煤焦油软膏联合长波和中波紫外线治疗寻常性银屑病

我们采用煤焦油软膏外用联合长波(UVA)和中波紫外线(UVB)照射(简称煤焦油光疗)治疗寻常性银屑病,收到良好疗效。     

补骨脂酊外用联合NB-UVB治疗银屑病

探讨补骨脂酊外用联合NB—UVB治疗银屑病的有效性和安全性。将60例寻常型银屑病患者随机分2组，对照组30例，单用NB—UVB治疗，治疗组采用30％补骨脂酊外用联合NB—UVB治疗。采用银屑病面积和严重程度指数（PASI）评分，治疗结束后评价疗效。结果：治疗组和对照组有效率分别为96．67％、86．7％，有显著差异（t=3．145，P〈O．05）。补骨脂酊外用联合NB-UVB照射治疗银屑病疗效优于单用NB—UVB治疗。     

药物联合NB—UVB治疗寻常型银屑病的疗效观察

目的观察药物联合NB-UVB治疗寻常型银屑病的疗效。方法治疗组75例为外用他扎罗汀乳膏＋口服复方甘草酸苷片＋NB-UVB,对照组39例为外用他扎罗汀乳膏＋口服复方甘草酸苷片。以银屑病皮损面积和严重度指数（PASI）评价疗效。结果在一个疗程（6周）即15次NB－UVB治疗后,两组治疗前后的有效率分别为88％,61．54％。治疗组与对照组的疗效比较（P〈0．05）有显著差异。结论药物联合NB－UVB治疗寻常型银屑病的疗效好。     

中药组方凉血消疕治疗寻常性银屑病67例临床观察

目的观察自拟方剂凉血消疕汤治疗寻常性银屑病的临床疗效。方法 126例寻常性银屑病患者随机分为治疗组(凉血消疕汤口服联合煤焦油软膏外用)和对照组(郁金银屑片口服联合煤焦油软膏外用),以银屑病面积和严重指数(PASI)评价疗效。结果在疗程早期(疗程不超过4周),对照组疗效优于治疗组;疗程中期(疗程在4～8周之间),二者疗效相当;疗程晚期(疗程在8～12周之间),治疗组疗效明显优于对照组。且治疗组总疗效亦明显高于对照组,不良反应发生率低。结论自拟方剂凉血消疕汤联合煤焦油外用治疗寻常性银屑病在足够疗程前提下疗效肯定,安全性好,值得临床应用。     

窄谱UVB照射联合阿维A及复方氟米松软膏治疗中、重度斑块型银屑病临床研究

目的观察评价窄谱中波紫外线（narrow band ultraviolet B,NB—UVB）联合阿维A及复方氟米松软膏治疗寻常性中、重度斑块型银屑病的I临床疗效及安全性。方法将112例中、重度斑块型银屑病患者随机分为2组。治疗组58例,对照组54例。对照组口服阿维A及复方氟米松软膏外用治疗;治疗组在此基础上加用窄谱UVB照射治疗;疗程8周。以银屑病皮损面积和严重程度（PASI）评分评价疗效,观察治疗前后PASI评分的变化、治疗的有效率以及不良反应发生情况。结果治疗组PASI评分（4．36~1．12）低于对照组（6．38~1．41）,差异有统计学意义X2=2．85,P〈0．05）;治疗组有效率为91．38％,对照组有效率为77．78％,差异有统计学意义∞。=4．01,P〈0．05）。2组未见明显不良反应。结论NB—UVB照射联合口服阿维A及复方氟米松软膏治疗中、重度斑块型银屑病具有良好的临床疗效及安全性。     

NB-UVB治疗寻常型银屑病的临床研究

为评价NB—UVB治疗寻常型银屑病的疗效和安全性。将95例寻常型银屑病患者随机分成两组。一组用窄谱中波紫外线（NB—UVB）治疗，另一组用宽谱中波紫外线（BB—UVB）治疗，隔天一次，4周结束后。观察分析两组治疗效果。结果：4周治疗后，NB—UVB治疗组有效率85．4％，其中1例患者发生严重光毒反应。BB—UVB治疗组有效率51．1％，其中5例患者发生严重光毒反应。x^2检验显示有非常显著性差异（P〈0．01）。NB—UVB治疗寻常型银屑病具有良好疗效，与BB—UVB相比，不仅疗效好，而且副作用较少，照射时间缩短。     

