针灸联合口服复方甘草酸苷治疗寻常型银屑病的效果研究  

Acupuncture combined with oral compound glycyrrhizin to treat psoriasis vulgaris

作　　者：崔瑜[1] 胡彩霞[1] 邸鸿轩 刘淑刚[2] 程毅[1] 顾艳丽 张国强[4] 王文氢[1] 张燕[1] CUI Yu;HU Caixia;DI Hongxuan(Department of Dermatology,the Fourth Hospital of Hebei Medical University,Hebei,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第四医院皮肤科,石家庄市050000 [2]河北医科大学第四医院中医科,石家庄市050000 [3]河北省唐县同仁皮肤病医院 [4]河北医科大学第一医院皮肤科

出　　处：《河北医药》2024年第24期3712-3716,共5页Hebei Medical Journal

基　　金：河北省中医药管理局科研计划项目(编号:2018143)。

摘　　要：目的探讨针灸联合口服复方甘草酸苷治疗寻常型银屑病的疗效。方法选取2018年1月至2022年1月收治的寻常型银屑病患者120例随机分为单纯口服复方甘草酸苷组和及针灸联合口服复方甘草酸苷组,每组60例。2组患者均给予复方甘草酸苷片2片/次,3次/d。针灸联合口服复方甘草酸苷组加用针灸治疗,血燥型取三阴交、太溪等,血瘀型取血海、膈俞。隔日治疗1次,连续12周。比较2组患者治疗前及治疗后银屑病皮损面积和严重程度指数(PASI)评分,酶联免疫吸附试验(ELISA)测定血清白介素17A(IL-17A)、肿瘤坏死因子α(TNF-α)和肿瘤坏死因子样细胞凋亡弱诱导因子(TWEAK)的水平。另选同期健康体检者60例为健康对照组。结果与健康对照组相比,寻常型银屑病患者血清中的IL-17A、TNF-α和TWEAK水平明显升高(P<0.05),且三者水平有相关性;口服复方甘草酸苷组经治疗12周后,患者PASI评分较前下降,血清中的IL-17A、TNF-α和TWEAK水平较治疗前明显降低(P<0.05);针灸联合口服复方甘草酸苷组经治疗12周后,患者PASI评分较前下降,血清中的IL-17A、TNF-α和TWEAK水平较治疗前明显降低(P<0.05);治疗12周后,针灸联合口服复方甘草酸苷组血清中的IL-17A、TNF-α和TWEAK水平较口服复方甘草酸苷组下降更明显。结论针灸联合口服复方甘草酸苷较单纯口服复方甘草酸苷能更显著地下调血清中IL-17A、TNF-α和TWEAK的水平,改善寻常型银屑病患者的临床症状,值得临床推广。Objective To investigate the clinical efficacy of acupuncture combined with oral compound glycyrrhizin on psoriasis vulgaris.Methods A total of 120 patients with psoriasis vulgaris admitted from January 2018 to January 2022 were randomly divided into simple oral compound glycyrrhizin group and acupuncture combined with oral compound glycyrrhizin group,with 60 cases in each group.All patients in the two groups were given two compound glycyrrhizin tablets,t.i.d.Acupuncture on the acupoints of Sanyinjiao(SP6)and Taixi(KI3)was applied to psoriasis vulgaris patients with the blood heat type,while that on the Xuehai(SP10)and Geshu(BL17)was given to those with the blood stasis type.Acupuncture was performed once every other day for 12 weeks.The Psoriasis Area and Severity Index(PASI)before and after treatment was compared between groups.Enzyme-linked immunosorbent assay(ELISA)was used to determine serum levels of interleukin-17A(IL-17A),tumor necrosis factor-α(TNF-α),and tumor necrosis factor-like weak inducer of apoptosis(TWEAK).Sixty healthy subjects who underwent physical examination during the same period were selected as the healthy control group.Results Compared with the healthy control group,the serum levels of IL-17A,TNF-αand TWEAK in psoriasis vulgaris patients were significantly higher,showing a significant correlation(P<0.05).After 12 weeks of treatment,the PASI and serum levels of IL-17A,TNF-αand TWEAK in the simple oral compound glycyrrhizin group and the acupuncture combined with oral compound glycyrrhizin group were significantly reduced(all P<0.05).Serum levels of IL-17A,TNF-αand TWEAK in the acupuncture combined with oral compound glycyrrhizin group after 12 weeks of treatment were significantly lower than those of the simple oral compound glycyrrhizin group(P<0.05).Conclusion Acupuncture combined with oral compound glycyrrhizin can significantly reduce the levels of IL-17A,TNF-αand TWEAK in serum compared with oral compound glycyrrhizin alone,and relieve the clinical symptoms of psoriasis vulgari

关 键 词：针灸 复方甘草酸苷 寻常型银屑病 IL-17A TNF-α TWEAK 

分 类 号：R758.63[医药卫生—皮肤病学与性病学]