退银汤联合窄谱中波紫外线治疗寻常型银屑病的疗效及对外周血相关细胞因子表达水平的影响  

Effect of Tuiyin decoction combined with NB-UVB in the treatment of psoriasis vulgaris and the influence on expression levels of related cytokines in peripheral blood

作　　者：盛国荣[1] 谢勇[1] 刘海琴[1] 

机构地区：[1]南通市疾病预防控制中心,江苏南通226007

出　　处：《中国医院药学杂志》2014年第7期576-580,共5页Chinese Journal of Hospital Pharmacy

基　　金：南通市指令性社会发展科技计划项目(编号:HS2011031)

摘　　要：目的:探讨退银汤联合窄谱中波紫外线(NB-UVB)治疗寻常型银屑病的疗效及对外周血IL-2、INF-γ、IL-4、IL-10、IL-17、IL-23表达水平的影响。方法:90例中/重度寻常型银屑病患者分为治疗组、对照Ⅰ组、对照Ⅱ组。治疗组内服退银汤,bid,并予NB-UVB局部照射,2次/周;对照Ⅰ组单纯内服退银汤;对照Ⅱ组单纯使用NB-UVB局部照射,方法均同治疗组,3组疗程均为12周。另选志愿者30例作为健康对照组。分别于治疗前和治疗后第4,8,12周记录PASI评分,同时评价临床疗效,检测健康对照组以及银屑病患者治疗前后IL-2、INF-γ、IL-4、IL-10、IL-17、IL-23表达水平。结果:治疗后,治疗组PASI评分为(1.91±1.12)、对照Ⅰ组为(4.63±1.36)、对照Ⅱ组为(5.35±1.54),治疗组与对照Ⅰ组、对照Ⅱ组比较,差异均有统计学意义(P<0.01);治疗组有效率为96.7%、对照Ⅰ组为73.3%、对照Ⅱ组为66.7%,治疗组与对照Ⅰ组、对照Ⅱ组比较,差异均有统计学意义(P<0.05或P<0.01);治疗组IL-2、INF-γ、IL-4、IL-10、IL-17、IL-23和对照Ⅰ组、对照Ⅱ组IL-2、INF-γ、IL-17、IL-23与治疗前比较,差异均有统计学意义(P<0.01);治疗组上述各指标与对照Ⅰ组、对照Ⅱ组比较,差异均有统计学意义(P<0.01);治疗组、对照Ⅰ组、对照Ⅱ组IL-2、INF-γ、IL-17、IL-23与PASI评分呈正相关性,治疗组IL-4、IL-10与PASI评分呈负相关性。结论:退银汤联合NB-UVB治疗寻常型银屑病疗效显著,可能是通过降低患者血清中Th1、Th17细胞相关因子IL-2、INF-γ、IL-17、IL-23表达水平,升高Th2细胞相关因子IL-4、IL-10表达水平来发挥治疗银屑病的作用。OBJECTIVE To investigate the curative effect of Tuiyin decoction combined with narrow-band ultraviolet B （NB- UVB） in the treatment of psoriasis vulgaris and the influence on the expression levels of IL-2, INF-7, IL-4, IL-10, IL 17, IL-23 of peripheral blood. METHODS 90 patients with medium/severe psoriasis vulgaris were divided into treatment group,control group Ⅰ and control group Ⅱ. Treatment group was treated with Tuiyin decoction by oral administration, bid,with NB-UVB lo- cal irradiation,2 times a week. Control group Ⅰ was treated with Tuiyin decoction only, and control group Ⅱ was treated with NB-UVB local irradiation only, and the therapeutic methods were the same with treatment group. All groups were treated for 12 weeks, and another 30 peoples were chosen as healthy control group. In 4^th, 8^th, 12^th week, before and after treatment, PASI scores were recorded respectively. Meanwhile, clinical curative effects were evaluated, and IL-2, INF-γ, IL-4, IL-10, IL-17, IL-23 levels of healthy control group and patients with psoriasis were determinated. RESULTS After treatment,PASI score of treat- ment group was（ 1.91 ± 1.12）, control group Ⅰ （4. 63 ± 1.36）, control group Ⅱ （5.35 ± 1.54）, and compared with two control groups, the difference had statistical significance （P〈0. 01）. The effective rate of treatment group was 96. 7%, control group Ⅰ 73.3 % and control group Ⅱ66. 7 %, compared with two control groups, the difference had statistical significance （P〈0. 05 or P〈0. 01 ）. The difference of IL-2, INF-γ, IL-4, IL-10, IL-17, IL-23 levels of treatment group and IL-2, INF-γ, IL-17, IL-23 levels of control group Ⅰ and Ⅱ , compared with those before treatment, was statistically significant （P〈0. 01） ; Compared with two control groups, the difference of above indicators of treatment group had statistical significance （P〈0. 01）;IL-2, INF-γ, IL-17, IL-23 levels of treatment group, control group Ⅰ and Ⅱ were positively correlated with PASI scor

关 键 词：寻常型银屑病 退银汤 窄谱中波紫外线 TH1细胞 TH2细胞 Th17细胞 

分 类 号：R969[医药卫生—药理学]