窄谱中波紫外线治疗寻常性银屑病临床观察

目的探讨311nm窄谱中波紫外线（NB—UVB）治疗寻常性银屑病的疗效及其安全性。方法应用NB—UVB治疗仪对472例患者进行照射，治疗3次／周，连续治疗12～24次。于治疗结束后3，6，12和18个月进行随访，评价疗效和安全性。结果472例患者中痊愈251例（53．18％），显效183例（38．77％），好转31例（6．57％），无效7例（1．48％），有效率为91．95％。结论NB—UVB治疗银屑病安全、有效，且操作简便，值得临床选择应用。     

窄谱中波紫外线治疗寻常型银屑病疗效观察

窄谱中波紫外线（NB-UVB波长311-313nm）照射治疗银屑病，该疗法等同或优于补骨脂素长波紫外线（PUVA）疗法，而且较PUVA安全，因此近年来临床应用渐多。我科自2005年5月以来采用NB-UVB治疗寻常型银屑病61例，取得满意疗效，现将观察结果总结如下。     

窄谱中波紫外线治疗寻常性银屑病疗效观察

我科于2007年7月～2008年6月采用窄谱中波紫外线(NB-UVB)治疗寻常性银屑病120例,取得满意疗效,现报告如下.     

窄谱中波紫外线加中药治疗寻常性银屑病疗效观察

目的比较窄谱中波紫外线（NB-UVB）加中药、中药、NB-UVB3种方法治疗寻常性银屑病的疗效,探讨一种提高寻常性银屑病治愈率的同时有效延长缓解期的方法：方法分别采用NB-UVB加中药、中药、NB-UVB治疗寻常性银屑病各35例,并随访2年。结果NB-UVB加中药组治愈30例,2年复发2例;NB—UVB组治愈23例,2年复发12例;中药组治愈14例,2年复发2例,结论NB-UVB加中药治疗寻常性银屑病既提高治愈率又有效延长缓解期。     

窄谱中波紫外线治疗寻常型银屑病临床观察

为观察窄谱中波紫外线照射治疗寻常型银屑病的疗效及安全性,我们使用窄谱中波紫外线照射治疗寻常型银屑病42例。结果:痊愈16例,显效20例,有效6例。总有效率85.7%,平均照射次数21.4次,平均照射剂量30.5 J/cm2。不良反应主要表现为轻度红斑、瘙痒及色素沉着。窄谱中波紫外线照射治疗寻常型银屑病疗效好、不良反应少、易于操作、患者易于接受。     

中药药浴联合窄谱中波紫外线治疗寻常性银屑病疗效观察

目的评价中药药浴联合窄谱中波紫外线照射(NB-UVB)治疗寻常性银屑病的临床疗效。方法把140例患者随机分为两组,治疗组75例,对照组65例。两组均外用15%尿素霜,且在治疗的前7d同时外用卤米松乳膏,外用面积不超过体表面积的20%,均1次/d。治疗组加用我科协定方(参卿止痒方)中药浴,同时进行NB-UVB照射,对照组仅加用NB-UVB照射治疗,均隔日1次,10次为1个疗程,共治疗2个疗程。结果治疗组有效率78.67%,对照组为56.92%,差异有统计学意义(P<0.01)。两组患者未见严重不良反应。结论参卿止痒方中药浴联合NB-UVB治疗寻常性银屑病有效,值得临床应用。     

窄谱中波紫外线联合甲氨蝶呤治疗寻常性银屑病临床疗效观察

2003年6月—2006年6月笔者采用甲氨蝶呤（methotre xate,MTX）与窄谱中波紫外线（narrowband ultraviolet B,NB-UVB）联合治疗寻常性银屑病,并与单用NB-UVB进行随机对照研究,现将临床初步研究结果报告如下。[第一段]     

