消银安神饮治疗寻常型银屑病血热证合并轻中度睡眠障碍患者34例随机对照研究  

iaoyin Anshen Beverage(消银安神饮)in the Treatment of 34 Psoriasis Vulgaris Patients of Blood-heat Syndrome Complicated with Sleep Disorder:A Randomized Controlled Trial

作　　者：高玥璇 段行武[1] 吴治民 朱泽兵 刁若涵 张润田[1] 田野[1] 黄敏[1] 陈广山[1] 张霞[1] 赵久丽 GAO Yuexuan;DUAN Xingwu;WU Zhimin;ZHU Zebing;DIAO Ruohan;ZHANG Runtian;TIAN Ye;HUANG Min;CHEN Guangshan;ZHANG Xia;ZHAO Jiuli(Dongzhimen Hospital.BeijingUniversityof ChineseMedicineB,eijing,100700)

机构地区：[1]北京中医药大学东直门医院,北京市东城区100700

出　　处：《中医杂志》2023年第9期909-915,共7页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(82074436)。

摘　　要：目的观察消银安神饮治疗寻常型银屑病血热证合并轻中度睡眠障碍患者的临床疗效,并探讨其可能作用机制。方法72例寻常型银屑病血热证合并轻中度睡眠障碍患者随机分为治疗组与对照组各36例。治疗组予口服消银安神饮,每日1剂;对照组予口服复方青黛胶囊,每次2 g,每日3次;两组均外用白凡士林软膏并进行睡眠卫生健康教育。两组均治疗8周。观察两组患者治疗前后银屑病皮损面积及严重程度指数(PASI)评分、匹兹堡睡眠指数量表(PSQI)评分、失眠严重程度指数量表(ISI)评分、中医证候积分、皮肤病生活质量量表(DLQI)评分、汉密尔顿焦虑量表(HAMA)评分;检测两组患者治疗前后炎症因子[白细胞介素17A(IL-17A)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)]、氧化应激相关指标[丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)]及褪黑素(MLT)水平。结果治疗组临床疗效总有效率为91.18%,高于对照组的75.76%(P<0.01)。与本组治疗前比较,两组患者治疗后PASI评分、中医证候积分、PSQI评分、ISI评分、DLQI评分、HAMA评分及血清IL-17A、TNF-α、IL-6水平均明显降低(P<0.05或P<0.01),治疗组治疗后MLT水平及SOD、GSH-Px活性升高,MDA水平下降(P<0.05或P<0.01)。治疗后两组间比较,治疗组PASI评分、中医证候积分、PSQI评分、ISI评分、血清IL-17A水平明显低于对照组,而MLT水平及SOD、GSH-Px活性高于对照组(P<0.05或P<0.01)。结论消银安神饮可明显改善寻常型银屑病血热证合并轻中度睡眠障碍患者皮损,提高生活和睡眠质量,其机制可能与减轻炎症、调节免疫平衡及提高机体抗氧化能力有关。Objective To observe the efficacy of Xiaoyin Anshen Beverage(消银安神饮,XAB)in the treatment of psoriasis vulgaris(PV)with sleep disorder of blood-heat syndrome,and to explore its possible mechanism.Methods Seventy-two patients with PV of blood-heat syndrome and sleep disorder were randomly divided into treatment group(36 cases)and control group(36 cases).The treatment group was given oral XAB,one dose daily,while the control group was given oral Compound Qingdai Capsule(复方青黛胶囊),2 g per time,three times daily;both groups were given vaseline ointment and sleep health education.The treatment duration was 8 weeks for both groups.The psoriasis area and the scores of psoriatic area and severity index(PASI),pittsburgh sleep index(PSQI),insomnia severity index(ISI),traditional Chinese medicine(TCM)symptoms,dermatology quality of life scale(DLQI)and Hamilton anxiety scale(HAMA)were evaluated before and after treatment.The levels of inflammatory cytokines including interleukin 17A(IL-17A),tumor necrosis factorα(TNF-α)and interleukin 6(IL-6),oxidative stress-related indicators including malondialdehyde(MDA),superoxide dismutase(SOD)and glutathione peroxidase(GSH-Px),as well as melatonin(MLT)were measured before and after treatment.Results The total effective rate of the treatment group was 91.18%,which was higher than 75.76%of the control group(P<0.05).After 8 weeks of treatment,the scores of PASI,TCM symptoms,PSQI,ISI,DLQI,and HAMA,as well as the levels of serum IL-17A,TNF-α,and IL-6 significantly decreased in both groups(P<0.05 or P<0.01);the MLT level,the activity of SOD,GSH-Px increased,while the MDA level decreased in the treatment group(P<0.05 or P<0.01).When compared between groups,the scores of PASI,TCM symptoms,PSQI,and ISI,and the serum IL-17A level were significantly lower in the treatment group,while the MLT level,SOD and GSH-Px activity were higher(P<0.05 or P<0.01).Conclusion XAB can significantly improve the skin lesions and improve the quality of life and sleep of PV patients of blood-he

关 键 词：寻常型银屑病 血热证 睡眠障碍 炎症因子 氧化应激 褪黑素 消银安神饮 

分 类 号：R275.9[医药卫生—中西医结合] R277.7[医药卫生—中医皮科]