清热凉血法治疗寻常型银屑病的效果及对PASI评分、TNF-α、IL-17水平、不良反应影响的Meta分析  

Meta analysis of effect of heat-clearing and blood-cooling in the treatment of psoriasis vulgaris and its influences on PASI score,TNF-α,IL-17 levels and adverse reactions

作　　者：高登雄 李美红 孙丹 陈璐 赵一丁 惠坤 GAO Dengxiong;LI Meihong;SUN Dan;CHEN Lu;ZHAO Yiding;HUI Kun(Traditional Chinese Medicine Hospital of Shenmu,Shenmu 719300;Shaanxi Provincial Hospital of Chinese Medicine,Xi'an 710003,China)

机构地区：[1]神木市中医医院,陕西神木719300 [2]陕西省中医医院,陕西西安710003

出　　处：《临床医学研究与实践》2022年第30期27-31,共5页Clinical Research and Practice

基　　金：陕西省重点研发计划项目(No.2021SF-376,No.2021ZDLSF04-12,No.2021SF-409)。

摘　　要：目的采用Meta分析法总结清热凉血法治疗寻常型银屑病的效果及对银屑病皮损面积与严重程度指数(PASI)评分、肿瘤坏死因子-α(TNF-α)、白细胞介素-17(IL-17)水平、不良反应的影响。方法从中国知网、万方数据库、中国生物医学文献数据库、中文生物医学期刊数据库及PubMed中检索对外公开发表的关于清热凉血法治疗寻常型银屑病的文献,对符合纳入及排除标准的文献精读后进行二次筛选,用Stata15.0软件进行数据分析。结果本研究共纳入13篇文献,患者总计1168例(脱落3例,实际纳入1165例),其中观察组593例(脱落1例,实际纳入592例),对照组575例(脱落2例,实际纳入573例)。Meta分析结果显示,观察组的临床疗效优于对照组,差异具有统计学意义(Z=7.416,P=0.000);观察组的PASI评分低于对照组,差异具有统计学意义(Z=2.796,P=0.005);观察组的TNF-α水平低于对照组,差异具有统计学意义(Z=6.199,P=0.000);两组的IL-17水平比较,差异无统计学意义(Z=0.548,P=0.583);两组的不良反应比较,差异具有统计学意义(Z=2.741,P=0.006)。结论清热凉血法治疗寻常型银屑病的效果较好,可以下调患者的TNF-α水平,改善临床症状,具有一定的推广应用价值。Objective To summarize the effect of heat-clearing and blood-cooling in the treatment of psoriasis vulgaris and its influences on Psoriasis Area and Severity Index(PASI)score,tumor necrosis factor-α(TNF-α),interleukin-17(IL-17)levels and adverse reactions by Meta analysis method.Methods The publicly published literature of heat-clearing and blood-cooling in the treatment of psoriasis vulgaris was retrieved from China National Knowledge Infrastructure,Wanfang Database,China Biomedical Literature Database,Chinese Biomedical Journal Database and PubMed.The literature that met the inclusion and exclusion criteria was subjected to secondary screening,and Stata15.0 software was used for data analysis.Results A total of 13 literatures were included in this study,with a total of 1168 patients(3 cases dropped out and 1165 cases actually included),including 593 cases in the observation group(1 case dropped out and 592 cases actually included)and 575 cases in the control group(2 cases dropped out and 573 cases actually included).Meta analysis results showed that the clinical efficacy of the observation group was better than that of the control group,and the difference was statistically significant(Z=7.416,P=0.000);the PASI score of the observation group was lower than that of the control group,and the difference was statistically significant(Z=2.796,P=0.005);the TNF-αlevel of the observation group was lower than that of the control group,and the difference was statistically significant(Z=6.199,P=0.000);there was no significant difference in IL-17 level between the two groups(Z=0.548,P=0.583);there was significant difference in adverse reactions between the two groups(Z=2.741,P=0.006).Conclusion Heat-clearing and blood-cooling in the treatment of psoriasis vulgaris has a good effect,it can down-regulate the TNF-αlevel in patients and improve the clinical symptoms,which has certain popularization and application value.

关 键 词：清热凉血法 寻常型银屑病 银屑病皮损面积与严重程度指数 肿瘤坏死因子-α 白细胞介素-17 META分析 

分 类 号：R256.4[医药卫生—中医内科学]