中药药浴联合窄谱中波紫外线治疗寻常型银屑病的观察及护理.doc

中药药浴联合窄谱中波紫外线治疗寻常型银屑病的观察及护理 Nursing and Chinese herbal bathing combination with NB-UVB treatment for psoriasis vulgaris 王蕾 张怡 邓文娅 张春玉 顾丽虹 上海市皮肤病医院 摘要 目的：总结256例寻常型银屑病患者应用中药药浴联合窄谱中波紫外线治疗的观察及护理措施。方法：2015年6月~2016年3月在我院就诊的寻常型银屑病患者共256例，应用中药药浴联合窄谱中波紫外线照射治疗，同时给予相应的护理，每周3次，连续1个月，观察治疗效果。结果：参照国际通用的PASI（Psoriasis area and severity index，银屑病面积和严重程度指数）标准，256例患者中红色斑块完全消退、鳞屑和瘙痒症状消失13例；红色斑块消退70%以上、鳞屑和瘙痒症状减轻141例；红色斑块消退50%及以上、鳞屑和瘙痒症状略减轻67例；红色斑块消退不足50%、鳞屑和瘙痒症状未见减轻35例。结论：中药药浴联合窄谱中波紫外线治疗寻常型银屑病，同时加强观察和护理，能有效减轻患者症状，取得较好的临床效果，值得临床上推广应用。 Abstract：Object：To explore the effect of Chinese herbal bathing with NB-UVB treatment and the nursing methods on the psoriasis vulgaris. Method:Retrospective analysis 256 cases of psoriasis vulgaris admitted in our clinic from June, 2015 to March 2016. All patient were treated with Chinese herbal bathing combination with NB-UVB, and nursed the corresponding methods. three times a week, fou month.The effect was analysized according to the number, size and color of lesions. Result: According to the international standard of PASI（Psoriasis area and severity index），In all 256 patients,the completely clearance of erythema, scale and released itching were in 13 patients. 70% clearance of lesions and lessened itching was found in 141 patients, 50% clearance in 67 patients.Less than 50% clearance of lesions and normal itching was found in 35 patients.Conclusion:The cutaneous nursing with treatment of Chinese herbal bathing and NB-UVB was effective on the psoriasis vulgaris. 关键词：寻常型银屑病；中药药浴；窄谱中波紫外线；护理 Keywords: psoriasis vulgaris;Chinese herbal bathing;NB-UVB;nursing 寻常型银屑病，是一种临床最常见的银屑病，是反复发作的慢性炎症性皮肤病，是遗传与环境等多种因素相互作用的多基因遗传性疾病，其发生机制与一种免疫介导有关，目前尚无完全治愈的方法。患者主要症状为境界清楚的红斑丘疹鳞屑性皮损，并伴有瘙痒感[1]，由于瘙痒，皮损处可同时伴有抓痕、结痂、色素沉着，局部皮肤增厚。它严重影响着银屑病患者的生活质量，尤其影响患者的睡眠及心理健康，许多患者甚至会出现皮损对称性发生于肘、膝关节伸侧和头部形状大小不一的红斑，周围有炎性红晕稍有浸润增厚表面覆盖多层银白色鳞屑，自觉不同程度的瘙痒。严重影响患者的生活质量，尤其影响患者的睡眠及心理健康，许多患者甚至出现PASI（Psoriasis area and severity index，银屑病面积和严重程度指数）标准[2]，包括皮损面积和皮损严重程度。观察患者治疗前后的皮损情况，包括皮损面积、红斑、浸润、表皮鳞屑的变化情况并