辨证与辨病相结合治疗银屑病的临床疗效

目的观察以辨证与辨病相结合组方治疗寻常型银屑病的临床疗效。方法治疗组87例，采用中药汤剂口服；对照组84例，采用迪银片口服。治疗8周后，经银屑病面积和严重程度指数（PASI）进行评分统计。结果2组治愈率及总有效率治疗组均优于对照组（P〈0．01和P〈0．05）。结论中药汤剂治疗寻常型银屑病，安全，有效，无不良反应，值得临床推广应用。     

Examples of Acupuncture Treatment for Intractable Diseases

1 Spermatorrhea
A patient, 16 years old, suffered from spermatorrhea for over one year. At the beginning, it happened once several days, and recently it happened once every other day or every night, accompanied by a withered complexion, soreness and weakness in the lower back and legs, poor sleep, poor memory, a red tongue tip with thin tongue coating, and a thready and rapid pulse. The condition is attributed to kidney deficiency leading to poor containing ability, seminal emissions, and intemal disturbance of monarch fire. Therefore, bilateral Tongli （HT 5）, Shenshu （BL 23）, Guanyuan （CV 4） and Taixi （KI 3） were punctured by the twisting technique for reinforcement,     

Serum Levels of Hyaluronic Acid in Patients with Psoriatic Arthritis

The purpose of this study was to evaluate the serum levels of hyaluronic acid (HA) in a group of patients with psoriatic arthritis (PsA), with special emphasis on the relationships between HA levels and clinical parameters of joint and skin activity. Thirty-four patients with PsA, 34 patients with rheumatoid arthritis (RA) and 49 healthy volunteers participated in the study. Assessment of joint disease in patients with PsA included duration of morning stiffness, number of tender and swollen joints, right and left grip, the presence of inflammatory back pain and Schober’s test. The current severity of skin involvement was graded according to the Psoriasis Area Severity Index (PASI). Serum levels of HA were measured by a radiometric assay. The mean HA serum levels of patients with PsA and RA were significantly increased in comparison with healthy controls (107 ± 39.6 μg/dl in patients with PsA, whereas in patients with RA it was 168 ± 32.4 μg/dl and 36.7 ± 5.5 μg/dl in healthy controls). A highly significant correlation was found between levels of HA and index of skin involvement, but no association was found between HA levels and clinical parameters of joint severity. We conclude that in this cohort of patients with PsA, HA levels clearly reflected psoriatic skin involvement although it did not correlate with joint disease. Received: 18 June 1999 / Accepted: 5 April 2000     

Psoriatic Arthritis: Interrelationships between Skin and Joint Manifestations Related to Onset,Course and Distribution

To assess the relationships between skin and joint disease, 70 patients with psoriatic arthritis were consecutively evaluated. Data were obtained regarding age, sex, duration of disease, age at onset, and flares of both skin and joint disease. Rheumatological assessment included morning stiffness, number of swollen, tender and deformed joints, involvement of distal interphalangeal joints (DIP), presence of dactylitis, Achilles tendinitis, and clinical lumbar and cervical involvement. Skin assessment included recording of the distribution of skin lesions and nail involvement, and grading of psoriasis severity using the PASI. The scalp was the most frequently involved site. Significant correlation was found between the PASI score and the number of deformed joints and Schober’s test. The scalp score was found to correlate with the number of swollen joints, deformed joints, sausage finger and DIP involvement. Synchronous flares of skin and joint were significantly more frequent in the patients with onset of skin and joint diseases within the same year. Likewise, these patients showed a highly significant association between the PASI score and the number of tender, swollen and deformed joints, Schober’s test and cervical involvement, whereas no such associations were found among patients with separate onset of skin and joint diseases. Received: 9 August 1999 / Accepted: 10 February 2000     

银屑病的生物治疗研究

银屑病是一种慢性T细胞介导的炎性、增殖性和复发性皮肤病。随着对银屑病发病免疫学机制的深入研究,一些具有靶位特异性的生物制剂相继出现,包括融合蛋白、单克隆抗体、重组细胞因子等,在临床应用中具有靶向特异性、毒副作用少并取得了可喜的治疗效果。本文对银屑病的免疫学基础、生物免疫治疗学机制及临床疗效评价进行了综述。     

48 CASES OF PSORIASIS TREATED WITH ACUPUNCTURE

The author has treated 48 cases of psoriasis using long needle combined with cup-ping.of 48 cases,32 cases（67％）were cured,10（21％）markedly effective,6（12％）effective.Thetotal effective rate was 100％.     

