邓利丽 刘艳

[摘要]目的：研究復方丙酸氯倍他索软膏联合窄谱紫外线（NB-UVB）治疗轻中度银屑病的疗效。方法：依据随机数表法将2017年11月-2020年2月笔者医院诊治的90例轻中度银屑病患者分为研究组（30例）、对照1组（30例）和对照2组（30例），对照1组给予NB-UVB治疗，对照2组给予复方丙酸氯倍他索软膏治疗，研究组给予复方丙酸氯倍他索软膏联合NB-UVB治疗。比较三组患者治疗前后皮损面积和严重性指数（PASI）评分、瘙痒程度、血清炎症因子水平，并评估疗效和安全性。结果：治疗前，三组患者皮损面积、红斑、浸润、鳞屑以及瘙痒程度评分值比较无统计学意义（P>0.05），治疗后，三组患者分值均显著降低，且研究组明显低于对照1、2组（P<0.05）;治疗前，三组患者血清炎症因子水平比较无统计学意义（P>0.05），治疗后，三组患者水平均显著降低，且研究组明显低于对照1、2组（P<0.05）;研究组患者治疗有效率明显高于对照1、2组（P<0.05）;研究组和对照2组不良反应发生率显著低于对照1组（P<0.05）。结论：复方丙酸氯倍他索软膏联合NB-UVB治疗轻中度银屑病的安全性和有效性更高，可显著改善患者临床症状，减少皮损，提高美容效果。

[关键词]复方丙酸氯倍他索软膏;窄谱紫外线;轻中度银屑病;瘙痒程度;安全性

[中图分类号]R758.63    [文献标志码]A    [文章编号]1008-6455（2021）06-0075-04

Cosmetic Effect of Compound Clobetasol Propionate Ointment Combined with Narrow-band Ultraviolet B on Mild to Moderate Psoriasis

DENG Li-li， LIU Yan

（Department of Dermatology， Chengdu Second People's Hospital， Chengdu 610000，Sichuan，China）

Abstract：Objective  To study the curative effect and cosmetic effect of compound clobetasol propionate ointment （JinNiuer） combined with narrow-band ultraviolet B （NB-UVB） on mild to moderate psoriasis. Methods  A total of 90 patients with mild to moderate psoriasis who were diagnosed and treated in the hospital during the period from November 2017 to February 2020 were divided into study group （30 cases）， control group 1 （30 cases） and control group 2 （30 cases） by random number table method. The control group 1 was treated with NB-UVB， the control group 2 was treated with compound clobetasol propionate ointment and the study group was treated with compound clobetasol propionate ointment combined with NB-UVB. The scores of psoriasis area and severity index （PASI）， itching degree and levels of serum inflammatory factors before and after treatment were compared among the 3 groups. The curative effect and safety were evaluated. Results  Before treatment， the differences in scores of skin lesion area， erythema， infiltration， scales and itching degree were not statistically significant among the 3 groups （P>0.05）. After treatment， the above scores in all groups were significantly decreased， which were significantly lower in study group than control group 1 and 2 （P<0.05）. Before treatment， there were no significant differences in levels of serum inflammatory factors among the 3 groups （P>0.05）. After treatment， the above levels in all groups were significantly decreased， which were significantly lower in study group than control group 1 and 2 （P<0.05）. The response rate of study group was significantly higher than those of control group 1 and 2 （P<0.05）. The incidences of adverse reactions in the study group and the control group 2 were significantly lower than that in the control group 1 （P<0.05）. Conclusion  Safety and effectiveness of compound clobetasol propionate ointment combined with NB-UVB are higher in the treatment of mild to moderate psoriasis. It can significantly improve the clinical symptoms of patients， reduce skin lesions， and improve cosmetic effect.

Key words： compound clobetasol propionate ointment; narrow-band ultraviolet B; mild to moderate psoriasis; degree of pruritus; security

银屑病是由多种炎症因子介导的一种慢性炎症性皮肤疾病，其发病率在世界范围内差异较大，其中我国发病率约为0.13%，且发病人群多集中于青中年，无较为明显的性别差异[1]。目前，针对银屑病的治疗主要根据患者病情的轻重程度和疾病的分型采取外用药物、口服药物及光疗等方法。窄谱紫外线（NB-UVB）具有镇痛、止痒、抗炎及抑制细胞增殖等作用，但照射时间过长会导致皮肤出现红肿、瘙痒和刺痛，且单一疗法疗效也有限[2]。复方丙酸氯倍他索软膏是一种具有抗炎和调节皮肤角化的复方药物，由丙酸氯倍他索和全反式维A酸组成，两种成分均是治疗银屑病的有效成分，已有研究表明该药物在湿疹、寻常型银屑病等疾病的治疗中效果显著[3-4]。本研……