CAJ | 학술논문

目的探讨口服复方甘草酸苷联合外用钙泊三醇倍他米松治疗掌跖脓疱病的临床效果.方法纳入2012年9月至2014年2月唐山市协和医院确诊的掌跖脓疱病患者,按照随机数字表法分为观察组、对照Ⅰ组和对照Ⅱ组,所有患者均口服复方甘草酸苷片,50 mg/次,3次/d;在此基础上观察组给予钙泊三醇倍他米松软膏、对照Ⅰ组给予复方氟米松软膏、对照Ⅱ组给予卤米松封包患处,均每晚1次,治疗8周.于治疗前,治疗后4周和8周进行皮损评分,观察并比较3组疗效,随访6个月,观察复发情况.结果共纳入患者101例,其中观察组34例、对照Ⅰ组32例、对照Ⅱ组35例.与治疗前比较,治疗后4周和8周3组皮损评分均较治疗前明显下降,差异有统计学意义[观察组:(0.9±0.6)、(0.4±0.6)分比(2.4±0.6)分,对照Ⅰ组:(1.2±0.6)、(0.7±0.7)分比(2.4±0.6)分,对照Ⅱ组:(1.1±0.7)、(0.8±0.7)分比(2.4±0.6)分;均P＜0.01],治疗后4周3组间皮损评分差异无统计学意义(均P＞0.05),治疗后8周观察组皮损评分明显低于对照Ⅰ和Ⅱ组(均P＜0.01).观察组、对照Ⅰ组和Ⅱ组治疗后4周总有效率分别为88.2％ (30/34)、56.3％ (18/32)和62.9％(22/35),治疗后8周总有效率分别为94.1％(32/34)、71.9％(23/32)和71.4％ (25/35),观察组总有效率均高于对照Ⅰ组和Ⅱ组,差异有统计学意义(均P＜0.05).随访6个月观察组、对照Ⅰ组和Ⅱ组复发率分别为5.9％(2/34)、25.0％(8/32)和22.9％(8/35),观察组复发率明显低于对照Ⅰ组和Ⅱ组(均P ＜0.05).结论口服复方甘草酸苷片联合外用钙泊三醇倍他米松软膏治疗掌跖脓疱病与联合外用复方氟米松及卤米松比较疗效更好,且复发率低.
목적 탐토구복복방감초산감연합외용개박삼순배타미송치료장척농포병적림상효과.방법 납입2012년9월지2014년2월당산시협화의원학진적장척농포병환자,안조수궤수자표법분위관찰조、대조Ⅰ조화대조Ⅱ조,소유환자균구복복방감초산감편,50 mg/차,3차/d;재차기출상관찰조급여개박삼순배타미송연고、대조Ⅰ조급여복방불미송연고、대조Ⅱ조급여서미송봉포환처,균매만1차,치료8주.우치료전,치료후4주화8주진행피손평분,관찰병비교3조료효,수방6개월,관찰복발정황.결과 공납입환자101례,기중관찰조34례、대조Ⅰ조32례、대조Ⅱ조35례.여치료전비교,치료후4주화8주3조피손평분균교치료전명현하강,차이유통계학의의[관찰조:(0.9±0.6)、(0.4±0.6)분비(2.4±0.6)분,대조Ⅰ조:(1.2±0.6)、(0.7±0.7)분비(2.4±0.6)분,대조Ⅱ조:(1.1±0.7)、(0.8±0.7)분비(2.4±0.6)분;균P＜0.01],치료후4주3조간피손평분차이무통계학의의(균P＞0.05),치료후8주관찰조피손평분명현저우대조Ⅰ화Ⅱ조(균P＜0.01).관찰조、대조Ⅰ조화Ⅱ조치료후4주총유효솔분별위88.2％ (30/34)、56.3％ (18/32)화62.9％(22/35),치료후8주총유효솔분별위94.1％(32/34)、71.9％(23/32)화71.4％ (25/35),관찰조총유효솔균고우대조Ⅰ조화Ⅱ조,차이유통계학의의(균P＜0.05).수방6개월관찰조、대조Ⅰ조화Ⅱ조복발솔분별위5.9％(2/34)、25.0％(8/32)화22.9％(8/35),관찰조복발솔명현저우대조Ⅰ조화Ⅱ조(균P ＜0.05).결론 구복복방감초산감편연합외용개박삼순배타미송연고치료장척농포병여연합외용복방불미송급서미송비교료효경호,차복발솔저.
Objective To evaluate the effect of calcipotriol betamethasone ointment combined with compound glycyrrhizin tablet in treatment of palmoplantar pustulosis.Methods Patients with palmoplantar pustulosis from September 2012 to February 2014 were enrolled and randomly divided into observation group,control Ⅰ group and control Ⅱ group.All the patients were treated with oral compound glycyrrhizin tablets (50 mg once,3 times/d);in addition,observation group was treated with calcipotriol betamethasone ointment,control Ⅰ group was treated with compound flumetasone ointment and control Ⅱ group was treated with halometasone cream under occlusion (all once every night for 8 weeks).Before treatment,4 and 8 weeks after treatment the score of skin lesion was assessed and the efficacy was calculated and compared among the three groups.The patients were followed up for 6 months to observe the recurrence.Results Totally 101 patients of palmoplantar pustulosis were enrolled and there were 34 in observation group,32 in control Ⅰ group and 35 in control Ⅱ group.Compared with pretreatment,the scores of skin lesion were significantly decreased after 4 and 8 weeks of treatment in all the three groups [observation group:(0.9 ± 0.6),(0.4 ± 0.6) scores vs (2.4 ± 0.6) scores,control Ⅰ group:(1.2 ± 0.6),(0.7±0.7) scores vs (2.4±0.6) scores,control Ⅱ group:(1.1 ±0.7),(0.8 ±0.7) scores vs (2.4 ± 0.6) scores,all P ＜ 0.05],no statistical differences were found among the three groups 4 weeks after treatment (P ＞ 0.05),while the score was significantly lower in observation group than that in control Ⅰ group and control Ⅱ group 8 weeks after treatment.The clinical efficacy in observation group,control Ⅰ group,control Ⅱ groups was 88.2％ (30/34),56.3％ (18/32),62.9％ (22/35) after 4 weeks of treatment,and 94.1％ (32/34),71.9％ (23/32),71.4％ (25/35) after 8 weeks of treatment;statistical differences were found between observation group and control Ⅰ,Ⅱ groups (all P ＜ 0.05).After 6 months of follow-up,the recurrence rate of observation group was significantly lower than that of control Ⅰ and Ⅱ group [5.9％ (2/34) vs 25.0％ (8/32),22.9％ (8/35),both P ＜ 0.05].Conclusion Oral compound glycyrrhizin combined with calcipotriol betamethasone ointementb is more effective in treatment of palmoplantar pustulosis than combination of compound glycyrrhizin and compound flumetasone ointment or halometasone cream,with a lower recurrence rate.