目的 探討復(fù)方氨肽素片聯(lián)合鹵米松乳膏治療尋常型銀屑病的臨床療效。方法 選擇2020年5月—2021年6月商丘市第一人民醫(yī)院接診的118例尋常型銀屑病，隨機(jī)分為對(duì)照組和治療組，每組各59例。對(duì)照組于患處涂薄層鹵米松乳膏，2次/d。治療組在對(duì)照組基礎(chǔ)上口服復(fù)方氨肽素片，5片/次，3次/d。兩組患者治療6周。觀察兩組患者臨床療效，比較治療前后兩組患者癥狀緩解時(shí)間，銀屑病皮損面積嚴(yán)重程度指數(shù)（PASI）評(píng)分，血清因子白細(xì)胞介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）、C反應(yīng)蛋白（CRP）、血管生長因子（VEGF）和白細(xì)胞介素-38（IL-38）水平，及不良反應(yīng)。結(jié)果 治療后，治療組臨床有效率為98.31%，明顯高于對(duì)照組的83.05%（P<0.05）。治療后，治療組患者出現(xiàn)的紅斑丘疹、皮損、鱗屑、瘙癢的癥狀緩解時(shí)間均早于對(duì)照組（P<0.05）。治療后，兩組PASI評(píng)分均較治療前顯著降低（P<0.05），治療組治療后1、3、6周的PASI評(píng)分均明顯低于對(duì)照組（P<0.05）。治療后，兩組患者IL-6、IL-38、TNF-α、CRP、VEGF水平均明顯降低（P<0.05），且治療組顯著低于對(duì)照組。治療組不良反應(yīng)發(fā)生率為6.78%，明顯低于對(duì)照組的16.95%（P<0.05）。結(jié)論 復(fù)方氨肽素片聯(lián)合鹵米松乳膏能有效改善癥狀，提高療效，縮小皮損面積，降低機(jī)體炎癥反應(yīng)。

Objective To investigate the clinical efficacy of Compound Amino-polypeptide Tablets combined with Halometasone Cream in treatment of psoriasis vulgaris. Methods Patients (118 cases) with psoriasis vulgaris in Shangqiu First People's Hospital from May 2020 to June 2021 were randomly divided into control and treatment group, and each group had 59 cases. Patients in the control group applied a thin layer of Halometasone Cream to the affected area, twice daily. Patients in the treatment group were po administered with Compound Amino-polypeptide Tablets on the basis of the control group, 5 tablets/time, three times daily. Patients in two groups were treated for 6 weeks. After treatment, the clinical evaluation was evaluated, the relief time symptom, PASI scores, the levels of serum IL-6, IL-38, TNF-α, CRP and VEGF, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 98.31%, which was significantly higher than that of the control group (83.05%) (P < 0.05). After treatment, the relief time of erythema papule, skin lesions, scales and itching in the treatment group was earlier than that in the control group (P < 0.05). After treatment, PASI score in both groups was significantly lower than that before treatment (P < 0.05), and PASI score in treatment group was significantly lower than that in control group at 1, 3 and 6 weeks after treatment (P < 0.05). After treatment, the levels of IL-6, IL-38, TNF-α, CRP and VEGF in two groups were significantly decreased (P < 0.05), and the indexes in the treatment group were significantly lower than those in the control group (P < 0.05). The incidence of adverse reactions in the treatment group was 6.78%, which was significantly lower than 16.95% in the control group (P < 0.05). Conclusion Compound Amino-polypeptide Tablets combined with Halometasone Cream in treatment of psoriasis vulgaris can effectively improve the symptoms and the curative effect, reduce the area of skin lesions and the inflammatory reaction of the body.

R986

河南省醫(yī)學(xué)科技項(xiàng)目（LHGJ20191499）