清热利湿饮治疗血热型银屑病及与SP、β-EP的相关性研究
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摘要
目的:观察导师应用清热利湿饮治疗血热型银屑病的临床疗效,并通过研究银屑病患者心理健康水平及对患者治疗前后P物质(SP)、β-内啡肽(β-EP)含量检测,观察清热利湿饮对神经肽的影响,探讨精神因素在银屑病发病中的重要作用。方法:将60例血热型银屑病患者随机分成两组,各30例,I治疗组予以清热利湿饮,II对照组予以清热凉血饮,疗程12周,观察皮损分布范围、红斑严重程度、鳞屑多少、浸润程度及瘙痒程度等。采用ZUNG自我评定抑郁量表(SDS)、ZUNG自我焦虑量表(SAS)调查30例银屑病患者发病前精神状态。治疗组取20例进行治疗前后SP、β-EP含量检测,并与20例健康成年人作对照。观察治疗组治疗前后SP、β-EP含量的变化。结果:治疗组治愈率56.67%,总有效率93.33%;对照组治愈率30.00%,总有效率70.00%。两组相比有差异性(P<0.05),治疗组疗效优于对照组。银屑病患者总体倾向有轻、中、重度的抑郁和焦虑,抑郁和焦虑的患者分别占总数的66.67%和76.67%。治疗后SP、β-EP含量较疗前显著降低,疗前疗后比较差异有显著性(P<0.01)。结论:清热利湿饮治疗血热型银屑病疗效确切,其作用机理可能是与调节精神因素、抗病原微生物、抑制表皮细胞增殖、抗炎、调节免疫、调节代谢障碍等有关;心理因素在银屑病的发生中起了重要作用。
Objective:To observe clinical efficacy of psoriasis of blood heat type patients treated with the Drink of Clearing Heat and Removing Damp by tutor. To observe the impact on neuropeptide by the Drink of Clearing Heat and Removing Damp through studying the mental and healthy level of psoriasis of blood heat type patients and the content of SP andβ-endorphin before and after treatment .To explore the effect on the occur of psoriasis by psychic factor. Method: 60 psoriasis of blood heat type patients were divided into two groups at random with the ratio of 1:1. Treatment group with the Drink of Clearing Heat and Removing Damp ,matched group with the drink of Clearing Heat and Cool The Blood. During 12 weeks’treatments,damage and distribution of skin, severity of erythema , quantity of dry scaly skin bits,degree of pruritus and soakage were observed.The psychic factors were studied with ZUNG Self-assess Depression Scale(SDS)and ZUNG Self-assess Anxiety Scale (SAS). We analysed changes of SP andβ-endorphin of 20 patients in treatment group before and after the treatment and was compared with 20 normal person’s.Results: Cure and obvious effect rate of The first group is 56.67% with total effect rate of 93.33%,Cure and obvious effect rate of The second group is 30.00% with total effect rate of 70.00%. there are difference between two groups(P<0.05).It was inclined to depression and anxiety of the mild and middling and severe degree in psoriatic patients. These were 66.67% and 76.67% respectively. After treatment ,the level of SP andβ-endorphin is decreased obviously, there are difference (P<0.01).Conclusion: Treating psoriasis of blood heat type with the clearing heat and removing damp has reliable efficacy and low recurrence rate. Adjusting psychosis and restrainting epidermal cell proliferation, anti-a inflammation effects,adjustments of immune and metabolical systems may act as its mechanisms.
Objective:To observe clinical efficacy of psoriasis of blood heat type patients treated with the Drink of Clearing Heat and Removing Damp by tutor. To observe the impact on neuropeptide by the Drink of Clearing Heat and Removing Damp through studying the mental and healthy level of psoriasis of blood heat type patients and the content of SP andβ-endorphin before and after treatment .To explore the effect on the occur of psoriasis by psychic factor. Method: 60 psoriasis of blood heat type patients were divided into two groups at random with the ratio of 1:1. Treatment group with the Drink of Clearing Heat and Removing Damp ,matched group with the drink of Clearing Heat and Cool The Blood. During 12 weeks’treatments,damage and distribution of skin, severity of erythema , quantity of dry scaly skin bits,degree of pruritus and soakage were observed.The psychic factors were studied with ZUNG Self-assess Depression Scale(SDS)and ZUNG Self-assess Anxiety Scale (SAS). We analysed changes of SP andβ-endorphin of 20 patients in treatment group before and after the treatment and was compared with 20 normal person’s.Results: Cure and obvious effect rate of The first group is 56.67% with total effect rate of 93.33%,Cure and obvious effect rate of The second group is 30.00% with total effect rate of 70.00%. there are difference between two groups(P<0.05).It was inclined to depression and anxiety of the mild and middling and severe degree in psoriatic patients. These were 66.67% and 76.67% respectively. After treatment ,the level of SP andβ-endorphin is decreased obviously, there are difference (P<0.01).Conclusion: Treating psoriasis of blood heat type with the clearing heat and removing damp has reliable efficacy and low recurrence rate. Adjusting psychosis and restrainting epidermal cell proliferation, anti-a inflammation effects,adjustments of immune and metabolical systems may act as its mechanisms.
