养血化斑汤治疗斑块型银屑病血燥证
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摘要
目的:观察养血化斑汤治疗斑块型银屑病血燥证的疗效及其对外周血肿瘤坏死因子-α(TNF-α)和血管内皮细胞生长因子(VEGF)的影响。方法:门诊纳入115例斑块型银屑病血燥证患者,随机分为治疗组和对照组,治疗组78例给予养血化斑汤治疗,对照组37例给予消银胶囊治疗,疗程8周;观察两组治疗前后银屑病皮损面积和严重程度指数评分(PASI)及中医症状变化;并采用酶联免疫吸附试验法(ELISA)检测治疗组治疗前后血清TNF-α和VEGF的水平。结果:养血化斑汤和消银胶囊能够显著改善斑块型银屑病血燥证PASI评分和中医症状(P<0.05),两组总有效率比较无差异,但在改善中医症状方面,治疗组优于对照组(P<0.05);斑块型银屑病血燥证患者血清TNF-α和VEGF水平较健康人群显著升高(P<0.01),养血化斑汤治疗后显著下降,其中TNF-α恢复到了正常水平(P<0.05)。结论:养血化斑汤对改善斑块型银屑病血燥证PASI评分和中医症状有良好疗效,其机制可能与拮抗TNF-α和VEGF从而抑制炎症及血管增生有关。
Objective: The aim of this study was to observe the clinical efficacy of Yangxue Huaban decoction( YXHB) and its effecton serum tumor necrosis factor-α( TNF-α) and vascular endothelial growth factor( VEGF) in treating the blood dryness syndrome of plaque type psoriasis. Method: In this study,one hundred and fifteen patients with the blood dryness syndrome of plaque type psoriasis were randomly divided into the treatment group and the control group. The 78 patients in the treatment group were treated with YXHB and the 37 patients in the control group were treated with Xiaoying capsule( XY). The changes in the score of psoriasis area,severity index( PASI) and the symptoms of traditional Chinese medicine were observed before and after treatment in two groups respectively. The levels of TNF-α and VEGF in serum of psoriastic patients before and after treatment in the treatment group were detected with enzyme-linked immunosorbnent assay( ELISA),with 30 healthy serum samples as healthy controls. The period of treatment was 8 weeks. Result: YXHB and XY apparently improved PASI score and the symptoms in TCM after treatment as compared with those before treatment( P < 0. 05). The total effective rate of YXHB was 78. 2%,with no significant difference compared with that of control group. YXHB relieved TCM symptoms much better than XY. Compared with healthy controls,the levels of TNF-α and VEGF with psoriastic patients were higher( P < 0. 05). And comparison of TNF-α and VEGF levels before and after treatment also showed significant differences( P < 0. 05). Conclusion: YXHB was effective in the treatment of the blood dryness syndrome of plaque type psoriasis. It reduced the levels of serum TNF-α and VEGF,which is partly responsible for the clinical efficacy.
Objective: The aim of this study was to observe the clinical efficacy of Yangxue Huaban decoction( YXHB) and its effecton serum tumor necrosis factor-α( TNF-α) and vascular endothelial growth factor( VEGF) in treating the blood dryness syndrome of plaque type psoriasis. Method: In this study,one hundred and fifteen patients with the blood dryness syndrome of plaque type psoriasis were randomly divided into the treatment group and the control group. The 78 patients in the treatment group were treated with YXHB and the 37 patients in the control group were treated with Xiaoying capsule( XY). The changes in the score of psoriasis area,severity index( PASI) and the symptoms of traditional Chinese medicine were observed before and after treatment in two groups respectively. The levels of TNF-α and VEGF in serum of psoriastic patients before and after treatment in the treatment group were detected with enzyme-linked immunosorbnent assay( ELISA),with 30 healthy serum samples as healthy controls. The period of treatment was 8 weeks. Result: YXHB and XY apparently improved PASI score and the symptoms in TCM after treatment as compared with those before treatment( P < 0. 05). The total effective rate of YXHB was 78. 2%,with no significant difference compared with that of control group. YXHB relieved TCM symptoms much better than XY. Compared with healthy controls,the levels of TNF-α and VEGF with psoriastic patients were higher( P < 0. 05). And comparison of TNF-α and VEGF levels before and after treatment also showed significant differences( P < 0. 05). Conclusion: YXHB was effective in the treatment of the blood dryness syndrome of plaque type psoriasis. It reduced the levels of serum TNF-α and VEGF,which is partly responsible for the clinical efficacy.
引文
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[12]李惠,原桂东,金亚宏,等.槐花饮片及其提取物止血作用的实验研究[J].中国中西医结合杂志,2004,24(11):1007-1009.
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[15]刘福君,赵修南,聂伟,等.地黄低聚糖增强小鼠免疫功能的作用[J].中国药理学学报,1998,14(1):90-92.
[16]韩凤梅,刘春霞,陈勇.山麦冬多糖对免疫低下小鼠的保护作用[J].中国医药学报,2004,19(6):347-348.
[17]刘蕾,朱秋双,王丽敏,等.复方威灵仙合剂抗炎、镇痛作用观察[J].黑龙江医药科学,2004,27(1):22-23.
[18]周效思,周凯,封芬.威灵仙对兔膝骨关节炎IL-1β,TNF-α,PGE2的影响[J].时珍国医国药,2011,22(5):1143-1144.
[19]刘玉琴.细胞因子与银屑病关系的研究进展[J].医学综述,2001,7(7):393-394.
[20]国冰芳,张小东.肿瘤坏死因子在炎症中的作用[J].国外医学生理病理科学与临床分册,1992,12(6):203-205.
