他扎罗汀凝胶治疗寻常型银屑病的临床观察

他扎罗汀是一种新型的受体选择性维A酸类药物犤1犦。其治疗银屑病的主要作用机制是调节角质形成细胞(KC)的分化异常,改善KC的过度增殖,促进炎症消退犤2犦。为进一步验证他扎罗汀凝胶治疗寻常型银屑病的疗效及安全性,笔者用他扎罗汀凝胶(重庆华邦制药有限公司)治疗了115例寻常型银屑病患者,并进行了临床观察,疗效满意,现报告如下。1对象与方法1.1观察对象为2001年10月～2002年1月在上海市12家医院就诊的寻常型银屑病患者,共115例。病人平均年龄45岁(18～65岁),病程6个月～20年。皮损面积占整个体表的2%～30%。靶皮损基线评分:斑块肥厚程度…     

他扎罗汀凝胶治疗寻常型银屑病疗效观察

我们自2002年1～12月用他扎罗汀凝胶(重庆华邦制药有限公司生产)治疗寻常型银屑病55例，取得了满意的疗效，现总结如下。临床资料病例选择：入选患者共55例，男32例，女23例，年龄16～65岁，平均41岁，病程3个月～30年，平均12．5年。排除可能妊娠、哺乳期妇女；红皮病型、脓疱型、关节病型银屑病；对他扎罗汀高度敏感者。     

养血活血汤配合NB-UVB治疗斑块状寻常型银屑病疗效观察

斑块状寻常型银屑病由点滴状银屑病久治不愈、反复发作、增厚所致,治疗较困难.2004年1月以来,我们应用自拟养血活血汤配合窄谱中波紫外线（NB-UVB）治疗斑块状寻常型银屑病68例,并与单纯NB-UVB治疗56例对照,疗效显著,现报道如下.     

他扎罗汀凝胶治疗寻常性银屑病

他扎罗汀(tazarotene)是新一代多芳香维A酸药物,治疗银屑病有良效。本院自2001年1~12月,应用他扎罗汀凝胶(重庆华邦制药股份有限公司生产)治疗寻常性银屑病60例,取得了满意的疗效,现总结报道如下。一、病例选择1.入选标准:18岁以上寻常性银屑病患者,性别不限,皮损2处以上。能遵医嘱用药,坚持用完全程,并定期复诊充分合作的患者。2.排除标准:有可能妊娠及妊娠、哺乳期妇女;红皮病性、脓疱性、关节病性银屑病;对他扎罗汀高度敏感者;治疗前1个月内曾外用或内服过其它维A酸类药物,或服用过皮质类固醇、甲氨蝶呤及其它治疗银屑病药物者;同时服用…     

他扎罗汀凝胶与糠酸莫米松乳膏联合治疗寻常型银屑病

2004年2月～2005年3月我科应用0．05％他扎罗汀凝胶（商品名：炔维，重庆华邦制药股份有限公司）与糠酸莫米松乳膏（商品名：艾洛松，上海先灵葆雅制药有限公司）联合治疗寻常型银屑病，取得满意疗效，现将结果报道如下。     

他扎罗汀凝胶治疗寻常性银屑病疗效观察

目的　探讨他扎罗汀治疗寻常性银屑病的临床疗效。方法　两组患者各为 45例 ,分别用他扎罗汀和氯松霜外用 ,根据皮损变化判定疗效。结果　他扎罗汀治疗寻常性银屑病有效率 82 .2 % ,斑块型的有效率 92 .0 % ,均高于氯松霜组 ( 6 2 .2 %、6 0 .7% )。结论　他扎罗汀治疗寻常性银屑病疗效较好 ,尤其适用于斑块型。     