窄谱中波紫外线治疗寻常型银屑病临床疗效观察

近10余年来，国外利用窄谱中波紫外线(NB-UVB，波长311～313nm)照射治疗银屑病，该疗法等同或甚至优于补骨脂素长波紫外线(PUVA)的疗效，而且较PUVA安全，因此临床应用日渐增多。为了探索NB-UVB对我国银屑病患者的疗效影响，自2002年10月起，笔者对40例寻常型银屑病患者采用NB-UVB全身照射并进行临床观察，现报告如下。     

阿维A联合窄谱中波紫外线治疗寻常性银屑病疗效观察

目的观察阿维A联合窄谱中波紫外线(NB-UVB)治疗寻常性银屑病的疗效。方法单独应用阿维A治疗、单独采用NB-UVB照射及阿维A联合NB-UVB治疗寻常型银屑病180例,以银屑病皮损面积和严重度指数(PAS1)评价疗效。结果联合组与阿维A组、NB-UVB组评分改善率及治疗时间差异均有统计学意义(P0.01),联合组总有效率优于阿维A组及NB-UVB组(P0.05)。结论阿维A联合NB-UVB治疗寻常型银屑病疗效满意。     

窄谱中波紫外线治疗寻常型银屑病2087例疗效观察

目的观察窄谱中波紫外线(NB-UVB)治疗寻常型银屑病的临床疗效及安全性。方法回顾性分析采用NB-UVB治疗2087例银屑病患者的有效率,治疗频次及不良反应等。结果NB-UVB治疗寻常型银屑病有效率为84.20%,平均治疗频次17.6次,不良反应以灼烧感、红斑、瘙痒为主。结论NB-UVB治疗寻常型银屑病,安全有效,患者依从性高,但其疗效与寻常型银屑病的分期及分型有关。     

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.     

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。     

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   

Bath psoralen+ultraviolet A photochemotherapy vs. narrow band‐ultraviolet B in psoriasis: a comparison of clinical outcome and effect on circulating T‐helper and T‐suppressor/cytotoxic cells

Background: Comparative success rates of bath psoralen+ultraviolet A (PUVA) and narrow band‐ultraviolet B (NB‐UVB) in psoriasis treatment are variably reported with no previous studies on the possible effect of bath PUVA on circulating CD4+ and CD8+ T cells. Objective: We aimed to compare the effect of bath PUVA and NB‐UVB clinically and on circulating T‐helper and T‐suppressor/cytotoxic cells in psoriasis. Patients and methods: Thirty‐four psoriatic patients divided into a bath PUVA‐treated group (18 patients) and a NB‐UVB‐treated group (16 patients) were compared regarding the disease severity by psoriasis area and severity index (PASI) score and percentage of circulating CD4+ and CD8+ T cells by flowcytometry before and after treatment. Results: After treatment, the bath PUVA group showed a significantly higher reduction of PASI score (85.44%) than the NB‐UVB group (58.72%). Mean peripheral CD4+ T‐cell percentage was significantly lower after [36.8; 95% confidence interval (CI) 33.80, 39.97] compared with before treatment (42.06; 95% CI 38.29, 45.83) (P<0.05) in the bath PUVA group while this difference was insignificant in the NB‐UVB group (P>0.05). Conclusion: Bath PUVA therapy is superior to NB‐UVB in the treatment of moderate and severe psoriasis with mild reversible side effects. Both modalities have a systemic effect decreasing peripheral CD4+ T cells, which is more with bath PUVA.     

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。     

口服阿维A结合光化学疗法治疗寻常型银屑病临床疗效观察

目的：评价口服阿维A结合光化学疗法治疗寻常型银屑病的疗效及不良反应。方法：60例寻常型银屑病患者随机分为两组，分别给予单一光化学治疗、口服阿维A及光化学治疗。结果：口服阿维A结合光化学治疗的疗效显著优于单一光化学治疗，长波紫外线的总暴露量可明显减少，可缩短近一半疗程。结论：口服阿维A结合光化学疗法是一种值得推广职至重度寻常型银屑病的方法。     

Two cases of eczematid‐like purpura of Doucas and Kapetanakis responsive to narrow band ultraviolet B treatment

Eczematid‐like purpura of Doucas and Kapetanakis is a type of pigmented purpuric dermatoses (PPDs) with eczematous changes in the purpuric surface. A 10‐year‐old male and a 44‐year‐old male patients were admitted to our clinics for itching and flaking of the skin rashes. Based on the clinical and histopathological evaluations, the rashes were identified as eczematid‐like PPDs of Doucas and Kapetanakis. Both patients were treated with narrow band ultraviolet B. The lesions were remarkably regressed following the treatment. These cases reported due its rarity and good response to narrow band ultraviolet B.     

