预见性护理干预在银屑病患者中的应用价值

目的探讨预见性护理干预在银屑病患者中的应用效果。方法分析本院收治的银屑病患者的临床资料,依据护理方式不同分为预见性护理组30例和常规护理组30例。结果预见性护理组护理后PASI评分明显优于常规护理组,预见性护理组差错发生率、综合满意度、护患纠纷投诉率均优于常规护理组,差异均有统计学意义（P〈0.05）。结论预见性护理干预可以明显改善银屑病患者的临床症状,提高临床护理质量,值得临床推广应用。     

消银胶囊联合复方甘草酸苷治疗寻常型银屑病

目的观察消银胶囊联合复方甘草酸苷治疗寻常型银屑病的临床疗效。方法将本院2009年1月～2011年6月收治的63例寻常型银屑病患者随机分为两组,对照组29例,口服消银胶囊5粒,3次/d,转移因子胶囊3mg,2次/d,同时外用复方氟米松软膏。治疗组34例在此基础上加用复方甘草酸苷片50mg,3次/d,两组均治疗6周观察疗效。结果治疗组治疗后PASI评分为（3.61±2.26）分,低于对照组的（7.3±1.7）分,差异有统计学意义（P〈0.05）;两组患者治疗后的有效率分别为85.3%、65.5%,两组比较差异有统计学意义（P〈0.05）;两组患者治疗前后血、尿常规、肝肾功能等各项指标均未见异常。结论消银胶囊联合复方甘草酸苷治疗寻常型银屑病可明显提高疗效,值得临床应用。     

阿维A联合甲氨蝶呤治疗难治性泛发性脓疱型银屑病的疗效观察

目的：探讨阿维A联合甲氨蝶呤治疗难治性泛发性脓疱型银屑病的疗效及安全性。方法169例难治性泛发性脓疱型银屑病患者,采用数字表法随机分为阿维A组、甲氨蝶呤组以及阿维A与甲氨蝶呤联合治疗组,观察不同治疗方法的临床疗效与安全性。结果联合治疗组的总有效率为96．55％,明显高于阿维A组的83．93％以及甲氨蝶呤组的80．00％（χ2＝5．210、7．603,均P＜0．05）。联合治疗组不良反应发生率为41．38％,显著高于阿维A组的21．43％（χ2＝5．251,P＜0．05）。结论阿维A联合甲氨蝶呤治疗难治性泛发性脓疱型银屑病的临床疗效显著,安全性好,值得在临床中推广应用。     

中药药浴联合NB-UVB照射治疗寻常性银屑病的效果观察

目的探讨中药药浴联合窄谱中波紫外线（NB-UVB）照射治疗寻常性银屑病的临床效果。方法将本院2010年5月~2013年8月收治的106例寻常性银屑病患者随机分为对照组和观察组,每组各53例。对照组给予NB-UVB照射治疗,观察组给予中药药浴联合NB-UVB照射治疗,比较两组患者的临床效果。结果观察组的总显效率为94.3%,明显高于对照组的83.0%（P〈0.05）;观察组的PASI评分明显低于对照组（P〈0.05）;两组的总不良反应发生率比较,差异有统计学意义（P〈0.05）。结论中药药浴联合NB-UVB照射治疗寻常性银屑病的临床效果显著,安全可靠。     

蜈蚣败毒饮对HaCaT细胞Keratin6 mRNA表达的影响

目的:研究蜈蚣败毒饮对角质形成(Ha Ca T)细胞角蛋白Keratin6 m RNA表达的影响。方法:36只Wistar大鼠随机均分为空白对照(等容生理盐水)组、甲氨蝶呤(0.22 g/100 g)组、复方青黛胶囊(0.26 g/100 g)组与蜈蚣败毒饮高、中、低剂量(11.88、5.94、2.96 g/100 g)组,ig给药,每天2次,连续3 d。末次给药后取腹主动脉血,各组血清作用于相应的Ha Ca T细胞培养24 h。通过实时荧光酶链聚合反应(RT-PCR)法测定Ha Ca T细胞Keratin6 m RNA的表达。结果:与空白对照组比较,各用药组Ha Ca T细胞Keratin6 m RNA表达减弱,蜈蚣败毒饮在减弱Ha Ca T细胞Keratin6 m RNA表达方面呈现出非剂量依赖关系。结论:蜈蚣败毒饮可能通过抑制Keratin6 m RNA的表达,从而降低了Ha Ca T细胞增殖来发挥抗银屑病作用。     