窄谱中波紫外线联合0.05%他扎罗汀凝胶治疗头皮银屑病的疗效观察

目的观察窄谱中波紫外线联合0.05%他扎罗汀凝胶治疗头皮银屑病的临床疗效。方法将入选的68例患者随机分为两组,治疗组予窄谱中波紫外线照射治疗30min,3次/周,且照射前1～2h予0.05%他扎罗汀凝胶外搽,3次/d;对照组仅予窄谱中波紫外线照射治疗30min,3次/周,两组均照射30次,治疗结束后评价疗效。结果治疗组有效率为88.89%,对照组为65.63%,两组患者的有效率比较,差异有统计学意义(P<0.05)。结论窄谱中波紫外线联合他扎罗汀治疗头皮银屑病的疗效优于单用窄谱中波紫外线治疗。     

他扎罗汀凝胶联合派瑞松霜治疗寻常型银屑病50例

目的 观察他扎罗汀凝胶联合派瑞松霜治疗寻常型银屑病（PV）的临床疗效。方法 选择100例PV患者，随机分为2组。治疗组用派瑞松霜早晚各涂患处一次，他扎罗汀凝胶晚上涂一次，对照组仅用派瑞松霜每日二次，涂于患处，两组均4周为一疗程。根据PASI评分判定疗效。结果 他扎罗汀凝膏联合派瑞松霜治疗PV有效率为82％，单用派瑞松霜有效率为62％，前者疗效明显优于后者（X^2=24．96，P〈0．05）。结论 他扎罗汀凝胶联合派瑞松霜治疗PV有较好疗效，尤其适用于斑块状。     

他扎罗汀凝胶治疗寻常性银屑病临床疗效观察

目的 :观察他扎罗汀凝胶治疗寻常性银屑病的疗效和安全性。方法 :治疗组外涂 0 0 5 %他扎罗汀凝胶 ,每日 1次 ,疗程 8周。对照组外涂恩肤霜 ,每日 2次 ,疗程 8周。结果 :经过一个疗程 8周后 ,治疗组痊愈率和总有效率明显优于对照组 (P <0 0 5 ) ,观察期间未见严重不良反应。结论 :他扎罗汀凝胶治疗寻常性银屑病疗效好且安全。     

以NB-UVB为主的联合疗法治疗寻常型银屑病疗效观察

采用NB-UVB照射,糠馏油硼酸氧化锌糊剂(PBZS)封包,泽它洗剂洗浴的三联疗法或增加转移因子注射的四联疗法治疗240例寻常型银屑病住院患者。以邮寄调查问卷的方式对患者进行以复发情况和治疗满意度为主的随访。结果:NB-UVB为主的联合疗法同以往方法相比使患者住院时间明显缩短,四联治疗组有效率比三联治疗组高,复发率为86.7%,平均复发时间为4.2个月。转移因子具有增强治疗效果的作用。     

311nm窄谱中波紫外线照射治疗寻常性银屑病疗效观察

目的观察311nm窄谱中波紫外线(NB-UVB)照射治疗寻常性银屑病的疗效及其影响因素。方法单独采用NB-UVB照射或联合糠馏油硼酸氧化锌软膏(PBZS)封包治疗寻常性银屑病87例,并以银屑病面积和严重度指数(PASI)评价疗效,分析性别、皮肤类型、临床分型及临床分期对疗效的影响,同时对采用其他方法治疗的30例寻常性银屑病患者进行回顾性的评价。结果在(17.60±4.42)d、(16.90±5.80)d、(25.80±6.67)d治疗后,NB-UVB组、NB-UVB+PBZS组及回顾分析组治疗前后PASI评分改善率分别为(76.3±24.6)%、(88.1±28.7)%、(76.5±26.2)%;与回顾分析组比较,NB-UVB组与其疗效相当(P>0.05),但治疗时间显著缩短(P<0.05),而NB-UVB+PBZS组则在更短的治疗时间(P<0.05)取得了更好的疗效(P<0.05);疗效相关因素分析表明,点滴状略优于斑块状、进行期略优于静止期(0.01相似文献   

