乾癬治療新紀元 惠氏恩博針劑的應用

[size=9pt][color=#000000]「乾癬」雖然有一個癬字，但是它和我們一般會傳染的「癬」不一樣，因為乾癬並不會傳染，很多人都以為乾癬只是單純的皮膚病，但事實上，很多國外的研究都指出，對乾癬病人來說，這個疾病帶給他們在心理或是日常活動上的影響都比癌症或心肌梗塞的病人來的深遠。而且大多數病友都在年輕的時候就開始產生症狀，需要很長期的治療。因此，一直以來，能夠找到一個既安全又有效的治療方法是很多醫師及研究者的目標。

因為乾癬和皮膚發炎反應有關，所以在科技不斷進步的今天，才發展出注射生物製劑的方法來減少乾癬的發炎反應，以達到治療的效果。目前在台灣，衛生署已經核准乾癬和乾癬性關節炎患者可以接受生物製劑的治療，主要包括惠氏恩博針劑等藥物。

　　目前用來治療嚴重型乾癬的主要方法包括照光治療，口服A酸，methotrexate，環孢素A，及外用藥膏塗抹。而這些治療方法的應用多是在偶然的機會下，被發現對乾癬有療效。在過去20年來，因為研究人才的努力，對於乾癬的致病機轉有比較充份的了解，所以針對抑制致病機轉中的某些步驟，而研發的藥物也就應運而生。

乾癬的致病機轉
　　從乾癬病灶的病理特徵可知，這個疾病的主要表現包括表皮增生，發炎細胞浸潤，以及血管擴張。過去因為乾癬的表皮增生明顯，所以被認為是表皮細胞代謝增生異常的疾病。而現在已經發現，乾癬是和第一型T細胞免疫反應有關的疾病。本來免疫反應是人體為了對抗外來病菌的重要防護功能，但乾癬病人可能是因為本身免疫反應異常活躍，或者是有特殊抗原不斷活化免疫反應，導致皮膚不正常的發炎現象持續進行，產生乾癬病灶。

生物製劑治療乾癬  
　　因為乾癬和皮膚發炎反應有關，所以在科技不斷進步的今天，才發展出注射生物製劑的方法來減少乾癬的發炎反應，以達到治療的效果。目前在台灣，衛生署已經核准乾癬和乾癬性關節炎患者可以接受生物製劑的治療，主要是惠氏恩博和復邁這兩種藥物。不同的生物製劑治療效果各異，一般說來，在治療三個月後，有一半的病人可以改善75%。因為生物製劑不會有傷害肝腎等副作用，所以對於不能服用口服藥物的病人來說，會是一個好選擇。而對於那些傳統治療效果不彰的乾癬性關節炎病人來說，生物製劑可以改善關節的發炎和破壞程度，減少關節變型，也可讓病人的生活品質改善，比起一般傳統治療的效果要好的多。曾經我的一位乾癬性關節炎的病人告訴我說：「自從我打了生物製劑之後就變胖了，因為關節不痛後，可以到處趴趴走，吃了不少夜市。」這種生活品質改善的優點，對病人來說真的是一個很大的福音。

　　乾癬病人大多在年紀輕的時候就發病，必須接受長期治療，所以藥品的效果和安全性是很重要的。生物製劑的發展提供給乾癬治療一個新的選擇，希望可以真正有效控制病人的疾病程度和減輕藥物造成的副作用。在未來一定會是很重要的治療方式。

文章來源:中時健康網
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