脾虚湿盛证寻常型银屑病皮肤屏障功能指标调查研究  

Study on skin barrier function in psoriasis vulgaris with spleen deficiency and dampness syndrome

作　　者：左永杰 姚文汇 许孟月 刘红霞[2] ZUO Yong-jie;YAO Wen-hui;XU Meng-yue;LIU Hong-xia(Fourth Clinical Medical College of Xinjiang Medical University,Urumqi 830000,Xinjiang,China)

机构地区：[1]新疆医科大学第四临床医学院,新疆乌鲁木齐830000 [2]新疆医科大学附属中医医院皮肤科,新疆乌鲁木齐830000

出　　处：《广东医学》2025年第1期48-53,共6页Guangdong Medical Journal

基　　金：国家自然科学基金项目(81960871);新疆维吾尔自治区重点研发计划项目(2021B03001-2)。

摘　　要：目的通过对脾虚湿盛证寻常型银屑病患者的临床调查,并与正常人进行对比,了解脾虚湿盛证寻常型银屑病患者皮肤屏障功能变化情况,初步探索脾虚导致的水湿代谢紊乱是否与银屑病的皮肤屏障功能的破坏具有临床上的相关性。方法研究共纳入研究对象162例,其中病例组132例,来自于2022年2月至2023年12月就诊于皮肤科门诊的132例脾虚湿盛证银屑病患者,30例健康志愿者作为对照组,分别检测病例组的皮损处、皮损与正常皮肤交界处、距离皮损10 cm的正常皮肤处和对照组皮肤角质层含水量(stratum corneum hydration,SCH)、经皮水分丢失量(trans-epidermal water loss,TEWL)、皮肤酸碱度值(potential of hydrogen,pH),分析脾虚湿盛证寻常型银屑病皮损处、皮损与正常皮肤交界处、距离皮损10 cm的正常皮肤处和健康志愿者皮肤屏障功能的差异性。结果与健康人群比较,脾虚湿盛证寻常型银屑病患者皮损处、皮损与正常皮肤交界处、距离皮损10 cm的正常皮肤的pH值[5.9(5.6,6.1)vs.5.05(4.6,5.4),5.6(5.4,5.9)vs.5.05(4.6,5.4),5.3(5.1,5.6)vs.5.05(4.6,5.4)]、TEWL较高[15(13,18)g/hm^(2)vs.10(9,11)g/hm^(2),13.5(11,15)g/hm^(2)vs.10(9,11)g/hm^(2),11(10,13)g/hm^(2)vs.10(9,11)g/hm^(2)],SCH偏低[17(14,19)%vs.43(41,44.25)%,21(18,24)%vs.43(41,44.25)%,43(41,44.25)%vs.43(41,44.25)%](P均<0.05)。与皮损区相比,距离皮损10 cm的正常皮肤处的SCH高于皮损处,差异有统计学意义(P<0.05);距离皮损10 cm的正常皮肤处的TEWL、pH值低于皮损区,差异有统计学意义(P<0.05)。结论脾虚湿盛证寻常型银屑病患者皮肤屏障功能遭到破坏,这也提示我们临床上加强皮肤屏障功能的修复,将有助于减轻银屑病的皮损症状,改善患者皮肤的干燥瘙痒。Objective To investigates the changes in skin barrier function in patients with psoriasis vulgaris with spleen deficiency and dampness syndrome and compares them with healthy controls to explore whether the disrupted water metabolism associated with spleen deficiency is clinically related to skin barrier dysfunction in psoriasis.Methods A total of 162 participants were enrolled,including 132 patients diagnosed with spleen deficiency and dampness syndrome psoriasis vulgaris(case group)and 30 healthy volunteers(control group).Measurements included stratum corneum hydration(SCH),transepidermal water loss(TEWL),and skin pH at the psoriatic lesions,the border between lesions and normal skin,and areas 10 cm away from the lesions.These metrics were compared to those in the control group to assess differences in skin barrier function.Results Compared with healthy controls,psoriatic patients exhibited significantly higher pH values[5.9(5.6,6.1)vs.5.05(4.6,5.4),5.6(5.4,5.9)vs.5.05(4.6,5.4),5.3(5.1,5.6)vs.5.05(4.6,5.4)],increased TEWL[15(13,18)g/hm^(2)vs.10(9,11)g/hm^(2),13.5(11,15)g/hm^(2)vs.10(9,11)g/hm^(2),11(10,13)g/hm^(2)vs.10(9,11)g/hm^(2)],and lower SCH[17(14,19)%vs.43(41,44.25)%,21(18,24)%vs.43(41,44.25)%,43(41,44.25)%vs.43(41,44.25)%]at the psoriatic lesions,the border between lesions and horman skin,and areas 10 cm away from the lesions(P<0.05).SCH at 10 cm from the lesion was significantly higher than at the lesion itself(P<0.05),while TEWL and pH were significantly lower at 10 cm from the lesion than at the lesion(P<0.05).Conclusion Psoriasis vulgaris patients with spleen deficiency and dampness syndrome show marked impairment of skin barrier function.This highlights the need for clinical efforts to restore skin barrier integrity,potentially alleviating psoriatic symptoms such as dryness and pruritus.

关 键 词：脾虚湿盛证 银屑病 屏障功能 调查研究 

分 类 号：R275.9[医药卫生—中西医结合] R751[医药卫生—中医皮科]