引文
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[3]国家中医药管理局,中华人民共和国中医药行业标准·中医皮肤病证诊断疗效标准,1995年1月1日实施.
[4]赵炳南,张志礼.简明中医皮肤病学,北京:中国展望出版社,1983,200-204.
[5]金起风.消银汤治疗银屑病58例疗效观察.辽宁中医杂志,1983;7(6):29.
[6]吴京海,杨思源,金岚等.丹参素对银屑病患者外周血单个核细胞粘附分子表达的影响.上海医科大学学报,1998;25(1):47.
[7]顾伯华主编.实用中医外科学(治疗银屑病的经验).上海科学技术出版社,1版,1987;296.
[8]朱波刚,沈悦,岳辉清.芳香宣透解毒法治疗寻常型银屑病56例.江苏中医,2001;22(3):20.
[9]刘景昀,刘景钟.中药治疗银屑病40例.光明中医,2004;19(4):60-61.
[10] KIMGAJ—ASADI A,USMAN A.The role of psychological stress In skin disease[J].Cutan Mde Sury,2001,5(2):140-150.
[11] Farber EM et al.Int J Dermatol,1995;34:685-693
[12]张长宋,陈树民.银屑病治疗研究的一些进展.国外医学·皮肤性病学分册,2003,29(1):10-13.
[13] Jiang WYRaychandhuri SP,FarbeEM.Double-labeled immunofluorescence study of cutaneous nerves in psoriasis. Int J Dermatol,1998,37(8):572-574
[14] Glinski W et al.Br J Dermatol,1994;131:260-264
[15]谢安莉,王梦柏,李美丽.重型银屑病患者30例心理护理的体会.解放军护理杂志,2001;18(2):31.
[16] Harvima RJ, Viinamaki H,Likka T et al.Association of psychic stress with clinical severity and symptoms of psoriasis patients.Acta Derm Venerol,1996,76:467-471.
[17]攸俊琪.心理干预对银屑病病人病情转归的影响CHINESENURSING RESEARCH August,2007Vo1.21No.8C.
[18]杨雪琴.心身性皮肤病概述.临床皮肤科杂志33卷3期Clin Dermatol,March 2004,Vo1.33,No.3.
[19]王萍,陈青莲.柴胡炮制品对小白鼠全血胆碱酯酶活力的影响.中药材,2000;23(4):219-219.
[20]冯炎民,姜秋,孙延波等.金银花对不同血清型变形链球菌的抑菌实验研究.白求恩医科大学学报,1996;22(2):150.
[21]王丽娟,关显智,李菁华.中药双话对金黄色葡萄球菌R质粒消除作用的试验研究.武警医学,1996;7(6):345.
[22]周邦靖编著,常用中药的抗菌作用及其测定方法,第1版.重庆:科学技术文献出版社置庆分社,1987:54—55.
[23]刘青云主编.现代药理学,北京:人民卫生出版社,2002,第2版:249-251.
[24]时东彦,李仲兴.31种中药体外抑制金黄色葡萄球菌的活性研究.医药导报,2006;25(8):775-777.
[25]陈洪铎.皮肤性病学.第4版.北京:人民卫生出版社,1999,110-115.
[26]路又璐,秦建中.17味中药对培养的表皮细胞增殖的影响.临床皮肤科志,1996;(4):202-204.
[27]齐欣,刘晓明,林熙然.清热凉血和活血化瘀中药对小鼠实验性银屑病模型的影响.大连医科大学学报,2002;24(3):173-176.
[28]刘梅青.紫草提取物对实验性表皮细胞过度增殖的抑制作用.中国药物与临床,2003;3(3A):7-9.
[29]邱静帆,殷颖.车前子的药学研究及应用.浙江中西医结合杂志,2002;12(1):55.
[30]延卫东,王瑞君,杨养贤等.黄芩苷药理作用研究进展.陕西中医,2002;23(12):1127-1129.
[31]刘圣,沈爱宗.土茯苓研究进展.中医药学报,1997;(5):54-56.
[32]雷载权,陈松育,高学敏等.中药学.上海:上海科学技术出版社,1995,第1版:63.
[33]彭宗根,陈鸿珊.紫草酸B的药理作用研究进展.中国药学杂志,2003;38(10):744-747.
[34]刘圣,沈爱宗.土茯苓研究进展.中医药学报,1997;(5):54-56.
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