蜈蚣败毒饮对血瘀证银屑病患者凝血因素影响的研究  

Effect of Wugong Baidu Decoction on coagulation factors in psoriasis patients with the syndrome of blood stasis

作　　者：张晴[1] 杨素清[1] 安月鹏[1] ZHANG Qing;YANG Suqing;AN Yuepeng(First Affiliated Hospital,Heilongjiang University of Chinese Medicine,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学附属第一医院,哈尔滨150040

出　　处：《吉林中医药》2022年第6期671-676,共6页Jilin Journal of Chinese Medicine

基　　金：国家自然科学基金(81904201,81973846);国家重点研发计划“中医药现代化研究”重点专项课题(2018YFC1705303);黑龙江省博士后资助经费项目(LBH-Z20198);黑龙江省普通本科高等学校青年创新人才培养计划(UNPYSCT-2020229)。

摘　　要：目的观察蜈蚣败毒饮对于血瘀证银屑病患者的皮损疗效,并通过对凝血和抗凝系统关键因子的检测,分析各凝血因素与银屑病皮损之间的相关性。方法血瘀证银屑病患者随机分为治疗组39例,对照组38例,治疗组口服蜈蚣败毒饮,对照组口服血府逐瘀胶囊,对患者进行治疗前、治疗4周后、治疗8周后3个时间点的观察,采用PASI法对患者的皮损指数进行量化并评价临床疗效,采用免疫比浊法对血清中凝血系统关键因子纤维蛋白原(FIB)、D-二聚体(DD),和抗凝系统关键因子抗凝血酶Ⅲ活性(AT-ⅢA)、纤溶酶原激活物抑制剂-1(PAI-1)、血管性血友病因子(vWF)进行检测,基于重复测量的方差分析,分析各指标的时间效应、分组效应、交互效应,并分析各凝血因素与皮损指数之间的相关性。结果蜈蚣败毒饮可以显著降低银屑病患者的PASI分值(P<0.05或P<0.01),降低FIB、DD、PAI-1、vWF的水平(P<0.05或P<0.01),并能够升高AT-ⅢA的水平(P<0.05或P<0.01)),在多时间点动态观察中显示出连续调控的趋势,同时,各指标的血清表达与皮损指数之间存在正相关性(P<0.01)。结论蜈蚣败毒饮能够有效治疗血瘀证银屑病,其干预机制可能通过抑制机体的凝血系统并激活抗凝系统来实现,通过这种双向调控作用,改善了血瘀证患者的瘀滞状态。Objective To observe the effect of Wugong Baidu Decoction on skin lesions of psoriasis patients with the syndrome of blood stasis,and to analyze the correlation between coagulation factors and psoriasis lesions by detecting the key factors of the blood coagulation system and anticoagulation system.Methods Psoriasis patients with the syndrome of blood stasis were randomly divided into a treatment group(39 cases)and a control group(38 cases).The treatment group was administered orally with the Wugong Baidu Decoction while the control group was administered orally with Xuefu Zhuyu Capsules.The patients were observed respectively before treatment,4 weeks after treatment and 8 weeks after treatment,while the PASI method was used to quantify the skin lesion indexes and evaluate their clinical efficacy,and the key factors of the serum fibrinogen(FIB),D-dimer(DD)in the coagulation system,the key factors of the antithrombin III activity(AT-IIIA),plasminogen activator inhibitor-1(PAI-1),von Willebrand factor(vWF)in the anticoagulation system were detected by immunoturbidimetry.Based on the repeated measurement analysis of variance,the time effect,grouping effect and interaction effect of each index were analyzed,and the correlation between each coagulation factor and skin lesion index was analyzed.Results The Wugong Baidu Decoction significantly reduced the PASI score of patients with psoriasis(P<0.05 or P<0.01),reduced the levels of FIB,DD,PAI-1 and vWF(P<0.05 or P<0.01),and increased the level of AT-IIIA(P<0.05 or P<0.01),which showed a trend of continuous regulation in the dynamic observation at multiple time points.At the same time,there was a positive correlation between the serum expression of each index and the skin lesion index(P<0.01).Conclusion Wugong Baidu Decoction can effectively treat psoriasis with the syndrome of blood stasis,and its intervention mechanism may be realized by inhibiting the body’s coagulation system and activating the anticoagulation system,and the patients’blood stasis state is thereby

关 键 词：蜈蚣败毒饮 血瘀证 银屑病 凝血 抗凝 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]