窄谱中波紫外线治疗对寻常性银屑病患者血清TNF-α,IL-10水平的影响

目的探讨窄谱中波紫外线(NB-UVB)治疗对寻常性银屑病患者血清TNF-α和IL-10水平的影响。方法 42例银屑病患者采用NB-UVB照射治疗,3次/周,共治疗6周,采用酶联免疫吸附试验(ELISA)测定患者治疗前后血清TNF-α和IL-10含量的变化情况,并与20例正常人对照。结果银屑病患者治疗有效率为80.95%,正常人血清TNF-α和IL-10浓度分别为(0.58±1.17)ng/mL和(16.91±4.58)pg/mL;银屑病患者治疗前后TNF-α浓度分别为(41.56±8.23)ng/mL和(12.40±7.21)ng/mL,治疗前后TNF-α水平比较,差异有统计学意义(P<0.01);银屑病患者治疗前后IL-10浓度分别为(7.45±2.32)pg/mL和(11.64±3.42)pg/mL,治疗前后IL-10水平比较,差异有统计学意义(P<0.05)。结论 NB-UVB照射治疗银屑病患者有效,可能与抑制银屑病患者血清TNF-α水平,提高IL-10水平有关。     

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。     

复方卡力孜然酊联合窄谱中波紫外线治疗白癜风疗效观察

目的观察复方卡力孜然酊联合窄谱中波紫外线(NB-UVB)治疗白癜风的疗效。方法将60例临床确诊的白癜风患者分为观察组32例,对照组28例。观察组予复方卡力孜然酊联合NB-UVB治疗,对照组单纯用NB-UVB治疗。结果观察组痊愈率为9.37%,显效率为50%,总有效率为93.75%。对照组痊愈率为7.14%,显效率为25%,总有效率为71.42%。两组总有效率差异有显著性(2=5.347,P0.05)。结论复方卡力孜然酊联合NB-UVB治疗白癜风疗效好。     

NB-UVB对银屑病患者外周血MCP-1及MIP-1α的影响

目的探讨窄谱中波紫外线(NB-UVB)对寻常型银屑病患者外周血单核细胞趋化蛋白-1(MCP-1)及巨噬细胞炎性蛋白-1α(MIP-1α)的影响。方法利用酶联免疫吸附法检测患者治疗前后和正常人血清中MCP-1及MIP-1α的值。结果寻常型银屑病患者外周血MCP-1及MIP-1α的值都明显高于正常人;照射治疗15次后,外周血中MCP-1明显降低(P<0.01),而MIP-1α却未见明显变化(P>0.05)。结论本研究提示NB-UVB可能通过降低外周血中MCP-1的含量而达到治疗银屑病的目的。     

NB-UVB联合罗哌卡因脊神经根阻滞治疗带状疱疹后遗神经痛疗效观察

目的：观察窄谱中波紫外线（NB-UVB）联合罗哌卡因脊神经根阻滞对带状疱疹后遗神经痛（PHN）的治疗效果。方法：选择带状疱疹后遗神经痛的患者60例,按随机原则分为治疗组（30例）和对照组（30例）,两组均给予罗哌卡因脊神经根阻滞,治疗组加用NB-UVB对受累的部位进行局部照射治疗。采用视觉模拟评分法（VAS法）,分别在治疗1个月后及出院后6个月进行VAS评分,评估两种方法的疗效和安全性。结果：治疗1个月后,治疗组有效率达96.67%,对照组有效率为80.00%,两组比较差异有统计学意义（χ2=4.043,P〈0.05）。出院后6个月时,治疗组疼痛消失者20例（66.67%）,疼痛减轻者2例（6.67%）,疼痛无缓解者1例（3.33%）;对照组疼痛消失者10例（33.33%）,疼痛减轻者5例（16.67%）,疼痛无缓解者8例（26.67%）,差异有统计学意义（P〈0.05）。结论：局麻药物罗哌卡因应用于脊神经根阻滞,对于PNH患者有明显缓解疼痛效果,NB-UVB联合罗哌卡因脊神经根阻滞治疗PNH,明显降低了PNH患者VAS评分,疗效明显优于单一治疗神经根阻滞。     

他克莫司软膏治疗白癜风的系统评价

目的系统评价外用他克莫司软膏治疗白癜风的临床疗效及安全性。方法计算机检索Cochorane图书馆、Pubmed,Embase、中国生物医学文献数据库、中国期刊全文数据库、万方学位论文数据库,收集所有外用他克莫司软膏治疗白癜风的随机对照试验(RCT),对其进行系统评价。结果共纳入13篇RCT。Meta分析显示他克莫司软膏联合308nm准分子激光或窄谱中波紫外线(NB-UVB)疗效优于单用308nm准分子激光或NB-UVB;单用他克莫司软膏疗效优于补骨脂醑,但与单用NB-UVB、卤米松或0.05%丙酸氯倍米松比较,疗效差异无显著性。他克莫司软膏的主要不良反应是皮肤烧灼感和红斑。结论他克莫司软膏是治疗白癜风的新选择,但临床应用的确切有效性和安全性尚需更多的RCT证实。     

散瘀消银汤综合疗法治疗重度斑块状银屑病45例临床观察

目的观察散瘀消银汤综合疗法治疗重度斑块状银屑病的临床疗效。方法将90例重度斑块状银屑病患者随机分为治疗组和对照组各45例,对照组给予中药药浴配合NB-UVB照射、卡泊三醇软膏外涂,治疗组在对照组基础上配合散瘀消银汤口服,每日1剂,4周为1个疗程,共治疗3个疗程。治疗前及治疗2、3个疗程后观察银屑病皮损面积、评定严重程度指数(PASI)评分,并判定临床疗效,6个月后随访复发情况。结果治疗组临床疗效总有效率为93.3%(42例/45例),对照组总有效率为75.6%(34例/45例),治疗组优于对照组(P<0.05)。治疗2个疗程后及3个疗程后,治疗组PASI评分明显低于对照组(P<0.05)。与本组治疗前比较,治疗2个疗程后两组PASI评分均低于治疗前(P<0.05)。治疗3个疗程后,两组PASI评分均低于治疗2个疗程后(P<0.05)。治疗组未见明显不良反应,对照组个别出现红斑、瘙痒症状,减少NB-UVB照射剂量后逐渐缓解。结论散瘀消银汤综合疗法治疗重度斑块状银屑病的临床疗效确切,复发率低,未见明显不良反应。     

窄谱中波紫外线照射配合药物治疗寻常型银屑病的疗效观察

目的观察窄谱中波紫外线(NB-UVB)照射治疗寻常型银屑病的疗效。方法将137例寻常型银屑病患者随机分为两组。治疗组93例,采用NB-UVB照射配合其他药物治疗,对照组44例,仅用药物治疗。以银屑病皮损面积和疗效指数评价对比两组的疗效。结果治疗组痊愈61例(65.59%),显效22例(23.66%),有效10例(10.75%),总显效率(痊愈 显效)为89.25%。对照组痊愈26例(59.09),显效8例(18.18),有效9例(20.45),总显效率为77.27%。两组疗效比较,有显著性差异(χ2=5.01,P<0.05)。治疗组疗程结束时NB-UVB平均照射剂量为1.48 J/cm2,平均照射次数为17.4次,累积照射剂量为19.2 J/cm2,有6例患者出现皮肤干燥、瘙痒灼热感等不良反应。结论采用NB-UVB照射联合其他方法治疗寻常型银屑病安全、方便,疗效可靠,值得推广应用。     

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.