雷公藤多苷片治疗顽固性银屑病的临床观察

目的 探讨雷公藤多苷片治疗顽固性银屑病的临床疗效.方法 选取顽固性银屑病患者66例,按照入院时间分为两组.治疗组给予雷公藤多苷片治疗,对照组给予红霉素和甘草甜素联合治疗.治疗中每两周复查血、尿常规,每月复查一次肝肾功能,治疗6周后,观察两组患者临床疗效和药物不良反应情况,随诊2年,观察两组复发情况.结果 治疗组痊愈8例,显效15例,好转8例,无效2例,总有效率69.7％；对照组分别为2例、7例、5例、19例,总有效率27.3％,两组总有效率差异有统计学意义（x2 =7.34,P＜0.05）.治疗组轻度头昏1例,ALT升高1例,月经不调1例,占9.1％；对照组轻度头昏3例,厌食1例,ALT升高1例,月经不调1例,占18.2％,停药2周后均恢复正常,两组不良反应总发生率差异有统计学意义（x2 =3.37,P＜0.05）.治疗组1年内复发1例,2年内复发2例,总复发率9.1％；对照组1年内复发5例,2年内复发7例,总复发率39.4％,两组总有效率差异有统计学意义（x2 =5.79,P＜0.05）.结论 雷公藤多苷片治疗顽固性银屑病显效时间短,临床疗效好,不良反应少,远期效果好,具有积极的临床意义,值得推广.

Clinical observation of Tripterygium wilfordii tablets in the treatment of intractable psoriasis

Objective To investigate the clinical efficacy of Tripterygium wilfordii tablets in the treatment of intractable psoriasis.Methods 66 patients with intractable psoriasis according to the time of admission were randomly divided into two groups.The treatment group was treated with Tripterygium wilfordii tablets,the control group was given erythromycin combined with Glycyrrhizin.During treatment period,the blood and urine were checked every two weeks,the liver and kidney function were examined monthly.After treatment for 6 weeks,the clinical efficacy and side effects were observed in two groups.The patients were followed up for 2 years,the recurrence was observed.Results In the treatment group,8 cases were cured,effective in 15 cases,8 cases were improved,2 cases were ineffective,the total effective rate was 69.7%.Those in the control group were 2 cases,7 cases,5 cases,19 cases,the total effective rate was 27.3%,the difference between the two groups was statistically significant （x2 =7.34,P 〈 0.05）.In the treatment group,mild dizziness in 1 case,transaminase increased in 1 case,irregular menstruation in 1 case,accounted for 9.1%.In the control group,3 cases occured mild dizziness,1 case occured anorexia,transaminase increased in 1 case,irregular menstruation in 1 case,accounted for 18.2%.2 weeks after withdrawal of the drug,they all returned to normal.The incidence rate of side effects between the two groups had statistically significant difference （x2 =3.37,P 〈 0.05）.In the treatment group,1 case relapsed within 1 year,2 cases relapsed within 2 years,the total recurrence rate was 9.1%.In the control group,5 cases relapsed within 1 year,7 cases relapsed within 2 years,the recurrence rate was 39.4%,there was significant difference between the two groups （x2 =5.79,P 〈 0.05）.Conclusion Tripterygium wilfordii tablets in the treatment of refractory psoriasis has short response time,good clinical effect,less side effects,and good long-term effect,which is worthy of promotion.