[21]Viemann D,Goebeler M,Schmid S,et al.Transcriptional profiling of IKK2/NF-kappa B-and p38MAP kinase-dependent gene expression in TNF-alphastimulated primary human endothelial cells[J].Blood,2004,103(9):3365-3373.
[22]Sabat R,Wallace E,Endesfelder S,et al.IL-19 and IL-20:two novel cytokines with importance in inflammatory diseases[J].Expert Opin Ther Targets,2007,11(5):601-612.
[23]Bowcock A M,Krueger J G.Getting under the skin:the immunogenetics of psoriasis[J].Nature Reviews Immunology,2005,5(10):699-711.
[24]Dvorak A M,Feng D.The vesiculo-vacuolar organelle(VVO)A new endothelial cell permeability organelle[J].J Histochem Cytochem,2001,49(4):419-432.
[25]肖李李,黄进华.寻常型银屑病皮损血管内皮生长因子和血管细胞黏附分子的表达[J].中华皮肤科杂志,2007,40(6):376-377.
[26]杨海龙,粟玉珍,孙瑞,等.HIF-1α,VEGF在银屑病皮损中的表达及意义[J].医学信息,2011,24(1):340-342.
[2]冯峥,张郁,李恒进,等.寻常性银屑病患者血清α-肿瘤坏死因子水平及生物学活性检测与相关性研究[J].临床皮肤科杂志,2005,34(6):354-355.
[3]林新瑜,何飞,董丹丹,等.表皮生长因子受体在寻常型银屑病中的表达及其意义[J].实用医院临床杂志,2010,7(6):58-60.
[4]中华医学会.临床诊疗指南(皮肤病与性病分册)[M].北京:人民卫生出版社,2006:372.
[5]Fredriksson T,Pettersson U.Severe psoriasis-oral therapy with a new retinoid[J].Dermatologica,1978,157(4):238-244.
[6]姜春燕,邓丙戌,陈凯,等.从血论治话“白庀”[J].中医杂志,2005,46(7):157-158.
[7]邓红娟,郭延生,曲亚玲,等.生当归、酒当归和油当归体外清除自由基活性研究[J].中草药,2009,40(5):784-787.
[8]郭振军,刘莉,张维璐,等.大黄、当归多糖对巨噬细胞甘露糖受体作用的研究[J].细胞与分子免疫学杂志,2008,24(5):514-516.
[9]Sun Y,Tang J,Gu X,et al.Water-soluble polysaccharides from Angelica sinensis(Oliv.)Diels:preparation,characterization and bioactivity[J].Int J Biol Macromol,2005,36(5):283-289.
[10]Li R W,David Lin G,Myers S P,et al.Antiinflammatory activity of Chinese medicinal vine plants[J].J Ethnopharmacol,2003,85(1):61-67.
[11]Liao H,Banbury L K,Leach D N.Antioxidant activity of 45 Chinese herbs and the relationship with their TCM characteristics[J].Evid Based Complement Alternat Med,2008,5(4):429-434.
[12]李惠,原桂东,金亚宏,等.槐花饮片及其提取物止血作用的实验研究[J].中国中西医结合杂志,2004,24(11):1007-1009.
[13]马利华,贺菊萍,秦卫东,等.槐花提取物抗氧化性能研究[J].食品科学,2007,28(9):75-77.
[14]徐强,王蓉,徐丽华,等.土茯苓对细胞免疫和体液免疫的影响[J].中国免疫学杂志,1993,9(1):39-42.
[15]刘福君,赵修南,聂伟,等.地黄低聚糖增强小鼠免疫功能的作用[J].中国药理学学报,1998,14(1):90-92.
[16]韩凤梅,刘春霞,陈勇.山麦冬多糖对免疫低下小鼠的保护作用[J].中国医药学报,2004,19(6):347-348.
[17]刘蕾,朱秋双,王丽敏,等.复方威灵仙合剂抗炎、镇痛作用观察[J].黑龙江医药科学,2004,27(1):22-23.
[18]周效思,周凯,封芬.威灵仙对兔膝骨关节炎IL-1β,TNF-α,PGE2的影响[J].时珍国医国药,2011,22(5):1143-1144.
[19]刘玉琴.细胞因子与银屑病关系的研究进展[J].医学综述,2001,7(7):393-394.
[20]国冰芳,张小东.肿瘤坏死因子在炎症中的作用[J].国外医学生理病理科学与临床分册,1992,12(6):203-205.
[21]Viemann D,Goebeler M,Schmid S,et al.Transcriptional profiling of IKK2/NF-kappa B-and p38MAP kinase-dependent gene expression in TNF-alphastimulated primary human endothelial cells[J].Blood,2004,103(9):3365-3373.
[22]Sabat R,Wallace E,Endesfelder S,et al.IL-19 and IL-20:two novel cytokines with importance in inflammatory diseases[J].Expert Opin Ther Targets,2007,11(5):601-612.
[23]Bowcock A M,Krueger J G.Getting under the skin:the immunogenetics of psoriasis[J].Nature Reviews Immunology,2005,5(10):699-711.
[24]Dvorak A M,Feng D.The vesiculo-vacuolar organelle(VVO)A new endothelial cell permeability organelle[J].J Histochem Cytochem,2001,49(4):419-432.
[25]肖李李,黄进华.寻常型银屑病皮损血管内皮生长因子和血管细胞黏附分子的表达[J].中华皮肤科杂志,2007,40(6):376-377.
[26]杨海龙,粟玉珍,孙瑞,等.HIF-1α,VEGF在银屑病皮损中的表达及意义[J].医学信息,2011,24(1):340-342.