补骨脂注射液联合冰黄肤乐软膏治疗寻常型银屑病疗效观察

目的：评价补骨脂注射液联合冰黄肤乐软膏治疗寻常型银屑病的疗效与安全性。方法：选择60例寻常型银屑病住院患者，随机分为治疗组和对照组，每组30例，均给予5％葡萄糖注射液250mL加入10％葡萄糖酸钙注射液20mL及维生素C3．0g静滴，每天1次；治疗组每天肌注补骨脂注射液2mL，每天2次外用冰黄肤乐软膏；对照组外用丁酸氢化可的松乳膏或卤米松乳膏，每天2次。疗程均为21天。结果：治疗组治疗前PASI评分为12．12±2．61，治疗后2．87±0．92，有效率为80．0％，对照组有效率为53．3％，两组有效率比较差异有统计学意义（P〈0．05）。结论：补骨脂注射液联合冰黄肤乐软膏治疗寻常型银屑病疗效好。不良反应少。     

百癣夏塔热片联合窄波UVB治疗寻常型银屑病疗效评价

目的:评价百癣夏塔热片联合窄波UVB治疗寻常型银屑病的疗效。方法:87例患者随机分为2组,治疗组(42例)采用百癣夏塔热片联合窄波UVB治疗,对照组(45例)仅窄波UVB照射,两组均外擦醋酸曲安尿素软膏,疗程均为8周。结果:两组有效率分别为92.9%和77.8%,差异有显著性(P0.05)。结论:百癣夏塔热片联合窄波UVB治疗寻常型银屑病有效。     

他扎罗汀凝胶外用联合NB-UVB治疗斑块状寻常型银屑病的疗效观察

目的：观察他扎罗汀凝胶外用联合NB-UVB照射治疗斑块状寻常型银屑病的疗效及安全性。方法：对35例轻、中度患者采用0．05％他扎罗汀凝胶每晚1次外涂配合NB-UVB每周2次照射，共治疗8周，用PASI积分评价疗效。结果：治疗开始1～2周后出现疗效，随着治疗时间的延长。有效率逐渐提高，治疗结束时痊愈率达到94．29％，有效率达100％。6例发生皮肤刺激反应，占17．14％。结论：他扎罗汀凝胶外用联合NB-UVB照射治疗斑块状寻常型银屑病具有良好疗效和安全性。     

复方甘草酸苷联合UVB治疗寻常型银屑病疗效观察

目的探讨复方甘草酸苷联合UVB治疗寻常型银屑病的疗效。方法将97例寻常型银屑病患者随机分为治疗组(51例,复方甘草酸苷内服联合UVB照射治疗)和对照组(46例,UVB照射治疗),观察其疗效和安全性。结果治疗组临床有效率、PASI评分改善程度均明显优于对照组(P<0.05),且无严重不良反应发生,不良反应发生率低于对照组。结论复方甘草酸苷联合UVB治疗寻常型银屑病疗效高、安全性好。     

Comparison of clinical effects of psoriasis treatment regimens among calcipotriol alone,narrowband ultraviolet B phototherapy alone,combination of calcipotriol and narrowband ultraviolet B phototherapy once a week,and combination of calcipotriol and narrowband ultraviolet B phototherapy more than twice a week

We compared the clinical efficacy of various psoriasis treatments among: (i) topical application of calcipotriol ointment twice daily (group I); (ii) topical application of calcipotriol ointment twice daily and narrowband ultraviolet B NB‐UVB phototherapy once a week (group II); (iii) topical application of heparinoid ointment twice daily and NB‐UVB phototherapy more than twice a week (group III); and (iv) topical application of calcipotriol ointment twice daily and NB‐UVB phototherapy more than twice a week (group IV). Ten patients were randomly selected for each group and treated by the indicated regimens for 12 weeks. All treatments were effective and significantly improved Psoriasis Area and Severity Index (PASI) scores, self‐administered PASI scores and visual analog scale scores of pruritus. Group IV showed most marked and rapid reduction in PASI and self‐PASI scores among the four regimens. Although the serum levels of interleukin (IL)‐17, IL‐20 and IL‐22 and psoriasis disability index were significantly decreased after the treatments, no significant difference was detected among the four groups. Our study indicates that combination of calcipotriol ointment plus NB‐UVB more than twice a week is superior to other treatment regimens, rapidly improving psoriasis lesions.     

