龙胆泻肝汤加减治疗寻常型银屑病(血热型)的临床观察  

Clinical Observation of Modified Longdan Xiegan Tang in the Treatment of Psoriasis Vulgaris(Blood Heat Type)

作　　者：雷鸣 李伟宁[3] 姚斌 顾雅蕊 张晓杰[3] 

机构地区：[1]山东中医药大学临床医学院,济南250014 [2]银川市中医医院,银川750001 [3]山东中医药大学附属医院,济南250014 [4]宁夏中宁县中医医院,宁夏中宁755100

出　　处：《中国药房》2017年第33期4640-4643,共4页China Pharmacy

基　　金：山东省自然科学基金(No.ZR2015HL121)

摘　　要：目的:观察龙胆泻肝汤加减治疗寻常型银屑病(血热型)的疗效和安全性。方法:80例寻常型银屑病(血热型)患者随机分为对照组(38例)和观察组(42例),另同期选择30例健康者为健康对照组。对照组患者给予消银片1.6 g,口服,每日3次,治疗4周。观察组患者给予龙胆泻肝汤加减,以水煎取汁400 mL,分2次于早、晚饭后1 h温服,7 d为1个疗程,共4个疗程。观察两组患者的临床疗效,治疗前后皮损面积和严重程度指数(PASI)评分,观察组患者治疗前后炎症因子[白细胞介素1(IL-1)、IL-6、IL-8、肿瘤坏死因子α(TNF-α)]水平、NF-κB蛋白表达水平及NF-κB基因表达水平,并与健康对照组进行比较,分析观察组患者治疗前炎症因子水平与NF-κB蛋白表达的相关性,治疗前后PASI评分与炎症因子、NF-κB表达水平的相关性,并记录不良反应发生情况。结果:观察组患者总有效率(85.7%)显著高于对照组(52.6%),差异有统计学意义(P<0.05)。治疗前,两组患者PASI评分比较,差异均无统计学意义(P>0.05)。治疗后,两组患者PASI评分均显著低于同组治疗前,且观察组显著低于对照组,差异均有统计学意义(P<0.05);观察组患者IL-1、IL-6、IL-8、TNF-α水平均显著低于治疗前,但与健康对照组比较,差异均无统计学意义(P>0.05);观察组患者NF-κB蛋白表达水平、NF-κB基因表达水平均显著低于治疗前,但显著高于健康对照组,差异均有统计学意义(P<0.01或P<0.05)。观察组患者治疗前IL-1、IL-6、IL-8、TNF-α水平与NF-κB蛋白表达水平呈正相关。观察组患者治疗前后PASI评分与IL-1、IL-6、IL8、TNF-α水平及NF-κB蛋白表达水平均呈正相关。结论:龙胆泻肝汤加减治疗寻常型银屑病(血热型)的疗效显著,可降低PASI评分,其机制可能与其降低NF-κB蛋白表达水平及炎症因子水平有关。OBJECTIVE ： To observe therapeutic efficacy and safety of modified Longdan xiegan tang in the treatment of psoria- sis vulgaris （blood heat type）. METHODS： A total of 80 patients with psoriasis vulgaris （blood heat type） were randomly divided into control group （38 cases） and observation group （42 cases）, other 30 healthy volunteers were included in healthy control group. Control group was given Xiaoyin tablet 1.6 g orally, 3 times a day for 4 weeks. Observation group was given modified Longdan xiegan tang, 400 mL after detected with water, 1 h after breakfast and supper, 7 d as a treatment course, for 4 courses. Clinical ef- ficacies and PASI score were observed before and after treatment. The levels of inflammatory factors （IL-1, IL-6, IL-8, TNF-α）, the expression of NF-κB protein and NF-κB gene were observed in observation group before and after treatment, and then were compared with healthy control group. The relationship of inflammatory factor levels with NF-κB protein expression in observation group before treatment, the relationship of PASI score with inflammatory factor and NF-κB expression were observed in observa- tion group before and after treatment, and the occurrence of ADR was recorded. RESULTS： Total response rate of observation group （85.7%） was significantly higher than that of control group （52.6%）, with statistical significance （P〈0.05）. Before treatment, there was no statistical significance in PASI score between 2 groups （P〉0.05）. After treatment, PASI score of 2 groups were significantly lower than before treatment, and the observation group was significantly lower than the control group, with statis- tical significance （P〈0.05）. After treatment, The levels of IL-1, IL-6, IL-8 and TNF-α in observation group were significantly lower than before treatment, but there was no statistical significance with healthy control group（P〉0.05） ; the expression of NF-κB protein and NF-κB gene in observation group were significantly higher t

关 键 词：寻常型银屑病(血热型) 龙胆泻肝汤加减 消银片 疗效 安全性 

分 类 号：R751[医药卫生—皮肤病学与性病学]