梅花针联合中药治疗银屑病的疗效观察及对Th1/Th2细胞因子和皮肤屏障功能的影响  

Observation of the therapeutic effect of the plum-blossom needle combined with Chinese medication in treating psoriasis and its effect on Th1/Th2 cytokines and skin barrier function

作　　者：杜笑青 石丽平 姚丽敏 吴琼 马旭 DU Xiaoqing;SHI Liping;YAO Limin;WU Qiong;MA Xu(980 Hospital of the Joint Service Support Force of the People’s Liberation Army of China,Shijiazhuang 050082,China;The First Hospital of Hebei Medical University,Shijiazhuang 050030,China)

机构地区：[1]中国人民解放军联勤保障部队第九八〇医院,石家庄050082 [2]河北医科大学第一医院,石家庄050030

出　　处：《上海针灸杂志》2024年第4期434-438,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：河北省医学科学研究课题计划项目(20211587,20231294)。

摘　　要：目的观察梅花针联合凉血消疕汤加减治疗银屑病的临床疗效及对患者血清Th1/Th2细胞因子水平和皮肤屏障功能的影响。方法选取银屑病患者72例,根据治疗方法分为联合组(36例)和对照组(36例)。对照组采用常规西药治疗,联合组予梅花针联合凉血消疕汤加减治疗。比较两组治疗前后的银屑病面积与严重程度指数(psoriasis area and severity index,PASI)评分、血清Th1/Th2细胞因子[肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、干扰素-γ(interferon-γ,IFN-γ)、白介素-10(interleukin-10,IL-10)和白介素-4(interleukin-4,IL-4)]水平以及皮肤屏障功能指标(角质层水含量、皮脂含量和经表皮水分丢失),比较两组临床疗效和不良反应发生情况。结果治疗后,两组PASI评分均降低(P<0.05),且联合组低于对照组(P<0.05);两组血清TNF-α和IFN-γ水平均降低(P<0.05),且联合组低于对照组(P<0.05);两组血清IL-10和IL-4水平均升高(P<0.05),且联合组高于对照组(P<0.05);两组角质层水含量和皮脂含量均升高(P<0.05),且联合组均高于对照组(P<0.05);经表皮水分丢失量均降低(P<0.05),且联合组低于对照组(P<0.05)。联合组总有效率高于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论梅花针联合凉血消疕汤加减治疗银屑病能改善患者的临床症状,调节血清Th1/Th2细胞因子水平,修复皮肤屏障功能,提高临床疗效。Objective To observe the clinical effect of the plum-blossom needle combined with modified Liang Xue Xiao Bi Tang in patients with psoriasis and its effect on serum Th1/Th2 cytokines levels and skin barrier function.Method Seventy-two patients with psoriasis were divided into a combination group(36 cases)and a control group(36 cases)according to the treatment methods.The control group was treated with conventional Western medicine.The combination group was treated with the plum-blossom needle combined with modified Liang Xue Xiao Bi Tang.The psoriasis area and severity index(PASI)score and serum Th1/Th2 cytokines[tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),interleukin-10(IL-10),and interleukin-4(IL-4)]levels and the skin barrier function indexes(stratum corneum water content,sebum content and transepidermal water loss)were compared between the two groups before and after treatment.The clinical efficacy and adverse reactions were compared between the two groups.Result After treatment,the PASI scores of the two groups were decreased(P<0.05),and the PASI score of the combination group was lower than that of the control group(P<0.05).The serum levels of TNF-α and IFN-γ in the two groups were decreased(P<0.05),and the serum levels of TNF-α and IFN-γ in the combination group were lower than those in the control group(P<0.05).The serum levels of IL-10 and IL-4 in the two groups were increased(P<0.05),and the serum levels of IL-10 and IL-4 in the combination group were higher than those in the control group(P<0.05).The water content and sebum content of stratum corneum were increased in the two groups(P<0.05),and those in the combination group were higher than the control group(P<0.05).The transepidermal water loss in the combination group was lower than that in the control group(P<0.05).The total effective rate of the combination group was higher than that of the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Con

关 键 词：梅花针疗法 皮肤针疗法 针药并用 银屑病 皮损 皮肤屏障 

分 类 号：R246.7[医药卫生—针灸推拿学]