洗方1号结合半枝莲方及卡泊三醇搽剂治疗血热证头皮银屑病的临床观察
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摘要
目的:观察洗方1号结合半枝莲方及卡泊三醇搽剂治疗血热证头皮银屑病的临床疗效并初步探索其作用机理。方法:将62例血热证头皮银屑病患者随机分成两组,对照组30例内服半枝莲方并外擦卡泊三醇搽剂,治疗组32例在对照组基础上加用洗方1号头部外洗。于治疗前和治疗后分别对两组患者进行PASI评分、DLQI评分和VAS评分,对患者进行皮损马拉色菌培养鉴定。结果:血热证头皮银屑病患者PASI评分、VAS评分和DLQI评分存在相关性(P<0.01)。治疗后治疗组总有效率、PASI评分(D21、D28)、VAS评分(D7、D14)和DLQI评分与对照组比较,差异均有统计学意义(P<0.05)。皮损培养马拉色菌阳性患者中,治疗组PASI、VAS和DLQI评分与对照组比较,差异有统计学意义(P<0.05),而阴性患者中两组PASI评分和DLQI评分比较,差异无统计学意义(P>0.05)。结论:洗方1号结合半枝莲方及卡泊三醇搽剂治疗热证头皮银屑病有较好疗效,能改善皮损,缓解瘙痒症状。
Objective: To observe the clinical efficacy of Xifang No.1, Banzhilian recipe combined with calcipotriol liniment in the treatment of scalp psoriasis with blood-heat syndrome and to explore its mechanism.Methods: A total of 62 patients with scalp psoriasis with blood-heat syndrome were randomly divided into two groups. 30 patients in the control group were given Banzhilian recipe and capotetriol liniment. 32 patients in the treatment group were given scalp washing Xifang No.1 on the basis of the control group. PASI score, DLQI score and VAS score were performed on the patients before and after treatment, and the patients were identified by Malassezia culture. Results: There were correlations among PASI score, VAS score and DLQI score in patients with scalp psoriasis of blood-heat syndrome(P<0.01). After treatment, the total effective rate, PASI score(D21, D28), VAS score(D7, D14) and DLQI scores in the treatment group were significantly different from those in the control group(P<0.05). Among the patients with malassezia positive lesions, PASI, VAS and DLQI scores in the treatment group were significantly different from those in the control group(P<0.05), while there was no significant difference in PASI and DLQI scores in patients with malassezia negative lesions(P>0.05). Conclusion:Xifang No.1, Banzhilian recipe combined with calcipotriol liniment can provide good clinical efficacy on scalp psoriasis with blood-heat syndrome, reduce skin lesion and relieve itching.
Objective: To observe the clinical efficacy of Xifang No.1, Banzhilian recipe combined with calcipotriol liniment in the treatment of scalp psoriasis with blood-heat syndrome and to explore its mechanism.Methods: A total of 62 patients with scalp psoriasis with blood-heat syndrome were randomly divided into two groups. 30 patients in the control group were given Banzhilian recipe and capotetriol liniment. 32 patients in the treatment group were given scalp washing Xifang No.1 on the basis of the control group. PASI score, DLQI score and VAS score were performed on the patients before and after treatment, and the patients were identified by Malassezia culture. Results: There were correlations among PASI score, VAS score and DLQI score in patients with scalp psoriasis of blood-heat syndrome(P<0.01). After treatment, the total effective rate, PASI score(D21, D28), VAS score(D7, D14) and DLQI scores in the treatment group were significantly different from those in the control group(P<0.05). Among the patients with malassezia positive lesions, PASI, VAS and DLQI scores in the treatment group were significantly different from those in the control group(P<0.05), while there was no significant difference in PASI and DLQI scores in patients with malassezia negative lesions(P>0.05). Conclusion:Xifang No.1, Banzhilian recipe combined with calcipotriol liniment can provide good clinical efficacy on scalp psoriasis with blood-heat syndrome, reduce skin lesion and relieve itching.
引文
[1]刘勇,孙丹,闫小宁.半枝莲方治疗银屑病血热证的临床观察[J].中医药导报,2018,24(2):81-83.
[2]赵辨.中国临床皮肤病学[M].南京:江苏科学技术出版社,2010:1012.
[3]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:299-302.
[4]中国医师协会皮肤科医师分会中西医皮肤科亚专业委员会.中成药治疗寻常性银屑病专家共识(2014)[J].中华皮肤科杂志,2014,47(3):215-216.
[5] LJOSAA T M,STUBHAUG A,MORK C. Improvement in Psoriasis Area and Severity Index score predicts improvement in skin pain over time in patients with psoriasis[J].Acta Derm Venereol,2013,93(3):330-334.
[6]朱定仙,吴银华,白娟,等.银屑病的瘙痒特征及相关因素分析[J].中国中西医结合皮肤性病学杂志,2017,16(5):412-414.
[7] CHEN S C,YEUNG J,CHREN M M. Scalpdex:a quality-of-life instrument for scalp dermatitis[J].Arch Dermatol,2002,138(6):803-807.
[8]李祝莲,王建湘.中西医结合治疗慢性荨麻疹54例临床观察[J].中医药导报,2013,19(2):51-52.
[9]张勇.姜黄治疗寻常型银屑病的临床疗效及外周血免疫学指标变化[D].青岛:青岛大学,2004.