补骨脂素长波紫外线和窄谱中波紫外线治疗寻常性银屑病临床疗效观察

目的:观察补骨脂素长波紫外线(PUVA)和窄谱中波紫外线(NB-UVB)治疗寻常性银屑病的临床疗效及其影响因素。方法:分别采用PUVA和311nmNB-UVB照射治疗146例寻常性银屑病患者,并以银屑病面积和严重度指数(PASI)评价疗效,分析照射剂量等对疗效和复发的影响。结果:NB-UVB治疗寻常性银屑病的疗效与PUVA相当,NB-UVB组患者的治疗时间明显短于PUVA组,NB-UVB组患者1年内复发率高于PUVA组。结论:NB-UVB治疗寻常性银屑病与PUVA相比,不良反应较少,起效较快。     

A single blind randomized clinical study: the efficacy of isotretinoin plus narrow band ultraviolet B in the treatment of psoriasis vulgaris

In this randomized clinical trial, 39 patients with psoriasis vulgaris were randomized in two groups. Intervention group received narrow band ultraviolet B (NBUVB)+isotretinoin (0.5 mg/kg/day), control group received NBUVB+placebo. Psoriasis Area Severity Index (PASI) scoring was recorded at baseline and weeks 4, 10, and 14. Thirty‐seven patients completed the study. According to recorded PASI scores the difference between efficacies of two treatments was not significant. Complete clearing was noticed in 14 and 13 patients in intervention group and controls. The mean cumulative NBUVB dose in intervention group and controls was 29.95 ± 16.11 vs. 45.77 ± 7.72 J/cm² (P=0.004). Isotretinoin+NBUVB can reduce number of phototherapy sessions and cumulative NBUVB dose.     

Combination therapy with tazarotene plus a topical corticosteroid for the treatment of plaque psoriasis

Although tazarotene monotherapy is generally efficacious and well tolerated, studies show that both the efficacy and the tolerability of tazarotene therapy can be further improved when it is used in combination with certain topical corticosteroids. The studies reported here evaluate the usefulness of two potential combination regimens. In one regimen, a corticosteroid is added to tazarotene treatment. In the other regimen, corticosteroid treatment alternates on a daily basis with tazarotene treatment. The results of the first study, which involved 300 patients, showed that additive combination therapy using tazarotene plus a mid- or high-potency topical corticosteroid significantly increased the percentage of plaques achieving treatment success at the end of the treatment period, compared with tazarotene plus placebo (91% and 95% vs. 80%, respectively; P  < 0.05 for both). Similarly, tazarotene plus a mid- or high-potency topical corticosteroid reduced the incidence of patient withdrawals compared with tazarotene plus placebo (5.5% and 9.6% vs. 13.3%). The results of the second study, which involved 398 patients, showed that a combination regimen that alternates between tazarotene and a high-potency topical corticosteroid treatment each day, significantly increased the treatment success rate compared with regimens using tazarotene alternating with a mid-potency corticosteroid or placebo (75% vs. 55% and 54%, respectively, at the end of the treatment period; P  < 0.05 for both). In addition, there was a trend towards a lower incidence of treatment-related adverse events as corticosteroid potency increased (from 42% with tazarotene plus placebo to 36%, 32%, and 31% with tazarotene plus the low-, mid-, and high-potency corticosteroid, respectively). Both treatment regimens are potentially useful and offer a rational approach to optimizing the efficacy and tolerability of tazarotene treatment for plaque psoriasis.     

Calcipotriol vs. tazarotene as combination therapy with narrowband ultraviolet B (311 nm): efficacy in patients with severe psoriasis

