【摘要】 目的:观察小剂量阿维A与甲氨蝶呤(MTX)联合治疗重症寻常型银屑病的疗效与不良反应。方法:观察组:阿维A0.3mg(kg·d),MTX2.5mg,12h1次,每周连服3次,辅以叶酸5mgd,维生素E300mgd,用药6周。对于6周内临床治愈的病人,先停用MTX,阿维A减半维持治疗2周,停药。对照组1:阿维A0.3mg(kg·d),3～5d后加至0.5mg(kg·d),叶酸和维生素E同观察组,用药6周;对照组2:MTX5mg,12h1次,每周连服3次,叶酸和维生素E同观察组,用药6周。结果:观察组、对照组1和对照组2的有效率分别为96.23%、65.54%和66.67%。三组相比有显著性差异(χ2=9.97,P<0.01)。三组间不良反应发生率分别为11.32%、33.33%和27.27%,有显著性差异(χ2=8.67,P<0.05)。结论:小剂量阿维A与小剂量MTX联合治疗重症寻常型银屑病疗效好,不良反应发生率低。更多还原

【Abstract】 Objective: To investigate the efficacy and adverse reactions of the combination therapy of lower dose of acitretin and methotrexate (MTX) in the treatment of severe psoriasis vulgaris. Methods: The patients in the study group took lower dose of acitretin (0.3 mg/kg·d) and MTX 2.5 mg, once every 12 hours for consecutive 3 times, supplemented by oral folic acid 5 mg/d and vitamin E 300 mg/d. On week 6 after treatment, the clinically cured patients stopped taking MTX, and took half dose of acitretin for 2 weeks, and then, stopped all the medicines. The control group 1 took acitretin (0.3 mg/kg·d) for 3-5 days, followed by 0.5 mg/(kg·d), and supplemented by folic acid 5mg/d and vitamin E 300 mg/d. The control group 2 took MTX 5 mg, once every 12 hours, thrice weekly, and supplemented by folic acid 5 mg/d and vitamin E 300 mg/d. Results: The response rates in the study group, control group 1 and control group 2 were 96.23%, 65.54% and 66.67%, respectively, with a significant difference in the three groups (χ2=9.97,P<0.01). The numbers of drug adverse reactions in the three groups were 6, 19 and 15, respectively, with significant differences in the three groups (χ2=8.67,P<0.05). Conclusion: The combination of lower dose of acitretin and MTX in the treatment of severe psoriasis vulgaris is effective and safe.更多还原