标题：单频准分子激光联合甲氨蝶呤治疗斑块型银屑病的疗效及对患者炎性因子、DLQI指数、PASI指数的影响

      作者：罗茜，王亚莎，黄俊萍，陈蕾，张敏    安康市中医医院皮肤科，陕西 安康 725000

      卷次： 2023年34卷14期

      【摘要】 目的 评价单频准分子激光联合甲氨蝶呤治疗斑块型银屑病的疗效，并探讨其对患者炎性因子、皮肤病学生活质量(DLQI)指数、严重程度指数(PASI)指数的影响。方法 回顾性分析2020年1月至2022年5月安康市中医医院皮肤科收治的380例斑块型银屑病患者的临床诊治资料，根据治疗方案不同分为观察组(n=122)和对照组(n=258)，对照组仅给予甲氨蝶呤治疗，观察组在对照组治疗的基础上给予单频准分子激光治疗，两组均连续治疗2周。比较两组患者的临床疗效以及治疗前后的炎性因子[肿瘤坏死因子-α (TNF-α)、白介素-6 (IL-6)和C反应蛋白(CRP)]、DLQI指数和PASI指数。结果 观察组患者的治疗总有效率为93.44%，明显高于对照组的77.90%，差异具有统计学意义(P<0.05)；治疗前，两组患者的TNF-α、IL-6和hs-CRP水平比较差异均无统计学意义(P>0.05)，治疗后，两组患者的炎症因子均下降，且观察组患者的TNF-α、IL-6和 hs-CRP水平分别为(13.49±1.12) mg/L、(12.89±1.18) ng/L、(13.47±2.41) mg/L，明显低于对照组的(16.87±1.09) mg/L、(17.63±1.18) ng/L、(16.22±2.18) mg/L，差异均具有统计学意义(P<0.05)；治疗前，两组患者的DLQI指数、PASI指数比较差异均无统计学意义(P>0.05)，治疗后，两组患者的DLQI指数、PASI指数均下降，且观察组患者的DLQI指数、PASI指数分别为(4.49±1.12)分、(9.24±1.38)分，明显低于对照组的(7.24±1.09)分、(14.36±1.42)分，差异均具有统计学意义(P<0.05)。结论 单频准分子激光联合甲氨蝶呤治疗斑块型银屑病能够有效改善患者的炎性因子，降低DLQI和PASI指数，临床应用疗效较高。
      【关键词】 斑块型银屑病；单频准分子激光；甲氨蝶呤；临床疗效；炎性因子
      【中图分类号】 R758.63 【文献标识码】 A 【文章编号】 1003—6350（2023）14—2037—04

Effects of monochromatic excimer laser combined with methotrexate on inflammatory factors, DLQI, and PASIin patients with plaque psoriasis.
LUO Xi, WANG Ya-sha, HUANG Jun-ping, CHEN Lei, ZHANG Min. Department ofDermatology, Ankang Hospital of Traditional Chinese Medicine, Ankang 725000, Shaanxi, CHINA
【Abstract】 Objective To investigate effects of monochromatic excimer laser combined with methotrexate oninflammatory factors, Dermatology Life Quality Index (DLQI), and Psoriasis Area and Severity Index (PASI) scores inpatients with plaque psoriasis. Methods The clinical data of 380 patients with plaque psoriasis in Department of Der-matology, Ankang Hospital of Traditional Chinese Medicine from January 2020 to May 2022 were retrospectively ana-lyzed. Patients were classified into two groups according to different treatment methods: the control group (n=258) re-ceived methotrexate therapy, and the experimental group (n=122) received monochromatic excimer laser combined withmethotrexate. Treatment in both groups lasted for 2 weeks. Then comparison was conducted on clinical efficacy rate, in-flammation factors [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP)], DLQI, and PASIscores. Results The clinical efficacy rate was 93.44% in experimental group, which was significantly higher than77.90% in the control group (P<0.05). Before treatment, the serum levels of TNF-α, IL-6, and hs-CRP showed no statis-tically significant difference between two groups (P>0.05). After treatment, the three inflammatory factors showed a de-crease in both groups, and the levels were (13.49±1.12) mg/L, (12.89±1.18) ng/L, and (13.47±2.41) mg/L in the experi-mental group, which were significantly lower than (16.87±1.09) mg/L, (17.63±1.18) ng/L, and (16.22±2.18) mg/L in thecontrol group (P<0.05). Baseline DLQI and PASI score showed no statistically significant difference between the twogroups (P>0.05). After treatment, DLQI and PASI scores decreased in both groups, and the scores in the experimentalgroup were (4.49 ± 1.12) points and (9.24 ± 1.38) points, which were significantly lower than (7.24 ±1.09) points and(14.36±1.42) points in the control group (P<0.05). Conclusion Application of monochromatic excimer laser combinedwith methotrexate therapy in the treatment of plaque psoriasis can effectively ameliorate the inflammatory factors, andreduce DLQI and PASI scores in patients, with high efficacy.
      【Key words】 Plaque psoriasis; Monochromatic excimer laser; Methotrexate; Clinical effect; Inflammation factor