BACKGROUND: Phototherapy has been shown to be one of the most effective treatment modalities for patients with psoriasis. Nevertheless, photocombination therapies capable both of reducing cumulative ultraviolet (UV) doses and of accelerating clearance of skin lesions are important and of high interest. There have been no published studies comparing the effect of narrowband UVB irradiation in combination with topical application of tazarotene vs. calcipotriol. OBJECTIVES: To determine, in a half-side manner, whether a combination of UVB (311 nm) and tazarotene is superior to UVB (311 nm) plus calcipotriol or vice versa. METHODS: Ten patients suffering from widespread symmetrical psoriasis were treated for at least 4 weeks with topical calcipotriol and tazarotene in a half-side distribution. Additionally, the whole body was irradiated with narrowband UVB (311 nm) four times a week. Before treatment and once weekly during therapy a modified Psoriasis Area and Severity Index was estimated for each body half. The total treatment time, number of treatment sessions and cumulative UVB dose necessary for clearance of skin lesions were determined in an observer-blind fashion for each patient. Furthermore, all patients completed a quality of life questionnaire. RESULTS: Clearance of psoriasis was observed after a median of 19 treatment sessions (range 14-28) and a median cumulative UVB dose of 22.98 J cm-2 (range 9.24-58.22) simultaneously for both body halves. On the side treated with topical tazarotene gel, four patients complained of itching and dryness of the skin, and skin irritation was observed in three of them. Six patients preferred the application of tazarotene gel, while four preferred calcipotriol. CONCLUSIONS: Our clinical comparison of narrowband UVB with either topical calcipotriol or topical tazarotene revealed no significant therapeutic difference between both regimens. Although these results need to be confirmed in larger patient groups, we feel that both photocombination therapies can broaden the therapeutic options for moderate to severe psoriasis vulgaris and may reduce the cumulative UVB dose during therapy.     

窄谱中波紫外线照射治疗寻常型银屑病60例疗效观察

目的观察窄谱中波紫外线(NB-UVB)照射治疗寻常型银屑病的临床疗效。方法分别采用单独照射NB-UVB和照射NB-UVB联合外用1%硝酸益康唑乳膏两种方法各治疗30例寻常型银屑病患者,并以银屑病ESI指数评价疗效。结果两组患者治疗后ESI评分显著下降(P<0.05),两种治疗方法总有效率相比较,P>0.05,无显著性差异。结论单独照射NB-UVB或照射NB-UVB联合外用1%硝酸益康唑乳膏两种治疗方法均可有效治疗寻常型银屑病,但两者疗效无显著性差异。     

C‐reactive protein and leucocyte activation in psoriasis vulgaris according to severity and therapy

Background Psoriasis vulgaris is a chronic recurrent inflammatory skin disease and psoriatic lesions have shown leucocyte infiltration. Objectives We aimed to study C‐reactive protein (CRP) and leucocyte activation markers/inhibitors as potential monitors of psoriasis vulgaris. Methods A cross‐sectional (n = 73) and a longitudinal study (before, at 3, 6 and 12 weeks of therapy; n = 47) was performed; 10 patients started topical treatment, 17 narrow‐band ultraviolet light B (NBUVB) and 20 psolaren associated to UVA (PUVA); psoriasis severity was defined by Psoriasis Area and Severity Index (PASI). Results Compared with control (n = 38), we found higher CRP levels, total leukocyte/neutrophil count, elastase, lactoferrin and α1‐antitrypsin. Increasing PASI was linked to increasing CRP and a trend to higher elastase and lactoferrin, suggesting that worsening enhances inflammatory response with neutrophil activation. CRP correlated with PASI, total leucocytes, neutrophils, elastase, lactoferrin and α1‐antitrypsin. NBUVB and PUVA presented similar effects. Conclusion We propose CRP as a useful marker of psoriasis severity that could be used to monitor psoriasis and its treatment, and, together with PASI and elastase, could also be used as a global index of severity.     

The role of tazarotene in the treatment of psoriasis

The recent availability of tazarotene, the first receptor-selective retinoid, provides a much-needed addition to the therapeutic armamentarium for mild-to-moderate plaque psoriasis. Tazarotene gel offers a welcome combination of good efficacy and cosmetic acceptability, with minimal risk of systemic adverse effects. The selectivity of tazarotene for the β and γ subtypes of retinoic acid receptors suggests a targeted action on psoriatic keratinocytes, which may help to minimize the risk of adverse effects. The potential for adverse effects is further minimized by the limited transcutaneous absorption of tazarotene, its rapid metabolism into hydrophilic metabolites, and its rapid elimination from the body. These pharmacokinetic features ensure that plasma levels of tazarotene and its main metabolite, tazarotenic acid, are minimized — thus limiting systemic exposure. The hydrophilicity of the metabolites also limits systemic exposure by ensuring that accumulation does not occur in lipophilic tissues.