中西医结合治疗天疱疮的疗效观察  

The clinical and laboratory research for Chinese traditional medicine in the treatment of pemphigus

作　　者：骆肖群[1] 祝禄川[1] 陶玲娣[1] 苏玮[1] 傅海军[2] 郑志忠[1] 蔡定芳[3] 翁孟武[1] 

机构地区：[1]复旦大学附属华山医院皮肤科,上海200040 [2]上海第二医科大学爱尔药物研究及临床药理中心,上海200025 [3]复旦大学中西医结合研究所,上海200040

出　　处：《临床皮肤科杂志》2003年第1期38-41,共4页Journal of Clinical Dermatology

摘　　要：目的:进行清热利湿中药方剂(Chinesetraditionaldrugs,CTD)联合糖皮质激素(corticosteroids,CS)和单用CS治疗天疱疮的临床对照研究,以及CTD治疗天疱疮作用机制的实验室研究。方法:选取年龄、皮损数量、病程、天疱疮抗体滴度及血清白介素-10(IL-10)、γ-干扰素(IFN-γ)和可溶性白介素2受体(sIL-2R)水平相当的急性发病期天疱疮患者40例,按区组随机法分为两组,一组以清热利湿方剂“天疱疮Ⅰ号”联合CS治疗,另一组单用CS治疗,比较两组在皮损愈合时间、皮损控制时的CS用量、抗体滴度、细胞因子水平等方面有无差别。同时建立天疱疮体外器官培养模型,将不同浓度的氢化可的松(HC)加入此模型中,观察抑制棘层细胞松解所需的HC用量;将按无毒限量稀释的“天疱疮Ⅰ号”与HC同时加入此模型中,观察“天疱疮Ⅰ号”有无抑制棘层细胞松解的作用。结果:“天疱疮Ⅰ号”联合CS治疗组与CS单独治疗组相比,皮损愈合时间缩短,但没有统计学意义(P>0.05);CS用量显著减少(P<0.05);抗体滴度下降没有差异(P>0.05);IFN-γ下降幅度明显增加(P<0.05)。天疱疮器官培养模型中,抑制棘层细胞松解所需的HC用量为1×10-3mol/L;但加入1∶100的“天疱疮Ⅰ号”后,0.5×10-3mol/LHC即可基本抑制棘层细胞松解。结论:“天疱疮Ⅰ号”Objective:To study the clinical efficacy of Chinese traditional medicine(CTM)in pemphigus.Methods:Forty patients with acute pem phi gus were divided randomly into two groups:one group was treated with CTM combined with corticosteroids(CS),and the anoth er group was treated with CS alone.The clinical efficacy was evaluated by investigat-ing the disap pearance of le sions,the amount of CS used,the titer of antibody and the serum level of IL-10,IFN-γand sIL-2R.Furthermore,CTM was also added into the cultured skin organ model of pemphigus in vitro to observing its effect on the inhibition of acantholysis by hydro cortisone(HC).Re sults:The clini cal results showed that,comparing with the group treated with CS only,the lesions disappeared more quickly(but no statistic difference),the dosage of CS was much lower(P<0.05)and the serum level of IFN-γdecreased more quickly(P<0.05)in the patients treated with CS and CTM.The skin organ cultures showed that the acantholysis was inhibited completely by0.5×10 -3 mol/L HC plus CTM,but it did not work by HC alone in same con centra tion.Conclusions:These studies suggest that the combi nation of CTM and CS could be a good choice,by which the dosage of corticosteroids might be reduced in the treatment of pem phi gus.

关 键 词：中西医结合治疗 天疱疮 疗效 天疱疮1号 皮质类固醇 细胞因子 

分 类 号：R758.66[医药卫生—皮肤病学与性病学]