凉血祛湿止痒颗粒对特应性皮炎血热湿蕴证患者IL-17A、IL-23的影响  

Effects of Liangxue Qushi Zhiyang Granules on the concentration of serum IL-17A and IL-23 in atopic dermatitis patients with syndrome of blood heat and dampness

作　　者：孙占学 王京军[3] 王旭昀 SUN Zhan-xue;WANG Jing-jun;WANG Xu-yun(Beijing University of Chinese Medicine Third Affiliated Hospital,Beijing 100029,China;Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China;Beijing Mentougou District TCM Hospital,Beijing 102300,China;Beijing Luhe Hospital Affiliated to Capital Medical University,Beijing 101149,China)

机构地区：[1]北京中医药大学第三附属医院皮肤科,北京100029 [2]北京中医药大学东方医院,北京100078 [3]北京市门头沟区中医医院,北京102300 [4]首都医科大学附属北京潞河医院,北京101149

出　　处：《中华中医药杂志》2021年第9期5653-5656,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：北京中医药大学东方医院1166中青年专家项目(No.040204001001002023);国家中医药管理局中医药治疗慢性病临床疗效研究(No.2015468001)。

摘　　要：目的:观察凉血祛湿止痒颗粒对特应性皮炎血热湿蕴证患者疗效及对血清白细胞介素(IL)-17A、IL-23、外周血CD4+单核细胞TLR2表达影响。方法:将符合纳入标准的68例特应性皮炎患者随机分为治疗组(凉血祛湿止痒颗粒)和对照组(西替利嗪片),每组34例,观察患者皮肤红斑、水肿、表皮剥脱、苔藓化症状,应用严重度指数评分法评价疗效,用流式细胞仪检测患者外周血CD4+单核细胞的TLR2表达,采用ELISA法检测患者血清IL-17A、IL-23以及肝肾功能,疗程4周。结果:对照组有效病例32例,脱落2例,治疗组有效病例32例,脱落2例。与本组治疗前比较,治疗后,两组红斑、水肿丘疹、表皮剥脱、苔藓化评分、外周血单核细胞TLR2及IL-17A、IL-23水平均显著下降(P<0.05,P<0.01),且治疗组低于对照组(P<0.01)。治疗组2、4周愈显率[75.00%(24/32)、87.50%(28/32)]显著优于对照组[15.63%(5/32)、46.88%(15/32)](P<0.01),且3个月后复发率[6.25%(2/32)]显著低于对照组[32.14%(9/28)](P<0.05);两组均未见明显不良反应。结论:中药凉血祛湿止痒颗粒治疗特应性皮炎血热湿蕴证具有一定的疗效,复发率低。Objective: To analyze the concentration of IL-17 A, IL-23 in serum and the expression of TLR2 in peripheral blood CD4+ monocytes and observe the effect on atopic dermatitis(AD) patients with syndrome of blood heat and dampness intervented by Liangxue Qushi Zhiyang Granules. Methods: A total of 68 cases of AD were randomly divided into treatment group with Liangxue Qushi Zhiyang Granules(34 cases) and the control group with Cetirizine Tablet(34 cases). The course of treatment was four weeks. The erythema, edema, skin exfoliation and moss of AD patients were observed in two groups by the means of the eczema area and severity index(EASI). The expression of TLR2 in peripheral blood CD4+ monocytes was detected by flow cytometry. IL-17 A and IL-23 in serum were detected by double antibody sandwich enzyme-linked immunosorbent assay(ELISA), and liver and kidney functions were tested too. Results: There were 32 effective cases and 2 lost follow-up medical cases. A Total of 32 cases were effective and 2 cases fell off in the treatment group. After treatment, the scores of erythema,edema, epidermal exfoliation and mossization, the expression levels of TLR2, IL-17 A and IL-23 in peripheral blood monocytes of the two groups decreased significantly(P<0.05, P<0.01), and the scores and levels in the treatment group were lower than those in the control group(P<0.01);The total effective rates of 2 weeks and 4 weeks [75.00%(24/32), 87.50%(28/32)]in the treatment group were significantly better than those in the control group [15.63%(5/32), 46.88%(15/32)](P<0.01), and the recurrence rate after 3 months [6.25%(2/32)] was lower than that in the control group [32.14%(9/28)](P<0.01). There were no obvious adverse reactions in both groups. Conclusion: Liangxue Qushi Zhiyang Granules is effective on patients with AD, and recurrence rate of AD is relatively low.

关 键 词：凉血祛湿止痒颗粒 特应性皮炎 血热湿蕴证 白细胞介素-17A 白细胞介素-23 

分 类 号：R275.9[医药卫生—中西医结合]