An Open Label Prospective Randomized Trial to Compare the Efficacy of Coal Tar-Salicylic Acid Ointment Versus Calcipotriol/Betamethasone Dipropionate Ointment in the Treatment of Limited Chronic Plaque Psoriasis

Background:Chronic plaque psoriasis is a common papulosquamous skin disorder, for which a number of topical agents are being used including coal tar, topical steroids and more recently topical calcipotriol/betamethasone dipropionate. There is no study comparing purified coal tar preparation with calcipotriol/betamethasone dipropionate ointment in limited chronic plaque psoriasis.Results:Mean PASI was significantly lower at week 2 (P = 0.01) and week 4 follow-up (P = 0.05) and the mean reduction in PASI was significantly higher at week 2 (P = 0.02) with calcipotriol/betamethasone than coal tar-salicylic acid, but this difference was not sustained at subsequent follow-up visits. Similarly, PGA scores at weeks 2 and 4 were significantly lower with calcipotriol/betamethasone dipropionate ointment (P = 0.003 and P = 0.007 respectively). There was no significant difference in any parameter during subsequent follow-up visits or at the end of the treatment phase (12 weeks).Conclusion:Topical nightly application of calcipotriol/betamethasone dipropionate ointment leads to an initial, more rapid reduction in disease severity, but the overall outcome parameters are comparable in the two treatment groups.     

Calcitriol 3 microg g-1 ointment in combination with ultraviolet B phototherapy for the treatment of plaque psoriasis: results of a comparative study

BACKGROUND: Combinations of topical treatments and ultraviolet (UV) B phototherapy for plaque psoriasis may be more beneficial than either type of treatment used alone. OBJECTIVES: To determine the efficacy of calcitriol 3 microg g-1 ointment in combination with UVB phototherapy in treating plaque psoriasis. METHODS: Calcitriol ointment with UVB was compared with vehicle plus UVB in a randomized, double-blind study in 104 patients. RESULTS: Mean global improvement scores for both groups increased over the 8-week study period; there was a statistically significant difference (P < 0.05) in favour of the calcitriol/UVB combination from week 1. At end-point, 45% of the calcitriol/UVB group showed considerable improvement or clearing of psoriasis, compared with 21% of the control group. The superiority of calcitriol plus UVB was also reflected in the global severity and Psoriasis Area and Severity Index (PASI) scores; at end-point the mean percentage decrease in PASI score was 65% for the calcitriol/UVB group and 43% for vehicle/UVB (P = 0.0014). The incidence of skin-related adverse events was low (< 12%) and similar in the two treatment groups. No clinically significant changes in blood chemistry, in particular calcium levels, occurred. The greater efficacy of combined calcitriol and phototherapy allowed a 34% decrease in total UVB exposure. CONCLUSIONS: Calcitriol 3 microg g-1 ointment and UVB phototherapy in combination provides a promising therapy for managing chronic plaque psoriasis.     

308nm准分子激光联合0.1%他克莫司软膏治疗寻常性银屑病疗效观察

目的探讨308nm准分子激光联合0.1%他克莫司软膏治疗寻常性银屑病的临床疗效。方法所有参加研究的患者均接受308nm准分子激光照射2次/w,共6周,且皮损处外搽0.1%他克莫司软膏,早、晚各1次,疗程6周。每2周根据皮损进行治疗前及治疗后的PASI评分比较。结果308nm准分子激光照射平均次数为7.31(5～11)次,外搽0.1%他克莫司软膏平均次数为79.2(69～91)次,治疗6周结束后平均PASI评分为3.15(3.34±1.98),治疗前平均PASI评分为15.31(17.59±3.67),有效率81.40%,治疗前、后2次PASI评分比较,差异有统计学意义(P<0.05)。不良反应轻微,发生率为20.93%。结论308nm准分子激光联合0.1%他克莫司软膏治疗寻常性银屑病疗效好,不良反应少。     

Comparison of suberythemogenic and maximally aggressive ultraviolet B therapy for psoriasis

