联合治疗银屑病的作用机制,为阿维A酸类药物与中药联合应用能更有效治疗银屑病提供临床依据；为进一步研究阿维A酸类药物疗效、如何降低其毒副作用提供有效思路。方法：分析郧阳医学院附属太和医院皮肤性病科于2008年9月-2009年2月,2009年9月-2010年2月门诊及住院经临床确诊为银屑病患者254例,采用随机数字表法分为三个治疗组。三组患者在平均年龄、病程、治疗前PASI评分均无统计学意义(P0.05),具有可比性。阿维A治疗组100例患者口服阿维A胶囊,中药复方治疗组80例患者口服中药复方煎剂。阿维A联合中药复方治疗组74例患者口服阿维A胶囊同时口服中药复方煎剂。三组患者均同时静脉输注复方甘草酸苷注射液、外用钙泊三醇软膏。疗程均为六周,每周随访一次,并且在治疗1个疗程后采用国际通用的银屑病皮损严重程度评分(PASI)法判定临床疗效,并观察不良反应,结果采用多个组间样本两两比较的X2检验,使用SPSS13.0统计软件进行统计学处理,以P0.05(a=0.05)、P0.017(a′=0.017)为差异具有统计学意义,对各组间的疗效进行统计学分析。结果：阿维A治疗组、中药复方治疗组、阿维A联合中药复方治疗组的总有效率为57.09%,各治疗组有效率分别是51.00%、43.75%和79.73%；阿维A治疗组和阿维A联合中药复方治疗组的有效率高于中药复方治疗组,三种治疗方法的有效率差别有统计学意义(P0.05),说明三种疗法的疗效有差别。通过两两组间比较阿维A治疗组和中药复方治疗组的有效率,发现差别没有统计学意义(P0.017)。进一步将阿维A联合中药复方治疗组分别与阿维A治疗组、中药复方治疗组的有效率进行两两比较时,发现他们两两之间的有效率差别有统计学意义(P0.017)。但临床观察中发现阿维A治疗组中有2例血钾降低,通过补钾后恢复；13例患者出现轻度血脂升高,5例患者出现转氨酶升高,44例患者治疗过程中出现不同程度的皮肤干燥、口角炎、口干、皮肤变脆变薄等毒副反应,疗程结束后停药并经适当治疗后恢复,未影响治疗。中药复方治疗组有2例患者出现腹泻,减少中药剂量后恢复,未影响治疗。阿维A联合中药复方治疗组未见明显不良反应。三组患者均未发生系统不良反应。结论：阿维A胶囊、中药复方、阿维A胶囊联合中药复方治疗银屑病均有较好疗效,其中阿维A胶囊联合中药复方的疗效明显优于阿维A胶囊和中药复方,阿维A胶囊与中药复方间的疗效无显著性差异。中药复方可有效降低阿维A胶囊的毒副作用。
[Abstract]:Objective: the purpose of this study was to compare the clinical efficacy of Avera, Chinese medicine compound and two drugs in the treatment of psoriasis by clinical observation, and to compare and evaluate the therapeutic effects of the three methods. On this basis, the mechanism of combination of Chinese and western medicine in the treatment of psoriasis was discussed, which provided the clinical basis for the combination of aretinoic acid and traditional Chinese medicine in the treatment of psoriasis, and provided the clinical basis for further study of the curative effect of aretinoic acid. How to reduce its toxicity and side effects to provide effective ideas. Methods: 254 patients with psoriasis were analyzed from September 2008 to February 2009, from September 2009 to February 2010, from the Department of Dermatology and venereal Diseases of Taihe Hospital affiliated to Yunyang Medical College. Three treatment groups were randomly divided into three groups: the average age, course of disease and PASI score before treatment were not statistically significant (P 0.05), which were comparable. 80 patients in the traditional Chinese medicine compound treatment group and 74 patients in the Avera combined Chinese medicine compound treatment group were given oral Avera capsule and Chinese medicine compound decoction simultaneously. All the three groups were given intravenous infusion of compound glycyrrhizin injection at the same time. The course of treatment was 6 weeks, followed up once a week, and after one course of treatment, the clinical efficacy was evaluated by the international PASI method, and the adverse reactions were observed. Results the X2 test was used to compare the samples of different groups, and the statistical analysis was carried out by SPSS13.0 software. The difference was statistically significant between the two groups (P 0.05, P 0.017, P 0.017, P 0.017), and the curative effect of each group was analyzed statistically. Results: Avera treatment group, traditional Chinese medicine compound treatment group, The total effective rate of Avera combined with traditional Chinese medicine compound treatment group was 57.09, the effective rate of each treatment group was 51.00 and 43.75% and 79.73% respectively, the effective rate of Avera treatment group and Avera combined Chinese medicine compound treatment group was higher than that of traditional Chinese medicine compound treatment group, the effective rate of each treatment group was 51.00% and 79.73%, respectively. The difference of the effective rate of the three treatment methods is statistically significant (P 0.05), which shows that there are differences in the efficacy of the three treatments. The effective rate of Avera treatment group and traditional Chinese medicine compound treatment group was compared by comparing the two groups. It was found that the difference was not statistically significant (P 0.017). Further, the effective rate of Avera combined with traditional Chinese medicine compound treatment group was compared with that of Avera treatment group and traditional Chinese medicine compound treatment group. It was found that there was a statistically significant difference in the effective rate between them (P 0.017). But in the clinical observation, there were two cases of hypokalemia in the Avera treatment group. After potassium supplementation, 13 patients with mild hyperlipidemia and 5 patients with elevated aminotransferase were found to have some toxic side effects, such as dry skin, mouth horn inflammation, dry mouth, brittle skin thinning and so on, in the course of treatment, 44 patients had different degrees of skin dryness, mouth horn inflammation, dry mouth, skin brittle thinning and so on. After the course of treatment, two patients in the treatment group developed diarrhea and recovered after reducing the dosage of traditional Chinese medicine. There were no obvious adverse reactions in the treatment group. No systemic adverse reactions were found in the three groups. Conclusion: Avea capsule, traditional Chinese medicine compound and Avera capsule combined with traditional Chinese medicine have better curative effect on psoriasis, and Avea capsule combined with traditional Chinese medicine compound has better curative effect than Avea capsule and traditional Chinese medicine compound. There was no significant difference in curative effect between Avera capsule and traditional Chinese medicine compound, which could effectively reduce the toxicity and side effect of Avera capsule.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R758.63

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