Tabolli Stefano, Calza Anna, Di Pietro Cristina, Sampogna Francesca, Abeni Damiano
Health Services Research Unit, Istituto Dermopatico dell'Immacolata (IDI-IRCCS), Rome, Italy.
Yonsei Med J. 2009 Apr 30;50(2):215-21. doi: 10.3349/ymj.2009.50.2.215.
An observational prospective study was conducted to study the effects of hypotonic spa-water baths and narrowband ultraviolet B therapy given alone or in combination for treatment of moderate-severe psoriasis.
TWO TREATMENTS WERE ANALYSED: 2 weeks of balneotherapy followed by ultraviolet-B (UVB) 311-nm phototherapy (BPT) or 2 weeks of daily bath treatments of Comano water alone (BT). One hundred and eleven adult patients with moderate to severe chronic plaque psoriasis were enrolled. Quality of life (QoL) questionnaires {36-item Short Form of the Medical Outcomes Study questionnaire (SF-36) and Skindex-29} were administered at baseline and 2 months from the end of therapy. The self-administered Psoriasis Area Severity Index (SAPASI), and the General Health Questionnaire (GHQ)-12 (to assess clinical severity and psychological distress, respectively) were also recorded at the same time-periods.
SAPASI was significantly reduced from 15.2 to 8.7 in BPT group and 11.6 to 7.8 in BT. A decrease of greater than 50% after therapy in SAPASI_50 score was reached by 42% and 37% of patients in the BPT and BT groups, respectively. At follow-up, both groups had better scores on all SF-36 scales (with statistically significant improvement in social functioning and mental health in the BPT group) and in all Skindex-29 scales. A statistically significant reduction of GHQ-12 positive cases was observed in the BPT group.
Comano spa-water alone or in combination with phototherapy had beneficial therapeutic effects on patients with psoriasis. Although our observational study design prevents us from making meaningful comparisons between the 2 interventions, the combination of balneo and phototherapy seems to improve QoL and lessen clinical severity, and reduced the proportion of GHQ-12 positive cases.
开展一项观察性前瞻性研究，以探讨低渗温泉水浴和窄谱中波紫外线（UVB）疗法单独或联合应用治疗中重度银屑病的效果。
分析了两种治疗方法：2周的浴疗，随后进行311纳米UVB光疗（BPT），或仅进行2周的科马诺水每日浴疗（BT）。招募了111例中重度慢性斑块状银屑病成年患者。在基线期和治疗结束后2个月时，发放生活质量（QoL）问卷{医学结局研究36项简表问卷（SF - 36）和皮肤病生活质量指数29项问卷（Skindex - 29）}。同时还记录了患者自行填写的银屑病面积和严重程度指数（SAPASI）以及一般健康问卷（GHQ）- 12（分别用于评估临床严重程度和心理困扰）。
BPT组的SAPASI从15.2显著降至8.7，BT组从11.6降至7.8。BPT组和BT组分别有42%和37%的患者在治疗后SAPASI_50评分下降超过50%。随访时，两组在所有SF - 36量表（BPT组的社会功能和心理健康有统计学显著改善）和所有Skindex - 29量表上的得分均更高。BPT组观察到GHQ - 12阳性病例有统计学显著减少。
单独使用科马诺温泉水或与光疗联合应用对银屑病患者有有益的治疗效果。尽管我们的观察性研究设计使我们无法对这两种干预措施进行有意义的比较，但浴疗和光疗联合应用似乎能改善生活质量、减轻临床严重程度，并降低GHQ - 12阳性病例的比例。
