摘要目的 观察雷公藤多苷联合多西环素治疗掌跖脓疱病的疗效.方法 选取长治市第二人民医院2014年6月至2017年11月治疗的掌跖脓疱病患者144例的临床资料进行回顾性分析,根据治疗方法的不同分为三组,每组48例.多西环素组采用多西环素治疗,雷公藤多苷组使用雷公藤多苷治疗,联合用药组采用雷公藤多苷联合多西环素治疗.比较三组患者的临床症状下降指数(SSRI)、临床效果、外周血T淋巴细胞亚群变化情况.结果 联合用药组脓疱、红斑、痂屑、瘙痒SSRI改善率分别为95.83％ (46/48)、93.75％(45/48)、97.92％ (47/48)、93.75％(45/48),与多西环素组[72.92％(35/48)、70.83％(34/48)、75.00％(36/48)、77.08％ (37/48)]、雷公藤多苷组[83.33％ (40/48)、81.25％ (39/48)、85.42％ (41/48)、89.58％(43/48)]差异均有统计学意义(x2 =9.417、8.542、10.568、6.306,均P＜0.05);联合用药组总有效率[95.83％(46/48)]高于多西环素组[66.67％ (33/48)]、雷公藤多苷组[81.25％ (39/48)](x2=5.285,P＜0.05;x2=1.771,P=0.076);三组CD4+、CD8+、CD4+/CD8+差异均有统计学意义(F=3.854、4.856、5.019,P=0.017、0.024、0.030).结论 雷公藤多苷联合多西环素治疗掌跖脓疱病,能改善患者的临床症状和T淋巴细胞免疫功能,提高临床疗效.

abstractsObjective To study the efficacy of Tripterygium wilfordii polyglycosides combined with doxycycline in the treatment of palmoplantar pustulosis.Methods From June 2014 to November 2017,144 patients with palmoplantar pustulosis treated in the Second People's Hospital of Changzhi were selected and divided into three groups according to different treatment methods,with 48 cases in each group.The doxycycline group was treated with doxycycline.The Tripterygium wilfordii polyglycosides group was treated with Tripterygium wilfordii polyglycosides.The combination group was treated with Tripterygium wilfordii polyglycosides combined with doxycycline.The symptom score decline index (SSRI),clinical effect and changes of T lymphocyte subsets in peripheral blood were compared among three groups.Results The SSRI improvement rates of pustule,erythema,scab and pruritus in the combination group were 95.83％ (46/48),93.75％ (45/48),97.92％ (47/48),97.92％ (47/48),respectively,which were higher than those in the doxycycline group [72.92％ (35/48),70.83％ (34/48),75.00％ (36/48),77.08％ (37/48)] and the Tripterygium wilfordii polyglycosides group [83.33 ％ (40/48),81.25 ％ (39/48),85.42％ (41/48),89.58 ％ (43/48)],the differences were statistically significant (x2 =9.417,8.542,10.568,6.306,all P ＜ 0.05).The total effective rate of the combination group was 95.83％ (46/48),which was higher than that of the doxycycline group [66.67 ％ (33/48)] and the Tripterygium wilfordii polyglycoside group [81.25 ％ (39/48)] (x2 =5.285,P ＜0.05;x2 =1.771,P =0.076).There were statistically significant differences in CD4+,CD4+,CD4+/CD4+ among the three groups (F =3.854,4.856,5.019,P =0.017,0.024,0.030).Conclusion Tripterygium wilfordii polyglycoside combined with doxycycline can improve the clinical symptoms and T lymphocyte immune function in patients with palmoplantar pustulosis.