清热凉血粥对血热内蕴证银屑病患者和动物模型角质形成细胞增殖与皮肤炎症的影响  

Effect of Qingre Liangxue Zhou on Keratinocyte Proliferation and Skin Inflammation in Psoriasis Patients with Internal Amassment of Blood Heat Syndrome and in Animal Models

作　　者：曾碧君[1] 蒋谷芬[2] 周红霞[1] 王畅[1] 张予晋 彭友华[1] 钟欣怡 杨志波[1] ZENG Bijun;JIANG Gufen;ZHOU Hongxia;WANG Chang;ZHANG Yujin;PENG Youhua;ZHONG Xinyi;YANG Zhibo(Department of Dermatology,the Second Affiliated Hospital of Hu′nan University of Traditional Chinese Medicine;Department of Chinese Medicine Surgery,the Second Affiliated Hospital of Hu′nan University of Traditional Chinese Medicine;Department of Nursing,the Second Affiliated Hospital of Hu′nan University of Traditional Chinese Medicine)

机构地区：[1]湖南中医药大学第二附属医院皮肤科,湖南长沙410005 [2]湖南中医药大学第二附属医院中医外科,湖南长沙410005 [3]湖南中医药大学第二附属医院护理部,湖南长沙410005

出　　处：《中国皮肤性病学杂志》2023年第9期1008-1015,共8页The Chinese Journal of Dermatovenereology

基　　金：湖南省创新型省份建设重大专项(2020SK2023);中医药管理局重点课题(A2023056);湖南省教育厅项目(20A372)。

摘　　要：目的 研究清热凉血粥对血热内蕴证银屑病患者和动物模型角质形成细胞增殖过程与皮肤炎症的影响。方法 收集2022年4月—2022年10月在湖南中医药大学附属第二医院诊治的24例银屑病患者的临床资料并进行辨证诊断,根据治疗方法分为对照组和干预组,每组12例。2组患者均行常规治疗2周,干预组在常规治疗基础上加用清热凉血粥。PASI评分评估银屑病皮损情况,HE染色观察皮损病理情况,免疫组织化学和ELISA检测IL-22、IL-1β、IL-17A和TNF-α表达水平。使用咪喹莫特(imiquimod,IMQ)构建银屑病小鼠模型,并分别进行清热凉血粥和甲氨蝶呤(methotrexate,MTX)灌胃处理。PASI评分评估银屑病皮损情况,HE染色观察皮损病理情况及角质层厚度,免疫组织化学染色检测增殖细胞核抗原(PCNA)、IL-22、IL-1β和IL-17A表达水平,ELISA检测IL-22、IL-1β、IL-17A和TNF-α表达水平。结果 与对照组银屑病患者相比,干预组患者的PASI评分、角质层厚度、IL-22、IL-1β、IL-17A和TNF-α水平显著降低,差异有统计学意义(P<0.01)。与磷酸盐缓冲液(phosphate buffer solution,PBS)组相比,IMQ组小鼠的PASI评分、角质层厚度、PCNA、IL-22、IL-1β、IL-17A和TNF-α水平显著升高,差异有统计学意义(P<0.01);与IMQ组相比,IMQ+清热凉血粥和IMQ+MTX组小鼠的PASI评分、角质层厚度、PCNA、IL-22、IL-1β、IL-17A和TNF-α水平显著降低,差异有统计学意义(P<0.01)。结论 清热凉血粥可改善银屑病角质形成细胞增殖与皮肤炎症反应。Objective To study the effect of Qingre Liangxue Zhou on keratinocyte proliferation and skin inflammation in psoriasis patients with internal amassment of blood heat syndrome and in animal models.Methods The clinical data of 24 psoriasis patients treated in the Second Affiliated Hospital of Hu′nan University of Traditional Chinese Medicine from April 2022 to October 2022 were analyzed and diagnosed according to syndrome differentiation.According to the treatment method,they were divided into a control group and an intervention group,with 12 people in each group.Patients in both groups received conventional treatment for 2 weeks,and the intervention group was supplemented with Qingre Liangxue Zhou on the basis of conventional treatment.The psoriasis lesions were evaluated by Psoriasis Area and Severity Index(PASI) score,the pathological conditions of the skin lesions were observed by HE staining,and the expression levels of IL-22,IL-1β,IL-17A and TNF-α were detected by immunohistochemistry and enzyme linked immunosorbent assay(ELISA).The psoriasis mouse model was constructed by using imiquimod(IMQ) cream and treated with Qingre Liangxue Zhou and methotrexate(MTX) by gavage respectively.The psoriatic lesions were evaluated by PASI score,and the pathological conditions of the skin lesions and the thickness of the stratum corneum were observed by HE staining.The expression levels of proliferating cell nuclear antigen(PCNA),IL-22,IL-1β and IL-17A were detected by immunohistochemistry,and the expression levels of IL-22,IL-1β,IL-17A and TNF-α were detected by ELISA.Results Compared with the psoriasis patients in the control group,the PASI score,stratum corneum thickness,IL-22,IL-1β,IL-17A and TNF-α levels in the intervention group were significantly reduced(P<0.01).Compared with the phosphate buffer solution(PBS) group,the PASI score,stratum corneum thickness,PCNA,IL-22,IL-1β,IL-17A and TNF-α levels of the mice in the IMQ group were significantly increased(P<0.01).Compared with the IMQ group,the PASI score,st

关 键 词：银屑病 血热内蕴证 清热凉血粥 角质形成细胞 皮肤炎症 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]