Mørk Cato, Ozek Mehmet, Wahl Astrid Klopstad
Hudavdelingen, Rikshospitalet, 0027 Oslo.
Tidsskr Nor Laegeforen. 2004 Jan 8;124(1):60-2.
For many years, Norwegian patients with psoriasis or arthritic psoriasis have been offered climate therapy. In 2002, Rikshospitalet University Hospital's department for treatment abroad organised this treatment for the first time for a group of patients with combined psoriasis and arthritic psoriasis.
In 50 patients, psoriasis severity (psoriasis area and severity index, PASI 0-72) was assessed at start and end of treatment in Turkey. Patients reported joint pain (VAS 0-100), skin (DLQI-N 0-29), arthritic psoriasis-related quality of life (ADI-N 0-33) and functional status of arthritis (MHAQ 1-4) at arrival, one week and two months after treatment. Standard response mean (difference/SD difference) was used to evaluate clinical relevance.
Disease activity was mild at start of treatment. The clinical relevance for the change in skin and arthritis related quality of life was considered high one week after treatment and moderate after two months. Change in psoriasis, pain and functional status of the joints had little clinic relevance. A statistical significant score improvement was found for PASI (6.0 vs. 2.0), DLQI-N (8.4 vs. 2.2 vs. 4.6), ADI-N (9.9 vs. 4.8 vs. 7.0) and MHAQ (1.6 vs. 1.3 vs. 1.4), all means. No significant change in pain score was demonstrated for those having arthritic psoriasis.
If climate therapy should be implemented as supplemental therapy, we recommend recruitment of patients with severe to moderate psoriasis and arthritic psoriasis and inclusion of an analysis of cost-effectiveness.
多年来，挪威的银屑病或关节病型银屑病患者一直接受气候疗法。2002年，里克斯医院大学医院的国外治疗部门首次为一组合并银屑病和关节病型银屑病的患者组织了这种治疗。
对50例患者在土耳其治疗开始和结束时评估银屑病严重程度（银屑病面积和严重程度指数，PASI 0 - 72）。患者在抵达时、治疗后1周和2个月报告关节疼痛（视觉模拟评分法，VAS 0 - 100）、皮肤情况（皮肤病生活质量指数 - 挪威版，DLQI - N 0 - 29）、关节病型银屑病相关生活质量（关节炎残疾指数 - 挪威版，ADI - N 0 - 33）以及关节炎功能状态（健康评估问卷，MHAQ 1 - 4）。采用标准反应均值（差值/标准差差值）评估临床相关性。
治疗开始时疾病活动度为轻度。治疗1周后皮肤和关节炎相关生活质量变化的临床相关性被认为较高，2个月后为中等。银屑病、疼痛和关节功能状态的变化临床相关性较小。发现PASI（6.0对2.0）、DLQI - N（8.4对2.2对4.6）、ADI - N（9.9对4.8对7.0）和MHAQ（1.6对1.3对1.4）的所有均值均有统计学显著的评分改善。关节病型银屑病患者的疼痛评分无显著变化。
如果将气候疗法作为补充疗法实施，我们建议招募中重度银屑病和关节病型银屑病患者，并纳入成本效益分析。
