摘要
目的 观察蜈蚣败毒饮治疗血热证寻常型银屑病患者的临床疗效及对其Th22细胞因子的影响。方法 选取2021年3月—2023年9月在黑龙江中医药大学附属第一医院皮肤科就诊的血热证寻常型银屑病患者80例,按随机数字表法分为对照组和治疗组,每组各40例。对照组以西医常规疗法治疗,治疗组在对照组治疗的基础上联合中药汤剂蜈蚣败毒饮治疗,疗程8周。观察比较两组患者临床疗效,治疗前后银屑病面积和严重指数[银屑病严重指数(Psoriasis area and severity index, PASI)评分]、皮损体表面积[皮肤病皮损体表面积(Body surface area, BSA)评分]、银屑病医师整体评价指数[银屑病医师整体评价指数(Physician′s global assessment, PGA)评分]、皮肤病生活质量指数[皮肤病生活质量指数(Dermatology life quality index, DLQI)量表评分]、Th22细胞因子[白细胞介素-21(Interleukin-21,IL-21)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白细胞介素-22(Interleukin-22,IL-22)水平]及安全性评价。结果 治疗后治疗组临床总有效率84.38%(27/32)明显高于对照组74.29%(26/35),差异有统计学意义(P<0.05)。治疗后两组患者PASI均较治疗前降低,差异有统计学意义(P<0.05),且治疗组PASI评分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者BSA评分均较治疗前降低,差异有统计学意义(P<0.05);两组间BSA评分比较,差异无统计学意义(P>0.05)。治疗后两组患者PGA评分较治疗前降低,差异有统计学意义(P<0.05);且治疗组PGA评分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者DLQI评分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组DLQI评分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清IL-21、TNF-α、IL-22水平均较治疗前降低,差异有统计学意义(P<0.05);且治疗组血清IL-21、TNF-α、IL-22水平均明显低于对照组,差异有统计学意义(P<0.05)。且两种治疗方式均安全有效。结论 蜈蚣败毒饮联合西医常规疗法治疗血热证寻常型银屑病患者的临床疗效较好,且安全性良好,可能与其对Th22细胞因子水平的负向调控有关。
Objective To explore the clinical efficacy of Wugong Baidu decoction on psoriasis vulgaris blood heatsyndrome and the decoction's effect on Th22 cytokines.Methods A total of 80 patients with psoriasis vulgaris blood heatsyndrome treated at the Dermatology Department,First Affiliated Hospital,Heilongjiang University of Chinese Medicine between March 2021 and September 2023 were selected and divided into a control group and a treatment group using a random number table,with 40 patients in each group.The control group received conventional Western medicine therapy,whilethe treatment group was additionally given traditional Chinese medicine(TCM)Wugong Baidu decoction.The treatment lasted for 8 weeks in both groups.After the treatment,clinical efficacy was compared in both groups,as well as the followingaspects before and after the treatment:psoriasis area and severity index(PASI)score,body surface area(BSA),physician'sglobal assessment(PGA)score,dermatology life quality index(DLQI),the Th22 cytokine levels[interleukin-21(IL-21),tumor necrosis factor-α(TNF-α),and interleukin-22(IL-22)].The safety of the two treatment methods was also evaluated. Results After treatment,the total clinical efficacy in the treatment group(84. 38% ,27/32) was significantlyhigher than that in the control group(74. 29% ,26/35) , with a statistically significant difference( P<0.05). PASI scoreswere significantly decreased in both groups( P<0. 05), with the scores being significantly lower in the treatment group(P<0. 05). The BSA scores were significantly decreased in both groups( P<0. 05), but there was no statistical significancebetween the two groups(P>0. 05). The PGA scores were significantly decreased in both groups(P <0. 05), withthe scores being significantly lower in the treatment group(P<0. 05). Similarly,the DLQI scores were significantly decreasedin both groups( P<0. 05) , with the scores being significantly lower in the treatment group(P<0. 05). Additionally,serumIL -21,TNF -α,and IL-22 levels were significantly decreased in both groups(P<0.05),with the above levelsbeing significantly lower in the treatment group. (P<0.05). Both treatment methods were safe and effective. ConclusionWugong Baidu decoction combined with conventional Western medicine therapy has demonstrated ideal safety andclinical efficiency in treating psoriasis vulgaris(blood heat syndrome). The mechanism may be related to its negative regulationof Th22 cytokine levels.
作者
林立
王姗姗
安月鹏
刘畅
杨素清
LIN Li;WANG Shan-shan;AN Yue-peng;LIU Chang;YANG Su-qing(Heilongjiang University of Chinese Medicine,Harbin Heilongjiang 150040;First Affiliated Hospital,Heilongjiang University of Chinese Medicine,Harbin Heilongjiang 150040)
出处
《世界中西医结合杂志》
2025年第7期1371-1375,共5页
World Journal of Integrated Traditional and Western Medicine
基金
国家自然科学基金项目(81973846、81904201)
黑龙江省自然科学基金(LH2019H108)。
