开玄消银汤联合中药药浴治疗寻常型银屑病临床研究  

Clinical observation of Kaixuan Xiaoyin decoction combined with traditional Chinese medicine medicated bath in the treatment of psoriasis vulgaris

作　　者：苗春澍 李娜[2] 李翔宇[2] 孙淑娜[2] 张晓杰[2] MIAO Chunshu;LI Na;LI Xiangyu;SUN Shuna;ZHANG Xiaojie(Shandong University of Traditional Chinese Medicine,Jinan 250355,China)

机构地区：[1]山东中医药大学中医学院,山东济南250355 [2]山东中医药大学附属医院皮肤科,山东济南250014

出　　处：《陕西中医》2022年第11期1535-1539,共5页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金青年基金资助项目(81804104);山东省中医药科技项目(2020Q014);山东省医药卫生科技发展计划项目(202004120987)。

摘　　要：目的:基于玄府理论探讨开玄消银汤联合中药药浴治疗寻常型银屑病疗效。方法:选择寻常型银屑病患者118例,根据随机数字表法分为观察组与对照组,每组59例。对照组患者给予窄谱中波紫外线光疗,观察组患者在对照组基础上给予开玄消银汤治疗。观察两组治疗前后皮损总面积评分、皮损严重程度评分(红斑、浸润、鳞屑评分)、PASI评分、皮肤瘙痒程度评分、皮肤病生活质量调查表(DLQI)评分;比较两组临床疗效、血清炎症因子指标[转化生长因子-β_(1)(TGF-β_(1))、肿瘤坏死因子-α(TNF-α)、白细胞介素-13(IL-13)]、血清免疫功能指标[辅助性T淋巴细胞1(Th_(1))百分比、辅助性T淋巴细胞2(Th_(2))百分比、Th_(1)/Th_(2)]水平;随访6个月,观察两组复发情况。结果:治疗后观察组总有效率94.64%,显著高于对照组的84.21%(P<0.05)。治疗后两组皮损总面积评分、红斑评分、浸润评分、鳞屑评分、血清TGF-β_(1)水平、TNF-α水平、IL-13水平、PASI评分、皮肤瘙痒程度评分、DLQI评分、Th_(1)百分比、Th_(1)/Th_(2)均较治疗前降低,且观察组低于对照组(P<0.05);治疗后两组Th_(2)百分比较治疗前升高,且观察组高于对照组(P<0.05)。随访结果显示,观察组复发率7.14%,显著低于对照组的21.05%(P<0.05)。结论:开玄消银汤联合中药药浴可提高患者免疫功能和临床疗效。Objective:To investigate the curative effect of Kaixuan Xiaoyin decoction combined with traditional Chinese medicine medicated bath in the treatment of psoriasis vulgaris based on Xuanfu theory.Methods:A total of 118 patients with psoriasis vulgaris were selected and divided into observation group and control group according to the random number table method,59 cases in each group,patients in the control group were given narrow-band UV light therapy,and patients in the observation group were given Kaixuan Xiaoyin decoction on the basis of the control group.Skin lesion area score,skin lesion severity score(erythema,infiltration,scale score),PASI score,skin pruritus score and skin disease quality of life questionnaire were observed before and after treatment in the two groups.Clinical efficacy,the level of serum inflammatory factor indexes[transforming growth factor-β_(1)(TGF-β_(1)),tumor necrosis factor-α(TNF-α),interleukin-13(IL-13)],serum immune function indexes[helper T lymphocyte 1(Th _(1))percentage,helper T lymphocyte 2(Th_(2))percentage,Th_(1)/Th_(2)]were compared before and after treatment in the two groups.The recurrence of the two groups was observed after 6 months of follow-up.Results:After treatment,the total effective rate of the observation group was 94.64%,which was significantly higher than 84.21%of the control group(P<0.05).After treatment,the total area score of skin lesions,erythema score,infiltration score,scale score,serum TGF-β1 level,TNF-αlevel,IL-13 level,PASI score,skin pruritus score,DLQI score,Th 1 percentage,Th 1/Th 2 was lower than before treatment,and the observation group was lower than the control group(P<0.05).Follow-up results showed that the recurrence rate of the observation group was 7.14%,which was significantly lower than 21.05%of the control group(P<0.05).Conclusion:Kaixuan Xiaoyin decoction combined with traditional Chinese medicine medicated bath can improve the immune function and has a significant clinical effect in the treatment of psoriasis vulgaris.

关 键 词：寻常型银屑病 玄府理论 开玄消银汤 中药药浴 炎症因子 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]