[10] WOZEL G, KLEIN E, MROWIETZ U, et al. Scalp psoriasis[J].J Dtsch Dermatol Ges,2011,9(1):70-74.
[11] VIEIM P L, JONG E C, WIERENGA E A, et al.Development of Th1-inducing capacity in myeloid dendritic celIs requires enviomental instuction[J]. J Immunol,2000,164(9):4507-4512.
[12] MATTOZZI C, RIRCHETTA A G, CANTISANI C.Psoriasis:new insight about pathogenesis,role of barrier organ integrity,NLR/CATERPILLER family genes and microbial flora[J].J Dermatol,2012,39(9):752-760.
[13] NARANG T, DOGRA S, KAUR I, et al. Malassezia and psoriasis:Koebner's phenomenon or direct causation[J]. J Eur Acad Dermatol Venereol,2007,21(8):1111-1112.
[14]苗雨露,张雯霞,王玉娥,等.清热解毒类中药抗炎机制研究进展[J].中国实验方剂学杂志,2018,24(8):1-7.
[15]贺锐锐,刘永刚,魏敏吉,等.紫草组分的抗肿瘤活性及其凋亡机制研究[J].中国临床药理学杂志,2012,28(1):43-45,52.
[16]王振龙,何霞,成明,等.地榆皂苷Ⅱ抑制肿瘤细胞增殖和诱导其凋亡的作用[J].华西药学杂志,2017,32(5):485-488.
[17]赵燕强,杨立新,张宪民,等.威灵仙的成分、药理活性和临床应用的研究进展[J].中药材,2008,31(3):465-470.
[18]戴岳,夏玉凤,陈海标,等.地肤子70%醇提物抑制速发型及迟发型变态反应[J].中国现代应用药学,2001,18(1):8-10.
[19]裴小平,杨斌,陈文静,等.白鲜皮提取液对湿疹模型小鼠血清IL-10、IL-17和IL-22含量的影响[J].皮肤性病诊疗学杂志,2017,24(3):168-172.
[2]赵辨.中国临床皮肤病学[M].南京:江苏科学技术出版社,2010:1012.
[3]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:299-302.
[4]中国医师协会皮肤科医师分会中西医皮肤科亚专业委员会.中成药治疗寻常性银屑病专家共识(2014)[J].中华皮肤科杂志,2014,47(3):215-216.
[5] LJOSAA T M,STUBHAUG A,MORK C. Improvement in Psoriasis Area and Severity Index score predicts improvement in skin pain over time in patients with psoriasis[J].Acta Derm Venereol,2013,93(3):330-334.
[6]朱定仙,吴银华,白娟,等.银屑病的瘙痒特征及相关因素分析[J].中国中西医结合皮肤性病学杂志,2017,16(5):412-414.
[7] CHEN S C,YEUNG J,CHREN M M. Scalpdex:a quality-of-life instrument for scalp dermatitis[J].Arch Dermatol,2002,138(6):803-807.
[8]李祝莲,王建湘.中西医结合治疗慢性荨麻疹54例临床观察[J].中医药导报,2013,19(2):51-52.
[9]张勇.姜黄治疗寻常型银屑病的临床疗效及外周血免疫学指标变化[D].青岛:青岛大学,2004.
[10] WOZEL G, KLEIN E, MROWIETZ U, et al. Scalp psoriasis[J].J Dtsch Dermatol Ges,2011,9(1):70-74.
[11] VIEIM P L, JONG E C, WIERENGA E A, et al.Development of Th1-inducing capacity in myeloid dendritic celIs requires enviomental instuction[J]. J Immunol,2000,164(9):4507-4512.
[12] MATTOZZI C, RIRCHETTA A G, CANTISANI C.Psoriasis:new insight about pathogenesis,role of barrier organ integrity,NLR/CATERPILLER family genes and microbial flora[J].J Dermatol,2012,39(9):752-760.
[13] NARANG T, DOGRA S, KAUR I, et al. Malassezia and psoriasis:Koebner's phenomenon or direct causation[J]. J Eur Acad Dermatol Venereol,2007,21(8):1111-1112.
[14]苗雨露,张雯霞,王玉娥,等.清热解毒类中药抗炎机制研究进展[J].中国实验方剂学杂志,2018,24(8):1-7.
[15]贺锐锐,刘永刚,魏敏吉,等.紫草组分的抗肿瘤活性及其凋亡机制研究[J].中国临床药理学杂志,2012,28(1):43-45,52.
[16]王振龙,何霞,成明,等.地榆皂苷Ⅱ抑制肿瘤细胞增殖和诱导其凋亡的作用[J].华西药学杂志,2017,32(5):485-488.
[17]赵燕强,杨立新,张宪民,等.威灵仙的成分、药理活性和临床应用的研究进展[J].中药材,2008,31(3):465-470.
[18]戴岳,夏玉凤,陈海标,等.地肤子70%醇提物抑制速发型及迟发型变态反应[J].中国现代应用药学,2001,18(1):8-10.
[19]裴小平,杨斌,陈文静,等.白鲜皮提取液对湿疹模型小鼠血清IL-10、IL-17和IL-22含量的影响[J].皮肤性病诊疗学杂志,2017,24(3):168-172.