We prospectively compared the maximally aggressive erythemogenic ultraviolet B (UVB) schedule (Le Vine et al, 1979) and a suberythemogenic UVB schedule (Frost et al, 1979) in the treatment of psoriasis. Patients were treated with either the maximally aggressive erythemogenic UVB (MAEUVB) schedule or the suberythemogenic UVB (SEUVB) schedule. Each patient received daily topical treatment with 2% crude coal tar ointment on half of the body and the ointment vehicle on the other half of the body. All patients were hospitalized and treated 7 days a week. The treatment results were determined daily be grading preselected reference lesions for erythema, scaling, and thickness. With both UV schedules, no difference in response could be detected between the ointment vehicle side and the tar ointment side. In a comparison of the two UV schedules, patients treated with MAEUVB had no statistically significant difference in the resolution of their psoriasis, and the length of remission was similar. The average energy needed for the SEUVB-treated patients was 984 mjoules/cm2, whereas the average for the MAEUVB-treated patients was 984 mjoules/cm2. Our findings suggest that neither crude coal tar nor MAEUVB is needed for the optimal UVB treatment of psoriasis in the hospital.     

The influence of psoriatic plaques pretreatment with crude coal tar vs. petrolatum on the efficacy of narrow-band ultraviolet B: a half-vs.-half intra-individual double-blinded comparative study

Background/purpose: The value of psoriatic plaques pretreatment with specific topical preparations in the setting of NB‐ultraviolet‐B (UVB) therapy is debatable. It may be clarified through a comparative assessment between crude coal tar and petrolatum as pretreatment candidates. Methods: A prospective study included 40 patients with plaque psoriasis undergoing NB‐UVB therapy. We compared among three treatment regimens: NB‐UVB alone (control group; n=20) as well as NB‐UVB preceded by crude coal tar 3% on one side and petrolatum on the other side (cases group I and II; n=20). Tar and petrolatum were topically applied thrice/day the day before NB‐UVB exposure. Applications were removed using olive oil directly before NB‐UVB exposure. Regimens' frequency was thrice/week and the clinical outcome was assessed, through both psoriasis area and severity index (PASI) and physician global assessment (PGA) scores, at baseline and 3 months later. Results: There were significant (P<0.01) decreases in both PASI and PGA scores in all the groups. In comparison with the controls, cases revealed significantly (P<0.05) higher improvement percentages in both PASI and PGA scores for both tar and petrolatum. This influence, through the PGA score, was significantly (P<0.05) in favor of petrolatum. Conclusion: The pretreatment of psoriatic plaques with either petrolatum or crude coal tar may enhance the therapeutic outcome of NB‐UVB, which appeared to favor petrolatum.     

UVABA therapy for psoriasis. Efficacy with shortened treatment times with the combined use of coal tar, anthralin, and metal halide ultraviolet machines

Rapid clearing of psoriasis in a psoriasis treatment center setting has been obtained with a combination of short-contact coal tar, phototherapy from high-pressure metal halide lamps (consisting of UVA and UVB), and short-contact high-potency anthralin therapy. These intensive 1 1/2- to 2-hour treatment sessions done three or four times weekly were as efficacious as reported responses to PUVA therapy or conventional psoriasis day care therapy. The treatment schedule allows minimal time away from work, decreased hours per week in contact with crude coal tar, shortened UV treatment times, decreased cost, and a low risk of side effects. It is suggested that the use of UVA and UVB combined with anthralin (UVABA) is effective for many patients with moderate to severe psoriasis.     

Comparison of clobetasol propionate cream plus coal tar vs. topical psoralen and solar ultraviolet A therapy in palmoplantar psoriasis

Aim. Palmoplantar psoriasis (PPP) produces significant morbidity and requires prompt treatment. Topical agents form the mainstay of therapy. We compared the efficacy and side‐effect profile of a steroid/coal‐tar combination with topical psoralen and solar ultraviolet A (PUVAsol) in PPP. Methods. In total, 52 patients with PPP were randomized to receive either a combination of clobetasol propionate cream and coal tar daily (group 1) or topical PUVAsol on alternate days (group 2) for 16 weeks. Response was assessed as change in Psoriasis Activity and Severity Index (PASI) and Patient Global Assessment (PGA). Results. Of the 52 patients, 43 completed the treatment phase. There was a reduction in PASI for the palms and soles in both treatment groups throughout the treatment period until week 16. There was a greater reduction in PASI in palmar psoriasis with topical PUVAsol, and a greater reduction in psoriasis of the soles with the steroid/coal‐tar combination. In both groups, patients perceived ‘good improvement’. Improvement or cure in palmar lesions was observed in 90% of cases in the topical steroid/coal‐tar group and in 75% of cases in the topical PUVAsol group; for the soles, these figures were 76% and 79%, respectively. No adverse effects were experienced with the steroid/coal‐tar combination, whereas for the topical PUVAsol, phototoxicity occurred in 22% of cases. Conclusion. Both treatments had comparable efficacy. In both groups, patients experienced ‘good improvement’ after 16 weeks of therapy.     