208例银屑病的临床分析

目的分析总结昆明地区银屑病患者在病因、临床表现、治疗等方面的情况,以提高临床诊疗水平.方法回顾性调查并分析2002～2003年昆明地区 208例银屑病患者的各项临床情况.结果遗传、感染、药物等因素在寻常型银屑病的发病中作用较大,脓疱型及红皮症型的发病多与治疗不当有关;外用新型的皮质类固醇及维甲酸类制剂可取得较好的治疗效果.结论银屑病的临床表现多样,病因复杂,可能存在着地区差异,新一代药物的治疗前景广阔.     

Krankheitsbezogener Stress bei der Psoriasis vulgaris Validierung des “Psoriasis-Alltagsstress-Inventars“ (PAI)

Background and Objective. Illness specific stress plays an important part in the daily life of psoriatic patients. Until now for the measurement of relevant aspects of daily stress only the “Psoriasis Life Stress Inventory” (PLSI) of Gupta &; Gupta exists; with the “Psoriasis-Alltagsstress-Inventar” (PAI), a German version of the PLSI is presented and its psychometric properties are discussed. Patients/Methods. 385 in-patients completed the PAI. The internal validity was examined by factor analysis. Moreover, the correlations between the PAI total score and sociodemographic parameters (ANOVA) and extent of skin involvement (multiple regression) were determined. Results. The PLSI score proves to be sufficiently independent of age, sex, age at onset, and general extent of skin involvement. However, affections of the hands, the lower abdomen and the genitals show a strong influence on the total score. We found marked interrelations with the stigmatization feeling (“Questionnaire on Experience with Skin Complaints” QES, Schmid-Ott et al. 1998). Conclusions. The results suggest that the PAI is a useful and psychologically relevant questionnaire for psoriatic patients.     

寻常型银屑病患者的健康指导

寻常型银屑病是一种常见病,其基本损害为表皮有银白色磷屑的丘疹或斑丘疹,皮疹可发生在全身各处,患者自觉有不同程度瘙痒。病程慢性,易于复发,目前尚无根治的药物。临床观察发现,寻常型银屑病的复发率与心理因素,是否合理饮食以及合理用药与否都有直接的关系。因此加强对寻常型银屑病患者的健康指导对控制病情的发展和复发,提高患者的生活质量有重要意义。现将指导内容及护理体会介绍如下。一般资料40例寻常型银屑病患者均为我科2000年5月至2003年月收治的门诊患者,均符合寻常型银屑病诊断标准,男37例,女17例,年龄16岁~65岁,病程3个月~13a。…     

吡硫翁锌联合他伐罗汀治疗寻常型银屑病疗效观察

目的探讨吡硫翁锌气雾剂联合他伐罗汀乳膏治疗寻常型银屑病的疗效以及安全性。方法62例斑块状银屑病患者随机分为治疗组和对照组，各31例；治疗组应用吡硫翁锌气雾剂联合他伐罗汀乳膏外用治疗，对照组单用他伐罗汀乳膏外用治疗；两组疗程均为8周。观察两组疗效、复发情况以及不良反应。结果治疗组有效率为83．9％；对照组有效率为61．3％；两组比较差异均有统计学意义（P〈0．05）。治疗组出现不良反应3例，对照组4例；停药后12周随诊，治疗组复发9例（29．0％），对照组复发17例（54．8％）。结论应用吡硫翁锌气雾剂联合他伐罗汀乳膏治疗斑块状银屑病效果显著，副作用小，治疗复发率低。