清热凉血解毒汤治疗血热型寻常性银屑病疗效及对外周血炎症因子的影响
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摘要
目的探讨清热凉血解毒汤治疗血热型寻常性银屑病的临床疗效及对外周血炎症因子的影响。方法选取我院2014年6月-2016年7月收治的108例血热型寻常性银屑病患者,采取随机数字表将其分成两组,每组54例。两组患者均给予常规西药治疗,观察组加用清热凉血解毒汤治疗,比较两组临床疗效、治疗前后银屑病面积与严重性指数(PASI)评分、主要证候积分、外周血炎症因子水平以及生活质量变化情况。结果观察组治疗总有效率为92.59%,与对照组(66.67%)相比有明显上升(P<0.01)。两组治疗后PASI评分与治疗前比较有显著下降(P<0.01)。两组患者治疗后瘙痒、红斑、心烦、口干口渴积分均较治疗前有明显下降(P<0.01),观察组治疗后各项主要证候积分均明显低于对照组治疗后(P<0.01)。两组患者治疗后生理状态、日常活动、心理状态、社交娱乐评分均较治疗前有明显下降(P<0.01)。两组患者治疗后血清IL-6,IL-8,TNF-α水平均明显低于治疗前(P<0.01)。结论清热凉血解毒汤治疗血热型寻常性银屑病可有效缓解临床症状、减轻机体炎症反应,疗效确切。
Objective To assess the clinical efficacy of Qingre Liangxue Jiedu decoction in treating blood heat type of psoriasis vulgaris and its effect on peripheral blood cytokines. Methods In our hospital from June 2014 to July 2016,108 cases of patients with blood heat type of psoriasis vulgaris were randomly divided into the treatment and control groups,54 cases per group. Both groups were given conventional western medicines.Patients in the treatment group were also treated with Qingre Liangxue Jiedu decoction. Both clinical efficacy and changes in psoriasis area and PASI scores,main symptom scores,levels of peripheral blood cytokines and the quality of life were compared between the two groups following the treatment. Results The total effective rates were significantly higher in the treatment group than in the controls(92. 59% vs. 66. 67%,P< 0. 01). Although both groups displayed a significant reduction in PASI scores( P < 0. 01). Similarly,the treatment group showed more significant improvement in symptom scores,including pruritus,erythema,upset,dry mouth and thirsty even though both groups achieved significant improvement( P < 0. 01). Moreover,both groups also showed significant improvements in other parameters such as physiological status,daily activities,psychological status,social entertainment scores and serum levels of IL-6,IL-8 and TNF-α( P <0. 01). Conclusion Qingre Liangxue Jiedu decoction is effective for blood heat type of psoriasis vulgaris.
Objective To assess the clinical efficacy of Qingre Liangxue Jiedu decoction in treating blood heat type of psoriasis vulgaris and its effect on peripheral blood cytokines. Methods In our hospital from June 2014 to July 2016,108 cases of patients with blood heat type of psoriasis vulgaris were randomly divided into the treatment and control groups,54 cases per group. Both groups were given conventional western medicines.Patients in the treatment group were also treated with Qingre Liangxue Jiedu decoction. Both clinical efficacy and changes in psoriasis area and PASI scores,main symptom scores,levels of peripheral blood cytokines and the quality of life were compared between the two groups following the treatment. Results The total effective rates were significantly higher in the treatment group than in the controls(92. 59% vs. 66. 67%,P< 0. 01). Although both groups displayed a significant reduction in PASI scores( P < 0. 01). Similarly,the treatment group showed more significant improvement in symptom scores,including pruritus,erythema,upset,dry mouth and thirsty even though both groups achieved significant improvement( P < 0. 01). Moreover,both groups also showed significant improvements in other parameters such as physiological status,daily activities,psychological status,social entertainment scores and serum levels of IL-6,IL-8 and TNF-α( P <0. 01). Conclusion Qingre Liangxue Jiedu decoction is effective for blood heat type of psoriasis vulgaris.
引文
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[14]田海刚,胡帅,尤立平,等.凉血解毒汤对寻常性银屑病血热证患者外周血Th17细胞相关细胞因子的影响[J].中日友好医院学报,2014,28(4):212-215.
