加味过敏煎联合度普利尤单抗治疗特应性皮炎风湿蕴肤证患者的疗效及对外周血T细胞亚群细胞的影响  

Curative effect of modified Guomin Decoction combined with duplizumab in the treatment of patients with atopic dermatitis of wind-damp stagnating in skin syndrome and its effect on peripheral blood helper T cell subsets

作　　者：姚荣[1] 李元文[1] 胡博 任雪雯 邓宇童 孟醒 YAO Rong;LI Yuan-wen;HU Bo(Department of Dermatology,Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学东方医院皮肤科,北京100078

出　　处：《临床和实验医学杂志》2025年第1期107-111,共5页Journal of Clinical and Experimental Medicine

基　　金：北京市自然科学基金(编号:7243181)。

摘　　要：目的观察加味过敏煎联合度普利尤单抗治疗特应性皮炎(AD)风湿蕴肤证患者的疗效及对外周血辅助性T细胞亚群细胞的影响。方法前瞻性选取2022年5月至2024年4月北京中医药大学东方医院收治的AD风湿蕴肤证患者216例作为研究对象。按照随机数表法将其分为对照组与观察组,每组各108例。对照组患者给予度普利尤单抗治疗,观察组在其基础上给予加味过敏煎联合治疗,两组均治疗3个月。比较两组疗效,治疗前、治疗3个月后特应性皮炎积分(SCORAD)评分、外周血Th1、Th2细胞比例、Th1/Th2、Th17细胞比例及血清炎症因子[白细胞介素(IL)-4、IL-17、γ干扰素(IFN-γ)]水平。统计治疗3个月期间两组不良反应发生情况。结果观察组疗效总有效率为98.15%,高于对照组(90.74%),差异有统计学意义(P<0.05)。治疗3个月后,两组皮肤病变范围、皮损程度、主观症状、SCORAD总分均较治疗前降低,且观察组皮肤病变范围、皮损程度、主观症状、SCORAD总分分别为(10.97±2.01)、(3.37±1.06)、(2.35±0.86)、(16.34±3.75)分,均低于对照组[(18.52±2.49)、(6.68±1.37)、(3.27±1.04)、(23.81±5.48)分],差异均有统计学意义(P<0.05)。治疗3个月后,两组外周血Th1、Th1/Th2均较治疗前升高,Th2、Th17均较治疗前降低,且观察组外周血Th1、Th1/Th2分别为(14.17±2.95)%、2.17±0.35,均高于对照组[(12.23±2.16)%、1.74±0.26],Th2、Th17分别为(6.54±1.09)%、(19.36±3.44)%,均低于对照组[(7.02±1.23)%、(20.89±3.81)%],差异均有统计学意义(P<0.05)。治疗3个月后,两组血清IL-4、IL-17水平均较治疗前降低,IFN-γ水平均较治疗前升高,且观察组血清IL-4、IL-17水平分别为(7.59±1.10)、(20.69±3.29)ng/L,均低于对照组[(9.01±1.13)、(21.64±3.38)ng/L],IFN-γ水平为(18.02±3.65)ng/L,高于对照组[(16.46±3.21)ng/L],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)。结论加味过敏Objective To observe the curative effect of modified Guomin Decoction combined with duplizumab in the treatment of patients with atopic dermatitis(AD)of wind-damp stagnating in skin syndrome and its effect on peripheral blood helper T cell subsets.Methods A total of 216 patients with AD rheumatic skin syndrome admitted to Dongfang Hospital,Beijing University of Chinese Medicine from May 2022 to April 2024 were prospectively selected as the research objects.According to the random number table method,they were divided into the control group and the observation group,108 cases in each group.Patients in the control group were treated with dupilumab,and those in the observation group were treated with modified Guomin Decoction combined with dupilumab.Both groups were treated for 3 months.The therapeutic effects,scoring of atopic dermatitis(SCORAD)scores,the proportions of Th1,Th2 and Th17 cells in peripheral blood,and the levels of serum inflammatory factors[interleukin(IL)-4,IL-17 and interferon-γ(IFN-γ)]before and after 3 months of treatment of the two groups were compared.The incidence of adverse reactions in the two groups during 3 months of treatment was statistically analyzed.Results The total effective rate of the observation group was 98.15%,which was higher than that of the control group(90.74%),and the difference was statistically significant(P<0.05).After 3 months of treatment,the range of skin lesions,the degree of skin lesions,subjective symptoms and the total score of SCORAD in the two groups were lower than those before treatment.The range of skin lesions,the degree of skin lesions,subjective symptoms and the total score of SCORAD in the observation group were(10.97±2.01),(3.37±1.06),(2.35±0.86)and(16.34±3.75)points,respectively,which were lower than those in the control group[(18.52±2.49),(6.68±1.37),(3.27±1.04)and(23.81±5.48)]points,the differences were statistically significant(P<0.05).After 3 months of treatment,Th1 and Th1/Th2 in peripheral blood of the two groups were higher than those

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分 类 号：R73[医药卫生—肿瘤]