加减仙方活命饮治疗重度痤疮的疗效及与血清IL-1α和IL-4表达的相关性分析  

Therapeutic Effect of Modified Xianfang Huoming Yin for Patients with Severe Acne and Its Correction with the Expression of Serum IL-1αand IL-4

作　　者：杨文志 潘锡伟 甘海芳 YANG Wen-Zhi;PAN Xi-Wei;GAN Hai-Fang(Dept.of Dermatology,Shenzhen Bao’an Traditional Chinese Medicine Hospital Group,Shenzhen 518100 Guangdong,China)

机构地区：[1]深圳市宝安中医院皮肤科,广东深圳518100

出　　处：《广州中医药大学学报》2022年第7期1536-1541,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：深圳市宝安区社会公益项目(编号:2016CX008)。

摘　　要：【目的】研究加减仙方活命饮治疗重度痤疮患者的临床疗效及其与血清白细胞介素1α(IL-1α)和白细胞介素4(IL-4)表达的相关性。【方法】将80例重度痤疮患者随机分为治疗组和对照组,每组各40例;另选取40例健康体检者作为正常组。2组患者均给予阿达帕林凝胶外涂治疗,在此基础上,治疗组给予加减仙方活命饮治疗,对照组给予盐酸多西环素片联合维生素B6片治疗,疗程为1个月。观察2组患者治疗前后皮损评分变化情况,评价2组患者的临床疗效及安全性;采用酶联免疫吸附(ELISA)法检测2组患者治疗前后血清IL-1α和IL-4水平,并与正常组作比较;同时,对治疗后血清IL-1α、IL-4表达水平与加减仙方活命饮的疗效作相关性分析。【结果】(1)治疗1个月后,治疗组的总有效率为90.0%(36/40),对照组为75.0%(30/40);组间比较,治疗组的疗效明显优于对照组(P<0.05)。(2)治疗后,2组患者的粉刺、丘疹、脓包、结节或囊肿等各项皮损评分及皮损总积分均较治疗前明显降低(P<0.05),且治疗组的降低作用均明显优于对照组(P<0.05)。(3)治疗后,2组患者的血清IL-1α与IL-4水平均较治疗前明显降低(P<0.05),其中,治疗组已基本恢复至正常组水平(P>0.05),而对照组仍均高于正常组水平(P<0.05);组间比较,治疗组对血清IL-1α与IL-4水平的降低作用均明显优于对照组(P<0.05)。(4)治疗过程中,治疗组的不良反应发生率为7.5%(3/40),对照组为10.0%(4/40),组间比较,差异无统计学意义(P>0.05)。(5)加减仙方活命饮治疗重度痤疮患者1个月后患者血清IL-1α和IL-4的相对表达水平与治疗后患者症状积分减少率呈负相关(r值分别为-0.51、-0.60,P<0.05)。【结论】加减仙方活命饮治疗重度痤疮疗效确切,安全性高;患者治疗后血清IL-1α、IL-4表达与疗效呈负相关,提示该方治疗重度痤疮的机制与其调节血清中失调的IL-1α、IL-4表达相关。Objective To observe the therapeutic effect of modified Xianfang Huoming Yin(Fairy Decoction for Cutaneous Infection)for the treatment of patients with severe acne,and to explore its correlation with the expression of serum interleukin 1α(IL-1α)and interleukin 4(IL-4).Methods A total of 80 patients diagnosed as severe acne were randomly divided into the treatment group and the control group,with 40 cases in each group.Another forty healthy controls who underwent the physical examination served as the healthy normal controls.Patients in the two groups were given external application of adapalene gel for topical treatment,and additionally the treatment group was given oral use of modified Xianfang Huoming Yin and the control group was treated with doxycycline hydrochloride tablets combined with vitamin B6 orally.The treatment covered one month.Before and after treatment,the changes of skin lesion scores in the two groups were observed.After treatment,the clinical efficacy and safety of the two groups were evaluated.Enzyme-linked immunosorbent assay(ELISA)was used to detect serum IL-1αand IL-4 in the two groups before and after treatment and then their levels were compared with those of the healthy controls.The correlation of the expression levels of serum IL-1αand IL-4 after treatment with the curative effect of modified Xianfang Huoming Yin was analyzed.Results(1)After one month of treatment,the total effective rate of the treatment group was 90.0%(36/40)and that of the control group was 75.0%(30/40).The intergroup comparison showed that the clinical efficacy of the treatment group was superior to that of the control group(P<0.05).(2)After treatment,the scores of skin lesions of acne,papule,pustule,nodule,and cyst as well as the overall skin lesion scores in the two groups were markedly decreased in comparison with those before treatment(P<0.05),and the decrease in the treatment group was superior to that in the control group(P<0.05).(3)After treatment,the levels of serum IL-1αand IL-4 in severe acne patients

关 键 词：重度痤疮 加减仙方活命饮 白细胞介素1α(IL-1α) 白细胞介素4(IL-4) 

分 类 号：R759.733[医药卫生—皮肤病学与性病学]