摘要
目的评价不同起始剂量308nm准分子光治疗斑块状银屑病的疗效及安全性。方法将94例银屑病患者按随机数字法分为小剂量组、中等剂量组和大剂量组,分别以1、3、6倍最小红斑量起始剂量308nm准分子光照射,每周最多2次,疗程8周。结果治疗后2、4、6、8周小剂量组与中等剂量之间及治疗后4、6、8周中等剂量组与大剂量组之间银屑病皮损面积和严重程度指数(PASI)评分及皮肤生活质量指数(DLQI)评分比较差异均有统计学意义(P<0.05)。3组DLQI评分与PASI评分呈显著正相关(r=0.826、0.835、0.861,P<0.01),DLQI评分改善率与PASI评分改善率亦呈显著正相关(r=0.845、0.851、0.896,P<0.01)。大剂量组与其余两组总有效率比较差异有统计学意义(χ~2=12.23、7.36,P<0.05);中等剂量组同小剂量总有效率比较差异有统计学意义(χ~2=9.14,P<0.05)。大剂量组较中等剂量组及小剂量组照射次数及总剂量少,治疗后满意度评分高(P<0.05);中等剂量组较小剂量组照射次数及总剂量少,治疗后满意度评分高(P<0.05)。大剂量及中等剂量组与小剂量组复发率比较差异有统计学意义(χ~2=10.58、7.64,P<0.05)。结论大剂量308nm准分子光治疗比小剂量疗效好,对于总面积小且顽固的皮损,可选择大剂量照射。
Objective To evaluate the efficacy and safety of different initial doses of 308 nm excimer laser in the treatment of plaque type psoriasis.Methods Ninety-four patients with stable plaque type psoriasis were randomly divided into the small-dose group,medium-dose group and large-dose group.The three groups were given 308 nm excimer laser radiation with 1,3,6-fold of initial minimal erythema dose（MED）,at most twice per week with the treatment course of 8weeks.Results The difference of the Psoriasis Area and Severity Index（PASI）score and Dermatology Life Quality Index（DLQI）score at 2,4,6,8weeks after treatment between the small-dose group and medium-dose group was statistically significant and the similar results were found between medium-dose group and large-dose group（P〈0.05）.The total efficacy rates of the three groups were a significant difference（P〈0.05）.The DLQI score in 3groups was significantly correlated with the PASI score（r=0.826,0.835,0.861,P〈0.01）and the DLQI score improvement rate also had significantly positive correlation with the PASI improvement rate（r=0.845,0.851,0.896,P〈0.01）.The total effective rate had statistical difference between the large-dose group and the other two groups（χ^2=12.23,7.36,P〈0.05）.The total effective rate had statistical difference between the medium-dose group and small-dose group（χ^2=9.14,P〈0.05）.The radiation frequency and total dose in the large-dose group were less than those in the medium-dose group and small-dose group and the satisfaction degree score after treatment was higher（P〈0.05）.The radiation frequency and total dose in the medium-dose group were less than those in the small-dose group and the satisfaction degree score after treatment was higher.The recurrence rate had statistical difference between the large-dose group and medium-dose group with the low-dose group（χ^2=10.58,7.64,P〈0.05）.Conclusion Large-dose of 308 nm excimer laser in treating plaque type psoriasis has better efficacy than small-dose,for the small total area and stubborn skin lesions,the large dose radiation may be selected.
出处
《重庆医学》
CAS
北大核心
2017年第3期359-361,365,共4页
Chongqing medicine
基金
基金项目:重庆三峡医药高等专科学校2015-2016年度苗圃工程(2016mpxz13)