The Role of Leptin in the Association between Obesity and Psoriasis

Adipose tissue secretes many adipokines which contribute to various metabolic processes, such as blood pressure, glucose homeostasis, inflammation and angiogenesis. The biology of adipose tissue in an obese individual is abnormally altered in a manner that increases the body’s vulnerability to immune diseases, such as psoriasis. Psoriasis is considered a chronic inflammatory skin disease which is closely associated with being overweight and obese. Additionally, secretion of leptin, a type of adipokine, increases dependently on adipose cell size and adipose accumulation. Likewise, high leptin levels also aggravate obesity via development of leptin resistance, suggesting that leptin and obesity are closely related. Leptin induction in psoriatic patients is mainly driven by the interleukin (IL)-23/helper T (Th) 17 axis pathway. Furthermore, leptin can have an effect on various types of immune cells such as T cells and dendritic cells. Here, we discuss the relationship between obesity and leptin expression as well as the linkage between effect of leptin on immune cells and psoriasis progression.     

牛皮癣34例临床观察及治疗对策研究

目的 开展了牛皮癣的临床治疗观察和治疗方法进行了详细研究.方法 选择自2011年1月-2013年3月在本院进行治疗的牛皮癣患者,随机分为治疗组和对照组,进行了内服和外用联合治疗和单纯性内服药治疗.结果 治疗组的总有效率为100％;对照组的总有效率为88％,治疗组的情况好于对照组,P＜0.05表示差异有统计学意义.结论 治疗牛皮癣要首先考虑中西医结合治疗的方式.     

咪喹莫特诱发银屑病的机制研究新进展

临床报道咪喹莫特能诱发人银屑病,实验研究发现咪喹莫特能诱导鼠类银屑病样皮肤改变,且发现有不同的作用机制参与此过程。本文对咪喹莫特诱导鼠类银屑病样皮肤变化过程中发现的作用机制进行综述,为探究银屑病复杂的发病机制和治疗提供新思路。     

Economic burden of psoriasis compared to the general population and stratified by disease severity

Abstract

Objective:

To evaluate health care utilization and costs for patients with psoriasis vs. the general population and by psoriasis severity.     

The burden of illness associated with psoriasis: cost of treatment with systemic therapy and phototherapy in the US

SUMMARY

Objective: To evaluate utilization and direct healthcare expenditures among psoriasis patients treated with systemic therapy and phototherapy in the United States.

Design: Cohort study using retrospective administrative medical claims.

Patients: Psoriasis patients treated with systemic therapy and phototherapy, as well as a matched cohort of non-psoriasis patients. All patients were covered by employer-sponsored insurance between 1 April 1996 and 31 December 2000.

Main outcome measures: Estimated risk of hospitalization and total annual healthcare expenditures overall and by comorbidity status were compared for persons with psoriasis using systemic therapy or phototherapy and persons without psoriasis. Annualized utilization rates for hospitalizations, and use of emergency department, outpatient physician, outpatient laboratory, and outpatient pharmaceutical services were also compared across the two cohorts.

Results: Seventeen percent of psoriasis patients were treated with systemic therapy or phototherapy. Patients with comorbid anemia, carcinoma, diabetes, depression, GI disorders, hepatotoxicity, hypertension, and nephrotoxicity had significantly higher expenditures than non-psoriasis patients with the same comorbidities (?p ≤ 0.05). Elevated risk of hospitalization also contributed to higher expenditures in patients treated with systemic therapy or phototherapy. Limitations of this study include those inherent in using claims data such as dependence on diagnosis coding, the fact that psoriasis severity cannot be determined directly from claims data, confounding comorbidities, and the fact that only direct healthcare expenditures were considered in this analysis.

Conclusion: Psoriasis patients treated with systemic therapies/phototherapies have significantly more comorbidities and higher mean total healthcare expenditures compared to non-psoriasis patients. Psoriasis patients with selected comorbidities have significantly higher mean total healthcare expenditures compared to non-psoriasis persons with the same comorbidities.