他卡西醇联合卤米松序贯治疗斑块型银屑病的临床疗效

目的]探讨他卡西醇联合卤米松序贯疗法治疗斑块型银屑病的临床疗效。方法]从2011年1月至2013年2月在我院诊治的斑块型银屑病患者中选取117例，随机分为治疗组（60例）与对照组（57例）。治疗组采用他卡西醇与卤米松序贯疗法，治疗分3个阶段完成（每个阶段各用2周时间）。第1阶段要求患者早晨外用卤米松（1次/d），晚上用他卡西醇（1次/d）涂抹皮损处；第2阶段改为周一到周五使用他卡西醇（2次/d），周六、日使用卤米松（2次/d）；第3阶段单独使用他卡西醇（2次/d）。对照组给予单独使用卤米松（2次/d）连续治疗6周。观察比较两组患者治疗过程中的不良反应及第2、4、6周PASI评分和临床疗效，并对所有患者随访3个月，观察其复发情况。结果]两组患者在治疗过程中PASI评分随着治疗时间的延长均有所下降，而且在第4、6周时治疗组的PASI评分下降更加显著（P＜0.05），并且两组患者在治疗过程中均未出现严重的不良反应。两组患者在完成6周的疗程后，治疗组总有效率达90.00%，明显优于对照组的71.90%（P＜0.05）。在随访的3个月中，治疗组的复发率只有10.00%，明显低于对照组的31.60%（P＜0.05）。结论]他卡西醇联合卤米松的序贯疗法治疗斑块型银屑病临床疗效显著，复发率低。

Sequential Therapy of Tacalcitol Combined with Halometasone Treat Plaque Psoriasis

Objective] To investigate the clinical efficacy of tacalcitol combined Halometasone sequential therapy in the patients of plaque psoriasis. Methods] 117 cases of plaque psoriasis col ected between 2011.01 and 2013.02 were randomly divided into treatment group and control group. The treatment group were treated with tacalcitol and Halometasone therapy, and required topical use Halometasone（1 time/day） in the morning ,tacalcitol use in the evening（1 time/day） before the first 2 weeks. Continuous two weeks treatment from Monday to Friday with tacalcitol（2 times/day）, Saturday and Sunday with Halometasone（2 times/day）, final y the transition to be used alone tacalcitol（2 times/day） in the next two weeks of continuous treatment. Control group of pa-tients given alone Halometasone（2 times/day） for 6 consecutive weeks. Observe the adverse reactions PASI scores during and after completion of treatment within the two groups. Al patients were fol owed for three months, observed recurrence. Results] The PASI score between two groups of patients declined during treatment, especial y at the 4th and 6th week within the treatment group. Both groups had no serious adverse reactions. In treatment group, 54 patients had effective responses, the total effective rate was 90%, significantly better than the control group（41 cases,71.9%）. In the fol ow-up of 3 months, the recur-rence rate was 11.1%in the treatment group, significantly lower than the control group（31.6%）. The difference of total efficiency and the recurrence rate with-in the two groups was statistical y significant. Conclusion] Tacalcitol combined Halometasone sequential therapy of plaque psoriasis has significant clinical effi-cacy and low recurrence rate.