The Effect Analysis Of Compound Flumetasone And Calcipotyiol Ointment Combined With Acitretin Treated Nail Psoriasis And Questionnaire Survey Of Iife Quality Of Patients

Objective: This study focus to analysis on the clinical curative effect and adverse reactions of compound flumetasone and calcipotriol ointment combined with acitretin capsules treated nail psoriasis, and through questionnaires, analyzing the impacts of nail psoriasis lesion on patients’ life quality and its related factors, thus providing a basis for the clinical treatment of nail psoriasis patients and improve the quality of life of patients.Methods: Collected 100 cases of nail lesion with psoriasis vulgaris patients who were randomly divided into two groups, both groups were treated with oral acitretin capsules for 20 mg/d(0.3 mg/kg).But combined treatment group setting to compound flumetasone ointment for occlusion used only qn, continue two weeks/month, total a month. Every weekend occlusion used 2 days, a total of 2 months. Calcipotyiol ointment external qd, two groups made 3 months as a course. All patients with psoriasis skin external calcipotyiol ointment qd, NB – UVB treated twice a week. Using NAPSI scoring method for regression of nail lesions after treatment. Effective treatment of patients in both groups entered the second stage, the course of 3 months. Acitretin group oral Acitretin capsule 10 mg/d, combined treatment group only external compound flumetasone ointment and calcipotyiol ointment, with the former method. After treatment recorded NAPSI with patients. Using the NPQ10 questionnaires and evaluating the life quality of 72 patients with nail psoriasis.Results: 100 cases of nail lesion with psoriasis vulgaris patients, male to female ratio is 1.56:1. The average age of them was 36.14±11.75 years old. Psoriasis lesion area: 69 cases of mild, moderate of 17 cases, 14 cases of severe ones. Two groups in age, sex and lesion area is not shown on the statistical difference(p > 0.05). Before treatment, the NAPSI score: Acitretin group(11.66 ± 2.83), combined treatment group(11.36 + 3.19), there was no statistical difference of NAPSI score in two groups(t = 0.498, p > 0.498). After 12 weeks and 24 weeks of drug treatment, the NAPSI score: Acitretin vs the combined treatment group(8.86 ± 2.15,5.05±1.59 vs 7.26 ± 1.95, 3.72±1.35), NAPSI score were statistically difference(t1 2 weeks = 3.903, t2 4 weeks = 3.302, p < 0.05). At 12 weeks, the patients of Acitretin group, in which 20 cases were improved, NAPSI score ≥ 25%, only 2 cases were NAPSI score ≥ 50%, combined treatment group,21 cases with NAPSI score≥ 25%, 11 cases with NAPSI score ≥ 50%; after 24 weeks of treatment, 4 cases of patients were clinical recovery in Acitretin group, recovery rate 18.18%,the efficiency was 58.09%; 17 cases of patients were clinical recovery in combined treatment group, recovery rate is 53.13%, the efficiency was 87.50%,comparaed effectiveness of two groups were statistically significant(x2 = 6.70, p < 0.01).In the process of treatment, 23 cases of Acitretin group had adverse reactions, the incidence of adverse reactions was 46.0%; 24 cases of combined treatment group had adverse reactions, the incidence of adverse reactions was 48.0%, there was no statistical significance difference of incidence of adverse reactions in the two groups.72 cases of nail lesion patients with psoriasis vulgaris, the NPQ10 score was 6.85 ± 2.21,and NPQ10 score of patients no obvious difference between gender and age. Unmarried with higher NPQ10 scores than married patients, there was statistical significance. Rank correlation analysis showed, in NPQ10 scores, the influence of the feelings and emotions, the use of transportation and facilities, and living skills were significantly correlated, and there was pair wise correlation among the housework and job influence, clothing choices and living skills(P <0.05). There was correlation as well between the use of transportation and its facilities and the clothing choice, the housework and job apart from feelings and emotions(P < 0.05). Spearman rank correlation analysis showed: NPQ10 score with the number of nail lesion and NAPSI score had correlation among each other(P < 0.05).Conclusion : 1. It is more effective to use compound flumetasone and calcipotyiol ointment combined with Acitretin capsules to treat the nail lesion with psoriasis vulgaris than to use Acitretin capsules singly. 2. The quality of life of patients with nail psoriasis is significantly correlative with the number of nail lesion and NAPSI score.