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目的:评价0.05%丙酸氟替卡松乳膏单独或与0.005%卡泊三醇软膏联合治疗轻中度斑块状银屑病的短期疗效和安全性。方法:2020年10月至2021年1月，于北京友谊医院对30例轻中度斑块状银屑病患者采用随机、开放、自身对照临床研究，一侧肢体皮损处早上外用0.005%卡泊三醇软膏、晚上外用0.05%丙酸氟替卡松乳膏（联合用药组），对侧肢体皮损处每日外用2次0.05%丙酸氟替卡松乳膏（丙酸氟替卡松组），疗程4周。分别于治疗前、治疗1、2、4周随访，采集静态临床医生整体评估（sPGA）、银屑病面积和严重程度指数（PASI）等临床指标，并记录不良事件。采用重复测量的方差分析、多变量方差分析、Mann-Whitney n U秩和检验和独立样本n t检验进行疗效和安全性评价。n 结果:治疗前，两组sPGA评分、PASI评分差异均无统计学意义（均n P > 0.05）。治疗1周，丙酸氟替卡松组sPGA（1.10 ± 0.31）分、PASI评分（1.05 ± 0.51）分显著低于联合用药组[sPGA（1.73 ± 0.45）分，PASI评分（1.38 ± 0.69）分， n F= 40.74、4.38，均n P < 0.05]；治疗2、4周，联合用药组sPGA为（0.83 ± 0.46）、（0.23 ± 0.43）分，PASI评分为（0.53 ± 0.47）、（0.23 ± 0.50）分，均显著低于丙酸氟替卡松组（ n F= 4.88、56.14、15.21、26.36，均n P < 0.05）。治疗1周，丙酸氟替卡松组浸润/肥厚严重程度评分显著低于联合用药组（ n U= 165.00，n P < 0.05）；治疗2、4周，联合用药组红斑、鳞屑严重程度评分均显著低于丙酸氟替卡松组（ n U= 540.00、765.00、825.00、795.00，均n P 0.05) . After 1-week treatment, the fluticasone propionate group showed significantly decreased sPGA (1.10 ± 0.31 points) and PASI scores (1.05 ± 0.51 points) compared with the combination group (1.73 ± 0.45 points, 1.38 ± 0.69 points, n F= 40.74, 4.38, respectively, both n P < 0.05) ; after 2- and 4-week treatment, the combination group showed significantly decreased sPGA (0.83 ± 0.46 points, 0.23 ± 0.43 points, respectively) and PASI scores (0.53 ± 0.47 points, 0.23 ± 0.50 points, respectively) compared with the fluticasone propionate group (sPGA: 1.03 ± 0.18 points, 0.97 ± 0.32 points, n F= 4.88, 56.14, respectively, both n P < 0.05; PASI: 1.03 ± 0.51 points, 0.92 ± 0.54 points, n F= 15.20, 26.36, respectively, both n P < 0.05) . After 1-week treatment, the infiltration/hypertrophy severity score was significantly lower in the fluticasone propionate group than in the combination group ( n U= 165.00, n P < 0.05) ; after 2- and 4-week treatment, the erythema and scaling severity scores were significantly lower in the combination group than in the fluticasone propionate group (erythema: n U= 540.00, 765.00, respectively, both n P < 0.05; scaling: n U= 825.00, 795.00, respectively, both n P < 0.05) .n Conclusion:Fluticasone propionate 0.05% cream alone exhibited a rapid onset of efficacy in the treatment of psoriasis, while fluticasone propionate 0.05% cream combined with calcipotriol 0.005% ointment was more effective after 2- and 4-week treatment, and both regimens showed a favorable safety profile.