紫草素结合解毒化瘀通络方治疗复发性中重度斑块型银屑病的临床研究  

Clinical study on the treatment of recurrent moderate-to-severe plaque-type psoriasis with a combination of comfreyin and detoxification,stasis-resolving and collateral-passing formulae

作　　者：邢溦 郭雯[1] 郭建辉[1] XING Wei;GUO Wen;GUO Jian-hui(Department of Dermatology,Cangzhou Hospital of Integrated Traditional and Western Medicine,Cangzhou Hebei 061001,China;Department of Traditional Chinese Surgery,Hebei University of Traditional Chinese Medicine,Shijiazhuang Hebei 050001,China)

机构地区：[1]沧州中西医结合医院皮肤科,河北沧州061001 [2]河北中医药大学中医外科学教研室,河北石家庄050001

出　　处：《临床和实验医学杂志》2024年第24期2668-2673,共6页Journal of Clinical and Experimental Medicine

基　　金：河北省中医药管理局关于2023年度中医药类科学研究课题计划项目(编号:2023440)。

摘　　要：目的观察紫草素结合解毒化瘀通络方治疗复发性中重度斑块型银屑病的临床效果。方法前瞻性选取2021年5月至2023年12月沧州中西医结合医院皮肤科收治的复发性中重度斑块型银屑病患者116例作为研究对象,按照简单随机法分为西药组和中西结合组,每组各58例。西药组给予乌司奴单抗治疗,中西结合组在西药组基础上给予紫草素结合解毒化瘀通络方治疗。比较两组治疗前、治疗8周后的中医证候评分、皮肤病生活质量指数(DLQI)、严重程度指数(PASI)评分、体表受累面积、皮肤生理屏障功能、银屑病面积与巨噬细胞集落刺激因子(M-CSF)、单核细胞趋化蛋白-1(MCP-1)、CD4^(+)T淋巴细胞群差异。记录两组的不良反应发生情况。结果治疗8周后,两组中医证候评分均较治疗前降低,且中西结合组的中医证候评分均低于西药组,差异均有统计学意义(P<0.05)。治疗8周后,两组DLQI评分、PASI评分和体表受累面积均较治疗前降低,且中西结合组的DLQI评分、PASI评分和体表受累面积均低于西药组,差异均有统计学意义(P<0.05)。治疗8周后,两组角质层含水量、皮脂含量均较治疗前升高,经表皮水分丢失量均较治疗前降低,且中西结合组的角质层含水量、皮脂含量均低于西药组,经表皮水分丢失量低于对照组,差异均有统计学意义(P<0.05)。治疗8周后,两组MCP-1、M-CSF水平均较治疗前降低,且中西结合组的MCP-1、M-CSF水平均低于西药组,差异均有统计学意义(P<0.05)。治疗8周后,两组Th1、Th17均较治疗前降低,Th2、Treg均较治疗前升高,且中西结合组的Th1、Th17低于对照组,Th2、Treg均低于西药组,差异均有统计学意义(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)。结论紫草素结合解毒化瘀通络方治疗复发性中重度斑块型银屑病可下调炎症反应免疫应答,减轻症状,改善皮肤生理屏障功能。Objective To observe the clinical effect of ziziphusin combined with detoxification,resolving blood stasis and circulation formula in the treatment of recurrent moderate-to-severe plaque-type psoriasis.Methods A total of 116 patients with recurrent moderate to severe plaque psoriasis admitted to the Department of Dermatology,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from May 2021 to December 2023 were prospectively selected and divided into the Western medicine group and the Chinese-Western medicine combination group according to the simple random method,with 58 cases in each group.The Western medicine group was treated with ustekinumab.The Chinese-Western medicine combination group was treated with ustekinumab combined with licorice and a decoction that promotes blood circulation and removes stasis,on the basis of the Western medicine group.The Chinese medicine syndrome scores,body surface affected area,dermatology life quality index(DLQI)score,skin physiological barrier function,psoriasis area and severity index(PASI)score,macrophage colony stimulating factor(M-CSF),monocyte chemoattractant protein-1(MCP-1),and CD4^(+)T lymphocyte subset differences were compared before and after 8 weeks of treatment between the two groups.The occurrence of adverse reactions in the two groups was recorded.Results After 8 weeks of treatment,the scores of chinese medicine syndromes in the two groups were lower than those before treatment,and the scores of chinese medicine syndromes in the Chinese-Western medicine combination group were lower than those in the western medicine group,the differences were statistically significant(P<0.05).After 8 weeks of treatment,the DLQI score,PASI score and body surface affected area of the two groups were lower than those before treatment,and the DLQI score,PASI score and body surface affected area of the Chinese-Western medicine combination group were lower than those of the Western medicine group,the differences were statistically significant(P<0.05).After 8 wee

关 键 词：银屑病 紫草素 解毒化瘀通络方 复发性 皮肤生理屏障功能 

分 类 号：R75[医药卫生—皮肤病学与性病学]