凉血消银汤对进行期寻常型银屑病Th17相关细胞因子的调节作用研究  

Study on the regulatory effect of Liangxue Xiaoyin Decoction on Th17-related cytokines in psoriasis vulgaris at active stage

作　　者：庄洪建 庄烁 ZHUANG Hong-jian;ZHUANG Shuo(Outpatients Department,Jinan People’s Government Organs,Jinan 250099,China)

机构地区：[1]山东济南市人民政府机关门诊部,250099 [2]山东中医药大学中医学院,250355

出　　处：《中国实用医药》2021年第24期1-5,共5页China Practical Medicine

摘　　要：目的观察凉血消银汤治疗进行期寻常型银屑病(血热证)的临床疗效及对辅助性T淋巴细胞17(Th17)细胞及相关炎症因子的调节作用。方法108例进行期寻常型银屑病患者,以随机数字表分为观察组和对照组,各54例。对照组中轻中度者采用钙泊三醇倍他米松软膏治疗,重度者加用甲氨蝶呤片治疗。观察组在西医治疗基础上给予自拟凉血消银汤内服。比较两组临床疗效、银屑病皮损面积和严重程度指数(PASI)评分、生活质量、血热证积分、Th17、调节性T细胞(Treg)、Th17/Treg、Th17相关细胞因子[白细胞介素-17(IL-17)、IL-23、IL-22和肿瘤坏死因子α(TNF-α)]水平。结果观察组PASI-50和PASI-75达到率分别为79.63%、62.96%均高于对照组的59.26%、38.89%,差异有统计学意义(P<0.05)。治疗后4、8周,两组患者PASI评分均明显低于本组治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者皮肤病生活质量指数(DLQI)评分和血热证积分均明显低于本组治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者Th17、Th17/Treg水平均明显低于本组治疗前,Treg水平高于本组治疗前;且观察组Th17、Th17/Treg水平均明显低于对照组,Treg水平高于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者IL-17、IL-23、IL-22和TNF-α水平均明显低于本组治疗前,且观察组均明显低于对照组,差异有统计学意义(P<0.05)。结论在西医常规治疗的基础上,给予凉血消银汤治疗进行期寻常型银屑病(血热证)患者,可调节Th17/Treg,抑制Th17相关细胞因子的表达,减轻炎症反应,改善了皮损程度,减轻了中医证候,提高了生活质量,PASI-50和PASI-75均优于单纯的西医措施,值得临床使用。Objective To observe the clinical efficacy of Liangxue Xiaoyin Decoction in the treatment of psoriasis vulgaris(blood-heat syndrome)at active stage and its regulating effect on helper T lymphocyte 17(Th17)cells and related inflammatory factors.Methods A total of 108 patients with psoriasis vulgaris at active stage were divided into observation group and control group according to random numerical table,with 54 cases in each group.In the control group,mild to moderate patients were treated with calcipotriol betamethasone ointment,and severe patients were treated with methotrexate tablets.In the observation group,patients were treated with self-made Liangxue Xiaoyin Decoction orally on the basis of Western medicine therapy.The clinical efficacy,psoriasis area and severity index(PASI)score,quality of life,blood-heat syndrome score,Th17,regulatory T cells(Treg),Th17/Treg,Th17 related cytokines[interleukin(IL)-17,IL-23,IL-22 and tumor necrosis factor-α(TNF-α)]were compared between the two groups.Results The attainment rates of PASI-50 and PASI-75 in the observation group were 79.63%and 62.96%,respectively,which were higher than 59.26%and 38.89%in the control group,and the difference was statistically significant(P<0.05).4 and 8 weeks after treatment,the PASI score of the two groups were obviously lower than those before treatment,and the observation group was lower than the control group.All the difference was statistically significant(P<0.05).After treatment,the dermatology life quality index(DLQI)and blood-heat syndrome score of the two groups were obviously lower than those before treatment,and the observation group was lower than the control group.All the difference was statistically significant(P<0.05).After treatment,the Th17 and Th17/Treg of the two groups were obviously lower than those before treatment,and the Treg was higher than that before treatment;the Th17 and Th17/Treg of the observation group were obviously lower than those of the control group,and the Treg was higher than that of the control group;a

关 键 词：寻常型银屑病 进行期 血热证 凉血消银汤 辅助性T淋巴细胞17 细胞因子 

分 类 号：R275.9[医药卫生—中西医结合]