窄谱中波紫外线治疗寻常性银屑病疗效观察及血清细胞因子变化

目的：研究窄谱中波紫外线治疗寻常性银屑病的疗程、近期不良反应及预后；观察照射前后血清细胞因子浓度改变．探讨治疗机制。方法：给予86例寻常性银屑病患者窄谱中波紫外线(NB-UVB)照射，每周3次，共267次，用酶联免疫吸附试验检测32例患者治疗前后血清白介素-8(1L-8)、血管内皮细胞生长因子(VEGF)水平。结果：86例患者治疗后15例痊愈，临床有效率为93．2％，32例患者治疗前血清IL-8水平较健康对照者水平高，照射后显著下降。治疗前仪斑块状银屑病患血清清VEGF水平较正常人为高，照射后显著下降：结论：NB-UVB治疗银屑病疗效高、不良反应少，复发率低、IL-8水平升高可能为寻常性银屑病的发病机制之一。VEGF水平升高可能是斑块状银屑病致病的因素之一。     

Comparison of the efficacy of local narrowband ultraviolet B (NB-UVB) phototherapy versus psoralen plus ultraviolet A (PUVA) paint for palmoplantar psoriasis

Palmoplantar psoriasis is an idiopathic disabling condition, often resistant to conventional therapies. The purpose of this study was to evaluate the efficacy and safety of local narrowband ultraviolet B (NB-UVB) phototherapy and to compare it with local psoralen plus ultraviolet A (PUVA) paint in patients with palmoplantar psoriasis unresponsive to conventional therapies other than phototherapy. A cohort of 25 patients with palmoplantar psoriasis were included in this study, which was based on a left-to-right comparison pattern. The treatments were administered with local narrowband UVB irradiation on one side and local PUVA on the other side three times a week over 9 weeks. Clinical assessments were performed at baseline and every 3 weeks during the 9-week treatment. There was a statistically significant decrease in the mean clinical scores at the third, sixth and ninth week with both treatments. The difference in clinical response between the two treatment modalities was statistically significant at the end of the treatment period, with the percentage reduction in severity index scores with the PUVA-paint-treated side being 85.45% compared with 61.08% for the NB-UVB treated side (t = 5.379, P = 0.0001, Student's t-test for unpaired samples). Our results show that, although some clinical improvement was achieved with local NB-UVB phototherapy, the results were better with local PUVA, and such a treatment option may be reserved for patients with palmoplantar psoriasis who experience phototoxic reaction to psoralens.     

Successful treatment of psoriasis vulgaris with targeted narrow-band ultraviolet B therapy using a new flat-type fluorescent lamp

Narrow-band ultraviolet B (NB-UVB) therapy is widely used for refractory skin diseases. Targeted phototherapy is now being used to reduce the number of sessions and to avoid exposing normal skin. We developed a targeted NB-UVB therapy using a flat-type lamp emitting a wavelength similar to that of the TL-01 fluorescent lamp. Six Japanese patients with psoriasis were recruited and treated with the flat-type NB-UVB device with an initial dose of 70% of the minimal erythema dose, with a 20% increase at each subsequent session. The plaque severity score was determined. All lesions of the tested patients were responsive to NB-UVB therapy using the flat-type lamp. The mean percent reduction of the lesion was 58.3 ± 17.7%. The mean cumulative dose was 20.8 ± 10.8 J/cm2. No side effects were observed during treatment. The flat-type targeted NB-UVB device is compact and convenient, and highly effective for the treatment of limited psoriasis lesions.