皮炎消净饮Ⅱ号联合窄谱UVB照射治疗血虚风燥型特应性皮炎的临床及免疫组化研究  

Clinical and Immunohistochemical Research of Piyan Xiaojin Decoction-2 Combining with Narrow-Spectrum UVB Exposure Treating Atopic Dermatitis(AD) with Blood Deficiency and Wind Dryness

作　　者：吴蓓玲[1] 杨晓红[1] 曹毅[1] 余土根[1] 奚爱妮[2] 程立峰[2] 金瀛凯[2] 陈琼[2] 

机构地区：[1]浙江省中医院皮肤科,浙江杭州310006 [2]浙江中医药大学,浙江杭州310053

出　　处：《中华中医药学刊》2012年第3期559-561,I0003,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：浙江省中医药科技计划资助项目(2003C045)

摘　　要：目的:观察皮炎消净饮Ⅱ号联合窄谱UVB照射对血虚风燥型特应性皮炎(AD)的临床疗效,及对AD患者治疗前后皮损局部ICAM-1和VCAM-1表达的调控,探讨AD的发病机理及临床意义。方法:采用皮炎消净饮Ⅱ号联合窄谱UVB照射治疗29例血虚风燥型AD患者,使用SCORAD积分系统,对治疗前后AD皮损及临床严重度进行评估,同时采用SABC免疫组化法观察治疗前后AD患者皮损局部ICAM-1和VCAM-1阳性面积、平均光密度、总光密度的表达情况。结果:29例AD患者基愈6例(20.69%),显效16例(55.17%),有效7例(24.14%),无效0例,总有效率为75.86%。AD患者治疗前后皮损中ICAM-1及VCAM-1的阳性表达均显著高于正常对照组(P<0.01);治疗后AD患者皮损中ICAM-1及VCAM-1的阳性表达均明显下降(P<0.05)。结论:皮炎消净饮Ⅱ号联合窄谱UVB照射治疗血虚风燥型AD,疗效确切、安全性高,其可能机制是通过抑制炎症因子的释放,调节ICAM-1、VCAM-l在局部皮损中的表达,从而抑制细胞间的黏附及炎症细胞的聚集,达到抗炎及免疫调节的目的。Objective ： The aim of the article is to observe the clinical effectiveness of Piyan Xiaojin Decoction - 2 com- bining with narrow - spectrum UVB exposure to treat Atopic Dermatitis （AD） with blood deficiency and wind dryness, and to evaluate the expressions of ICAM - 1 and VCAM - 1 in local impaired skin before and after the treatment, there- fore to investigate its pathogenesis and clinical significance. Method： 29 AD patients with blood deficiency and wind dryness have been treated by combination of Piyan Xiaojin Decoction - 2 and narrow - spectrum UVB exposure. The authors used SCORAD integral system to evaluate clinical severity of impaired skin before and after the treatment, meanwhile adopting SABC immunohistochemical method to assess the positive area, average optical density, total optical density, expressions of ICAM - 1 and VCAM - 1 in impaired skin. Result ： Among 29 AD patients, 6 were completely healed （20. 69% ）, 16 gained significant effect （55.17%）, 7 had good effect （24.14%） , no patient showed ineffective, and the total efficiency rate was 75.86%. After and before the treatment, AD patients＇ positive expressions of ICAM - 1 and VCAM - 1 of impaired skin were all higher than those in normal group （ P 〈 0.01 ） ; After the treatment, AD patients＇ positive expressions of ICAM - 1 and VCAM - 1 in skin impairment were all declined （ P 〈 0.05 ）. Conclusion ： Piyan Xi- aojin Decoction -2 combining with exposure of narrow - spectrum UVB is effective and safe in treating blood deficiency and wind dryness AD. The possible mechanism is suppressing the release of inflammatory factor, and modulating the expressions of ICAM - 1 and VCAM - 1 in local impaired skin , consequently suppressing the conglutination of cells and the aggregation of inflaratnatory corpuscles, thus to reach the goal of anti - inflammation and regulating immune system.

关 键 词：特应性皮炎 皮炎消净饮Ⅱ号 窄谱UVB ICAM-1 VCAM-l 

分 类 号：R758.19[医药卫生—皮肤病学与性病学]