Efficacy and safety of a new combination of calcipotriol and betamethasone dipropionate (once or twice daily) compared to calcipotriol (twice daily) in the treatment of psoriasis vulgaris: a randomized,double-blind,vehicle-controlled clinical trial

BACKGROUND: Calcipotriol and betamethasone dipropionate are both widely used, effective treatments for psoriasis. Vitamin D analogues and topical corticosteroids have different mechanisms of action in the treatment of psoriasis. A new vehicle has been developed in order to contain both calcipotriol (50 micro g g-1) and betamethasone dipropionate (0.5 mg g-1) in an ointment form. By using calcipotriol and a corticosteroid together, greater efficacy may be achieved than by using either compound alone. OBJECTIVES: The present study was conducted in order to compare the clinical efficacy and safety of the combined ointment formulation used once daily with the vehicle ointment used twice daily, calcipotriol ointment used twice daily and the combined formulation used twice daily in psoriasis vulgaris. METHODS: This was an international, multicentre, prospective, randomized, double-blind, vehicle-controlled, parallel group, 4-week study in patients with psoriasis vulgaris amenable to topical treatment. Patients were randomized to one of four treatment groups: combined formulation once daily, combined formulation twice daily, calcipotriol twice daily or vehicle twice daily. Efficacy and safety were assessed. RESULTS: There was no statistically significant difference in the mean percentage change in the Psoriasis Area and Severity Index (PASI) from baseline to end of treatment between the two combined formulation groups, but the difference in PASI reduction was significantly higher in the combined formulation groups (68.6% once daily, 73.8% twice daily) than in both the twice daily calcipotriol group (58.8%) and the vehicle group (26.6%). Safety data showed the frequency of adverse events to be less in the combined formulation groups than in both the calcipotriol group and the vehicle group. The proportion of patients with lesional/perilesional adverse reactions was less in the combined formulation groups and vehicle group than in the calcipotriol group (9.9% combined formulation once daily, 10.6% combined formulation twice daily, 19.8% calcipotriol, 12.5% vehicle). CONCLUSIONS: No statistically significant nor clinically relevant difference in efficacy was seen between the combined formulation used once daily and twice daily. When compared to vehicle ointment or calcipotriol ointment alone, the combined formulation was shown to be clearly more efficacious.     

UVA1光疗联合卡泊三醇软膏治疗甲银屑病的临床疗效观察

目的探讨UVA1光疗联合卡泊三醇软膏治疗甲银屑病的临床疗效,进而为甲银屑病患者的治疗提供临床依据。方法将收集的60例寻常型银屑病甲损害的患者随机分为2组,均给予卡泊三醇软膏2次/d,联合治疗组予以UVA1照射(2次/周)治疗,2组治疗方案疗程均为6个月;在治疗前及治疗后,对患者进行银屑病甲严重程度指数(NAPSI)。结果 60例寻常型银屑病甲损害患者中,平均年龄(50.57±16.24)岁,2组在年龄、性别、病程比较差异无统计学意义(P0.05);2组患者病甲治疗前NAPSI评分:联合治疗组:27.07±10.86,卡泊三醇软膏组:25.93±10.73,2组比较差异无统计学意义(t=0.449,P0.05);治疗后2组NAPSI评分分别为:联合治疗组:12.67±7.60,卡泊三醇软膏组:18.10±8.93,NAPSI评分差异有统计学意义(P0.05);治疗后联合治疗组临床痊愈10例,痊愈率33.33%,有效率56.67%,卡泊三醇软膏组临床痊愈0例,痊愈率0%,有效率13.33%,2组有效率的比较有统计学意义(P0.01)。结论UVA1联合卡泊三醇软膏治疗甲银屑病的疗效优于单纯使用卡泊三醇软膏。