圣愈汤加味治疗进行期寻常型银屑病气血两虚证的临床观察  

Clinical Efficacy of Modified Shengyutang in Treatment of Active Stage Psoriasis Vulgaris due to Qi and Blood Deficiency

作　　者：李圆圆 王诗煜 张步鑫[1] 徐胜东 韩冰莹 刘爱民[1] LI Yuan-yuan;WANG Shi-yu;ZHANG Bu-xin;XU Sheng-dong;HAN Bing-ying;LIU Ai-min(Henan University of Chinese Medicine,Zhengzhou 450002,China)

机构地区：[1]河南中医药大学,郑州450002

出　　处：《中国实验方剂学杂志》2021年第2期87-92,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(81874471)。

摘　　要：目的:研究圣愈汤加味对进行期寻常型银屑病气血两虚证患者的临床疗效,并探讨其作用机制。方法:134例患者随机分为对照组和观察组,每组67例。对照组口服阿维A胶囊+当归补血丸,观察组口服阿维A胶囊+圣愈汤加味,疗程均为4周。观察两组治疗前后皮损面积与严重程度指数(PASI),皮肤病生活质量指数(DLQI),寻常型银屑病气血两虚证(中医证候)。检测两组血清生长因子[内皮细胞特异性分子-1(ESM-1),转化生长因子-β1(TGF-β1),血管内皮细胞生长因子(VEGF)],血流变学指标[高切血液黏度(HBV),低切血液黏度(LBV),红细胞沉降率(ESR)],血清及皮损处组织液中CC趋化因子受体6(CCR6),CC趋化因子配体20(CCL20),单核细胞趋化蛋白4(MCP-4)。比较两组临床疗效、随访12个月复发情况,评价两组安全性。结果:研究期间对照组脱落3例,观察组脱落1例。观察组总有效率96.97%(64/66),高于对照组的81.25%(52/64)(χ^(2)=5.064,P<0.05)。随访至少12个月,观察组复发率20.31%(13/64),低于对照组的51.92%(27/52)(χ^(2)=6.038,P<0.05)。与对照组治疗后比较,观察组PASI,DLQI,中医证候,ESM-1,TGF-β1,VEGF,HBV,LBV,ESR,CCR6,CCL20,MCP-4明显降低(P<0.05)。两组治疗期间均未见明显血、尿常规,心、肝、肾功能异常。观察组治疗期间不良反应发生率3.03%(2/66),低于对照组的26.56%(17/64)(χ^(2)=5.764,P<0.05)。结论:圣愈汤加味可明显改善进行期寻常型银屑病气血两虚证患者的临床症状,复发率和不良反应发生率低。Objective:To study the clinical efficacy of modified Shengyutang on patients with active stage psoriasis vulgaris due to Qi and blood deficiency.Method:The 134 cases were randomly divided into control group and observation group,with 67 cases in each group.The control group was given avic a capsule+Danggui Buxuewan,while the observation group was given avic a capsule+modified Shengyutang for 4 weeks,respectively.The psoriasis area and severity index(PASI),dermatological life quality index(DLQI)and psoriasis vulgaris due to Qi and blood deficiency syndrome were observed before and after treatment.The serum growth factor[endothelial cell specific molecule-1(ESM-1),transforming growth factor-β1(TGF-β1),vascular endothelial cell growth factor(VEGF)],hemorheological indicators[high cut blood viscosity(HBV),low cut blood viscosity(LBV),erythrocyte sedimentation rate(ESR)],CC cphenotype receptor(CCR)6,CC cphenotype ligand 20(CCL20),monocyte chemotactic protein-4(MCP-4)in serum and tissue fluid of lesions were detected.Clinical efficacy and recurrence follow-up for 12 months were compared.The safety was evaluated between two groups.Result:Three cases in control group and one case in observation group fell off during the study period.The total effective rate was 96.97%(64/66)in observation group,which was higher than 81.25%(52/64)in control group (χ^(2)=5.064,P<0.05).During the 12-month follow-up,the recurrence rate was 20.31%(13/64)in observation group,which was lower than 51.92%(27/52)in control group (χ^(2)=6.038,P<0.05).Compared with control group after treatment,PASI,DLQI,TCM syndromes,ESM-1,TGF-β1,VEGF,HBV,LBV,ESR,CCR6,CCL20 and MCP-4 in observation group were significantly reduced(P<0.05).No obvious blood and urine routine,or heart,liver and renal dysfunction was observed in the two groups.The incidence of adverse reactions was 3.03%(2/66)in observation group,which was lower than 26.56%(17/64)in control group (χ^(2)=5.764,P<0.05).Conclusion:Modified Shengyutang can significantly improve the clinical symptoms

关 键 词：圣愈汤加味 进行期 寻常型银屑病 气血两虚证 

分 类 号：R22[医药卫生—中医基础理论] R242[医药卫生—中医学]