Objective To evaluate the effect of calcipotriol betamethasone ointment combined with compound glycyrrhizin tablet in treatment of palmoplantar pustulosis.Methods Patients with palmoplantar pustulosis from September 2012 to February 2014 were enrolled and randomly divided into observation group,control Ⅰ group and control Ⅱ group.All the patients were treated with oral compound glycyrrhizin tablets (50 mg once,3 times/d);in addition,observation group was treated with calcipotriol betamethasone ointment,control Ⅰ group was treated with compound flumetasone ointment and control Ⅱ group was treated with halometasone cream under occlusion (all once every night for 8 weeks).Before treatment,4 and 8 weeks after treatment the score of skin lesion was assessed and the efficacy was calculated and compared among the three groups.The patients were followed up for 6 months to observe the recurrence.Results Totally 101 patients of palmoplantar pustulosis were enrolled and there were 34 in observation group,32 in control Ⅰ group and 35 in control Ⅱ group.Compared with pretreatment,the scores of skin lesion were significantly decreased after 4 and 8 weeks of treatment in all the three groups [observation group:(0.9 ± 0.6),(0.4 ± 0.6) scores vs (2.4 ± 0.6) scores,control Ⅰ group:(1.2 ± 0.6),(0.7±0.7) scores vs (2.4±0.6) scores,control Ⅱ group:(1.1 ±0.7),(0.8 ±0.7) scores vs (2.4 ± 0.6) scores,all P ＜ 0.05],no statistical differences were found among the three groups 4 weeks after treatment (P ＞ 0.05),while the score was significantly lower in observation group than that in control Ⅰ group and control Ⅱ group 8 weeks after treatment.The clinical efficacy in observation group,control Ⅰ group,control Ⅱ groups was 88.2％ (30/34),56.3％ (18/32),62.9％ (22/35) after 4 weeks of treatment,and 94.1％ (32/34),71.9％ (23/32),71.4％ (25/35) after 8 weeks of treatment;statistical differences were found between observation group and control Ⅰ,Ⅱ groups (all P ＜ 0.05).After 6 months of follow-up,the recurrence rate of observation group was significantly lower than that of control Ⅰ and Ⅱ group [5.9％ (2/34) vs 25.0％ (8/32),22.9％ (8/35),both P ＜ 0.05].Conclusion Oral compound glycyrrhizin combined with calcipotriol betamethasone ointementb is more effective in treatment of palmoplantar pustulosis than combination of compound glycyrrhizin and compound flumetasone ointment or halometasone cream,with a lower recurrence rate.%目的 探讨口服复方甘草酸苷联合外用钙泊三醇倍他米松治疗掌跖脓疱病的临床效果.方法 纳入2012年9月至2014年2月唐山市协和医院确诊的掌跖脓疱病患者,按照随机数字表法分为观察组、对照Ⅰ组和对照Ⅱ组,所有患者均口服复方甘草酸苷片,50 mg/次,3次/d;在此基础上观察组给予钙泊三醇倍他米松软膏、对照Ⅰ组给予复方氟米松软膏、对照Ⅱ组给予卤米松封包患处,均每晚1次,治疗8周.于治疗前,治疗后4周和8周进行皮损评分,观察并比较3组疗效,随访6个月,观察复发情况.结果 共纳入患者101例,其中观察组34例、对照Ⅰ组32例、对照Ⅱ组35例.与治疗前比较,治疗后4周和8周3组皮损评分均较治疗前明显下降,差异有统计学意义[观察组:(0.9±0.6)、(0.4±0.6)分比(2.4±0.6)分,对照Ⅰ组:(1.2±0.6)、(0.7±0.7)分比(2.4±0.6)分,对照Ⅱ组:(1.1±0.7)、(0.8±0.7)分比(2.4±0.6)分;均P＜0.01],治疗后4周3组间皮损评分差异无统计学意义(均P＞0.05),治疗后8周观察组皮损评分明显低于对照Ⅰ和Ⅱ组(均P＜0.01).观察组、对照Ⅰ组和Ⅱ组治疗后4周总有效率分别为88.2％ (30/34)、56.3％ (18/32)和62.9％(22/35),治疗后8周总有效率分别为94.1％(32/34)、71.9％(23/32)和71.4％ (25/35),观察组总有效率均高于对照Ⅰ组和Ⅱ组,差异有统计学意义(均P＜0.05).随访6个月观察组、对照Ⅰ组和Ⅱ组复发率分别为5.9％(2/34)、25.0％(8/32)和22.9％(8/35),观察组复发率明显低于对照Ⅰ组和Ⅱ组(均P ＜0.05).结论 口服复方甘草酸苷片联合外用钙泊三醇倍他米松软膏治疗掌跖脓疱病与联合外用复方氟米松及卤米松比较疗效更好,且复发率低.
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