Tang Ya-Juan, Xu Wan-Wen, Liu Xiao-Ming, Zhang Ru-Zhi, Xu Chun-Xing, Xu Bin, Cheng Sai, Liu Qi
Department of Dermatology, The Third Affiliated Hospital of Soochow University Changzhou 213003, Jiangsu, China ; Department of Dermatology, Wuhan City Hospital NO.3 & Tongren Hospital of Wuhan University Wuhan 430060, China.
Department of Dermatology, Wuhan City Hospital NO.3 & Tongren Hospital of Wuhan University Wuhan 430060, China.
Int J Clin Exp Med. 2014 Sep 15;7(9):2844-50. eCollection 2014.
This study aims to compare the differences of clinical efficacy and safety of treatment of stable psoriasis vulgaris with calcipotriene ointment in combination with 308 nm excimer laser to 308 nm excimer laser alone.
Randomized, open and self-control trial was conducted in 36 selected patients. The skin lesions from these patients with stable psoriasis vulgaris were divided into two sides along the midline of torso, one side was treated with 308 nm excimer laser, 2 times/week, at meantime Calcipotriene was applied externally, 2 times/day (treatment group); the other side was given 308 nm excimer laser alone, 2 times/week, the treatment period was 6 weeks (control group). Skin lesion area, PASI scores and cumulative doses of 308 nm excimer laser in patients with psoriasis were assessed before treatment and on weeks 2, 4 and 6 after treatment.
32 of 36 patients with stable psoriasis vulgaris completed study, effective rates in two groups were better on week 6 (84.37%, 56.25%) than on week 4 (53.12%, 37.5%) and on week 2 (31.25%, 18.75%) (P < 0.05). Effective rate on week 6 in control group (56.25%) was lower than treatment group (84.37%) (P < 0.05). The two groups showed that PASI scores on weeks 2 and 4 after treatment were significantly lower than before treatments (P < 0.05), and PASI scores on week 6 in treatment group was significantly lower than control group (P < 0.05). The average cumulative laser doses in treatment group at the end of trial was 4.69 (2.03) J/cm(2), which was significantly lower than in control group 8.41 (2.42) J/cm (P < 0.05). Treatment efficacies in the head, folds, back, abdomen and limbs were similar and no serious adverse effects, however the number of treatment and irradiation doses in the head and folds were significantly less than in back, abdomen and limbs (P < 0.05).
Treatment of psoriasis vulgaris with 308 nm excimer laser in combination with external application of Calcipotriene ointment can improve long-term treatment efficacy, decrease cumulative laser doses, and reduce adverse effects induced by laser irradiations.
本研究旨在比较卡泊三醇软膏联合308nm准分子激光与单纯308nm准分子激光治疗寻常型稳定性银屑病的临床疗效及安全性差异。
选取36例患者进行随机、开放、自身对照试验。将这些寻常型稳定性银屑病患者的皮损沿躯干中线分为两侧，一侧采用308nm准分子激光治疗，每周2次，同时外用卡泊三醇，每天2次（治疗组）；另一侧仅给予308nm准分子激光治疗，每周2次，治疗周期为6周（对照组）。分别在治疗前及治疗后第2、4、6周评估银屑病患者的皮损面积、银屑病面积和严重程度指数（PASI）评分以及308nm准分子激光的累积剂量。
36例寻常型稳定性银屑病患者中32例完成研究，两组在第6周的有效率（84.37%，56.25%）均高于第4周（53.12%，37.5%）和第2周（31.25%，18.75%）（P<0.05）。对照组第6周的有效率（56.25%）低于治疗组（84.37%）（P<0.05）。两组治疗后第2周和第4周的PASI评分均显著低于治疗前（P<0.05），且治疗组第6周的PASI评分显著低于对照组（P<0.05）。试验结束时治疗组的平均累积激光剂量为4.69（2.03）J/cm²，显著低于对照组的8.41（2.42）J/cm（P<0.05）。头、褶皱处、背部、腹部和四肢的治疗效果相似，且无严重不良反应，然而头和褶皱处的治疗次数及照射剂量显著少于背部、腹部和四肢（P<0.05）。
308nm准分子激光联合外用卡泊三醇软膏治疗寻常型银屑病可提高长期治疗效果，降低累积激光剂量，并减少激光照射引起的不良反应。
