退银汤联合窄谱中波紫外线治疗银屑病的对照研究

Efficiency of Tuiyin Decoction Combined with NB-UVB Irradiation in Treating Psoriasis

关键词:  银屑病  退银汤  窄谱中波紫外线  临床疗效

Key words:  psoriasis  Tuiyin decoction  NB-UVB  clinical efficacy

摘要:

目的 研究退银汤内服联合窄谱中波紫外线(NB-UVB)照射治疗银屑病的有效性和安全性。方法 将入选的126例银屑病患者分为3组，治疗组42例，内服退银汤200 mL，2次·d^-1，予NB-UVB局部照射，初始剂量为0.5 J·cm^-2，每周2次，每次剂量递增10%~20%，至出现红斑时维持治疗，疗程12周；对照I组42例，仅内服退银汤；对照II组42例，仅NB-UVB照射，疗程均为12周。结果 治疗组、对照I组、对照II组有效率分别为95.24%，80.95%，73.81%，治疗组与对照I组、对照II组比较，差异均有统计学意义(P<0.05或P<0.01)，对照I组和对照II组比较差异无统计学意义；治疗组患者4周、8周及12周后的PASI改善率均高于对照I组、对照II组。所有患者进行期有效率显著优于静止期，点滴状疗效显著优于斑块状；治疗组起效时间明显短于对照I组、对照II组，差异均有统计学意义(P<0.01)，对照I组和对照II组比较，差异无统计学意义。结论 退银汤联合NB-UVB治疗银屑病疗效显著，值得临床推广使用。

Abstract:

OBJECTIVE To determine the clinical efficiency and safety of Tuiyin decoction combined with NB-UVB irradiation in treating psoriasis. METHODS One hundred and twenty-six patients with psoriasis were divided into 3 groups. In treating group with 42 cases, Tuiyin decoction 200 mL was orally given twice a day, and combined with NB-UVB irradiation twice per week with an initialed dose of 0.5 J·cm^-2 and increasing the dose with 10%-20% per time till the erythema appeared with 3 months treating course. In control group Ⅰ with 42 cases, only taken Tuiyin decoction, and in control group Ⅱ with 42 cases, only NB-UVB irradiation was applied for 3 months treating course. RESULTS The efficiency in treatment group, control group Ⅰ and control group Ⅱ were 95.24%, 80.95%, 73.81%, respectively. The difference between the treatment group and the two control groups was statistically significant(P<0.05 or P<0.01), and the difference between the two control group Ⅰ and Ⅱ was not statistically significant. The PASI improvement rates of the combination treatment at the 4th week, the 8th week and the 12th week were all higher than that of the control groups. The patients in psoriasis guttata was better than in plaque type, efficiency of the patients in active stage was remarkably higher than that in rest stage. The onset time of the treatment group was significantly shorter than that in control groups, and the difference was statistically significant(P<0.01). But the control group I compared with control group II, the difference was not statistically significant. CONCLUSION Tuiyin decoction combined with NB-UVB irradiation is clinically effective and safe in treating psoriasis.