单一外用与外用联合窄谱中波紫外线治疗轻度斑块状银屑病疗效观察

发布时间：2018-04-06 01:04

本文选题：银屑病　切入点：斑块状　出处：《临床皮肤科杂志》2017年10期

【摘要】：目的:比较单一外用与外用联合窄谱中波紫外线(NB-UVB)光疗治疗轻度斑块状银屑病的疗效、安全性、复发情况及治疗经济学。方法:采用随机对照临床试验,共纳入123例轻度斑块状银屑病患者,随机分为单一外用治疗组和外用联合光疗组,患者银屑病皮损面积和严重程度指数(PASI)积分下降达90%(PASI 90)时即进入维持治疗,分别于第6、12、24周评价疗效,并于第24周评价治疗经济学。结果:共86例患者完成24周治疗。在第6周时,单一外用治疗组22.50%患者达到PASI 75,外用联合光疗组为23.91%(P0.05)。单一外用治疗组皮肤病生活质量指数(DLQI)分值较基线下降57.89%,外用联合光疗组下降52.39%(P0.05)。在第12周时,单一外用治疗组40.00%的患者达到PASI 75,外用联合光疗组为45.70%(P0.05)。第24周时,单一外用治疗组50%的患者达到PASI 75,外用联合光疗组为63.04%(P0.05)。单一外用治疗组DLQI分值较基线下降64.60%,外用联合光疗组下降65.31%(P0.05)。在24周的研究中,单一外用治疗组2例复发,外用联合光疗组3例复发。单一外用治疗组24周总费用平均为835.4元,外用联合光疗组为1894.23元。结论:单一外用疗法与外用药联合NB-UVB光疗均安全、有效、复发率低,且疗效相当。单一外用疗法更经济,适用于轻度斑块状银屑病的长期治疗。
[Abstract]:Objective: To compare the single external and external use of narrow-band ultraviolet B (NB-UVB) phototherapy treatment efficacy, mild plaque psoriasis safety, recurrence and treatment of economics. Methods: a randomized controlled clinical trial, 123 cases of mild plaque psoriasis patients were included and randomly divided into single topical therapy group and topical combined with phototherapy group. Patients with psoriasis area and severity index (PASI) score decreased 90% (PASI 90) is in maintenance treatment, respectively in 6,12,24 weeks and twenty-fourth weeks to evaluate the efficacy, evaluation of treatment economics. Results: a total of 86 patients completed 24 weeks of treatment. After sixth weeks, the single reached 75 PASI topical treatment group of 22.50% patients, combined with topical phototherapy group was 23.91% (P0.05). Group dermatology life quality index (DLQI) score a single topical treatment was 57.89% lower than the baseline, combined with topical phototherapy group decreased 52.39% (P0.05) in twelfth weeks. When a single topical treatment group of 40% patients reached PASI 75, combined application of phototherapy group was 45.70% (P0.05). At twenty-fourth weeks, patients with single topical treatment group 50% was PASI 75, the combination of topical phototherapy group was 63.04% (P0.05). A single topical treatment group DLQI score decreased by 64.60% compared to the baseline, combined with topical phototherapy group. 65.31% (P0.05). In the 24 week study, single topical treatment group of 2 cases of recurrence, 3 cases of recurrence group phototherapy combined with topical topical treatment group for 24 weeks. The single total average cost is 835.4 yuan, 1894.23 yuan for the combined application of phototherapy group. Conclusion: single topical therapy and medication combined with NB-UVB phototherapy are safe and effective. And the recurrence rate is low, and the curative effect is similar. A single topical therapy is more economical, suitable for long-term treatment of mild plaque psoriasis.

【作者单位】：北京大学人民医院皮肤科;首都医科大学附属北京友谊医院皮肤科;首都医科大学宣武医院皮肤科;
【基金】：首都医学发展科研基金(2009-1016)资助项目
【分类号】：R758.63

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