龙胆泻肝汤联合维胺酯治疗银屑病的临床疗效  

Clinical Effect of Gentian Xergan Decoction combined with Viamidate in the Treatment of Psoriasis

作　　者：熊学平 张娜 XIONG Xue-Ping;ZHANG Na(Department of Dermatology,Yingtan Hospital of Traditional Chinese Medicine,Yingtan 335499,China;Department of Pharmacy,Yingtan 184 Hospital,Yingtan 335000,China)

机构地区：[1]鹰潭市中医院皮肤科,江西鹰潭335499 [2]鹰潭市一八四医院药剂科,江西鹰潭335000

出　　处：《中国药物经济学》2024年第8期58-61,65,共5页China Journal of Pharmaceutical Economics

摘　　要：目的探讨龙胆泻肝汤联合维胺酯对银屑病患者外周血细胞毒性T细胞(Tc细胞)与辅助T细胞(Th细胞)平衡及核因子κB(NF-κB)、脂蛋白相关磷脂酶A2(Lp-PLA2)的影响。方法选取2021年7月至2023年8月鹰潭市中医院收治的116例银屑病患者作为研究对象,按照随机数字表法分为对照组和观察组,各58例。对照组口服维胺酯胶囊,观察组在对照组基础上给予龙胆泻肝汤。比较两组患者临床疗效,治疗前后银屑病皮损面积和严重程度指数(PASI)评分,Tc与Th细胞水平,NF-κB和Lp-PLA2水平,治疗期间不良反应发生情况。结果观察组治疗有效率高于对照组(P<0.05);治疗后,观察组PASI评分低于对照组(P<0.05);治疗后,与对照组比较,观察组Th1细胞和Th1/Th2水平降低幅度及Th2细胞水平增加幅度更显著(P<0.05);治疗后,与对照组比较,观察组Tc1细胞和Tc1/Tc2水平降低幅度及Tc2细胞水平增加幅度更显著(P<0.05);治疗后,观察组NF-κB及Lp-PLA2水平低于对照组(P<0.05);观察组不良反应发生率低于对照组(P<0.05)。结论龙胆泻肝汤联合维胺酯可通过调节免疫、抑制炎症反应,提高银屑病患者的临床治疗效果,减少不良反应。Objective To explore the effects of Gentian Xiegan Decoction combined with viamidate on the balance of Tc and Th cells,nuclear factorκB(NF-κB)and lipoprotein-associated phospholipase A_2(Lp-PLA_2)in peripheral blood of patients with psoriasis.Methods A total of 116 patients with psoriasis admitted to Yingtan Hospital of Traditional Chinese Medicine from July 2021 to August 2023 were selected as the study objects,and were divided into control group and observation group according to random number table method,with 58 cases in each group.The control group was given oral viaminate capsule,and the observation group was given Gentian xergan decoction on the basis of the control group.The clinical efficacy,psoriasis lesion area and severity index(PASI)score,Tc and Th cell levels,NF-κB and Lp-PLA_2 levels before and after treatment,and the occurrence of adverse reactions during treatment were compared between the two groups.Results The effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,PASI score of observation group was lower than that of control group(P<0.05).After treatment,Th1 cells and Th1/Th2 levels decreased and Th2 cell levels increased significantly in observation group compared with control group(P<0.05).After treatment,compared with control group,Tc1 cells and Tc1/Tc2 cells levels decreased and Tc2 cells levels increased significantly in observation group(P<0.05).After treatment,the levels of NF-κB and Lp-PLA2 in observation group were lower than those in control group(P<0.05).The incidence of adverse reactions in observation group was lower than that in control group(P<0.05).Conclusion Gentian Xergan Decoction combined with viamidate can improve the clinical therapeutic effect of psoriasis patients and reduce adverse reactions by regulating immunity and inhibiting inflammatory response.

关 键 词：龙胆泻肝汤 维胺酯 银屑病 细胞毒性T细胞 辅助T细胞 核因子ΚB 脂蛋白相关磷脂酶A2 

分 类 号：R758.63[医药卫生—皮肤病学与性病学] R289.5[医药卫生—临床医学]