[15]祁战涛.凉血解毒汤治疗寻常性银屑病的疗效观察[J].陕西中医,2016,37(8):1033-1034.
[16]Silver S,Tuppal R,Gupta AK,et al.Effect of calcipotriene plus betamethasone dipropionate topical suspension on the hypothalamic-pituitary-adrenal axis and calcium homeostasis in subjects with extensive psoriasis vulgaris:an open,non-controlled,8-week trial[J].Journal of drugs in dermatology,2013,12(8):882-887.
[17]沈芳,谢韶琼.细胞因子与银屑病发病关系的研究进展[J].中国麻风皮肤病杂志,2015,31(3):156-159.
[18]孙月,胡秀伟,甄志贤,等.清热消银汤治疗血热风盛型寻常性银屑病疗效分析[J].现代中西医结合杂志,2015,24(3):297-298,331.
[19]李生存,马文宇,燕华玲.解毒化瘀汤对银屑病患者的疗效及炎性因子水平的影响[J].中药材,2014,37(7):1307-1309.
[2]谢少梅.生物反馈放松疗法治疗寻常性银屑病疗效评价[J].中国麻风皮肤病杂志,2016,32(9):541-543.
[3]宋红霞,薛晓东.消银汤对寻常性银屑病血热证疗效及对外周血Th17细胞相关细胞因子表达水平的影响[J].重庆医学,2016,45(23):3267-3269.
[4]孙文,陈雨佳,邓婉莹,等.银屑I号对咪喹莫特诱导小鼠银屑病模型核转录因子-κB的调控作用及机制[J].中国皮肤性病学杂志,2017,31(1):79-94.
[5]段茜,程燕,储雷,等.中药药浴联合NB-UVB照射治疗寻常性银屑病疗效及安全性的系统评价[J].中国皮肤性病学杂志,2013,27(2):192-195.
[6]赵辨,张振楷,倪容之,等.临床皮肤病学[M].3版.南京:江苏科学技术出版社,2001:759-772.
[7]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.
[8]Van de Kerkhof PC.The psoriasis area and severity index and alternative approaches for the assessment of severity:persisting areas of confusion[J].Br J Dermatol,1997,137(4):661-662.
[9]中华人民共和国卫生部.中药新药临床研究指导原则[M].北京:中国医药科技出版社,1993:198.
[10]Mazzotti E,Picardi A,Sampogna F,et al.Sensitivity of the dermatology life quality index to clinical change in patients with psoriasis[J].Br Dermatol,2003,149(2):318-322.
[11]赵辩.中国临床皮肤病学[M].南京:江苏科学技术出版社,2003:1165-1169.
[12]Emre S,Metin A,Demirseren DD,et al.The relationship between oxidative stress,smoking and the clinical severity of psoriasis[J].J Eur Acad Dermatol Venereol,2013,27(3):e370-375.
[13]刘爱民,崔利莎,张步鑫,等.麻防犀角地黄汤与犀角地黄汤治疗冬季血热型银屑病的疗效观察[J].中国皮肤性病学杂志,2016,30(6):629-630.
[14]田海刚,胡帅,尤立平,等.凉血解毒汤对寻常性银屑病血热证患者外周血Th17细胞相关细胞因子的影响[J].中日友好医院学报,2014,28(4):212-215.
[15]祁战涛.凉血解毒汤治疗寻常性银屑病的疗效观察[J].陕西中医,2016,37(8):1033-1034.
[16]Silver S,Tuppal R,Gupta AK,et al.Effect of calcipotriene plus betamethasone dipropionate topical suspension on the hypothalamic-pituitary-adrenal axis and calcium homeostasis in subjects with extensive psoriasis vulgaris:an open,non-controlled,8-week trial[J].Journal of drugs in dermatology,2013,12(8):882-887.
[17]沈芳,谢韶琼.细胞因子与银屑病发病关系的研究进展[J].中国麻风皮肤病杂志,2015,31(3):156-159.
[18]孙月,胡秀伟,甄志贤,等.清热消银汤治疗血热风盛型寻常性银屑病疗效分析[J].现代中西医结合杂志,2015,24(3):297-298,331.
[19]李生存,马文宇,燕华玲.解毒化瘀汤对银屑病患者的疗效及炎性因子水平的影响[J].中药材,2014,37(7):1307-1309.