中华皮肤科杂志 ›› 2012, Vol. 45 ›› Issue (9): 647-649.

• 论著 • 上一篇    下一篇

消银汤联合卡泊三醇软膏对血热型寻常性银屑病疗效及相关细胞因子水平的影响

汪五清1,高志祥2,3,郭志丽4,郭强5,杨勤萍6,顾军7   

  1. 1. 上海瑞金医院集团闵行区中心医院
    2.
    3. 第二军医大学长海医院
    4. 上海第二军医大学长海医院皮肤科
    5. 上海市第二军医大学附属长海医院
    6. 复旦大学附属华山医院皮肤科,复旦大学附属华山医院南汇分院
    7. 上海第二军医大学附属长海医院皮肤科
  • 收稿日期:2011-10-09 修回日期:2011-11-09 出版日期:2012-09-15 发布日期:2012-08-31
  • 通讯作者: 顾军 E-mail:gujun79@163.com
  • 基金资助:

    上海市卫生局基金资助

Efficacy of Xiaoyin decoction combined with calcipotriol ointment in patients with vulgaris psoriasis of blood heat type and their effects on related cytokines

  • Received:2011-10-09 Revised:2011-11-09 Online:2012-09-15 Published:2012-08-31
  • Contact: GU Jun E-mail:gujun79@163.com

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摘要：

目的 探讨消银汤联合卡泊三醇软膏治疗进展期血热型轻/中度（PASI评分 < 10）寻常性银屑病疗效和对IL-17、IL-22、TNF-α水平影响。方法 60例进展期血热型轻/中度寻常性银屑病患者分为治疗组及对照组，每组各30例。治疗组予消银汤口服；对照组予安慰剂口服，2组同时外用卡泊三醇软膏；另选志愿者30例作为健康对照组；疗程12周。记录治疗前、后PASI评分，检测治疗前、后Th17细胞、TNF-α、IL-22、IL-17水平。结果 治疗前，与健康对照组相比，治疗组及对照组在Th17细胞水平及血清IL-17、IL-22和TNF-α水平差异有统计学意义（P ＜ 0.05），治疗组及对照组水平高于健康对照组；治疗后，上述指标与治疗前比较，差异有统计学意义（P ＜ 0.05）。治疗组治疗后PASI评分为（1.83 ± 1.28），对照组为（2.91 ± 1.42），差异有统计学意义（P ＜ 0.05）。治疗组总有效率为93.33%，与对照组总有效率73.33%比较差异有统计学意义（P ＜ 0.05）。治疗组在PASI评分，治疗总有效率及细胞因子水平改善方面优于对照组。结论 Th17细胞及血清IL-17、IL-22和TNF-α水平在轻/中度寻常性银屑病患者存在异常，消银汤联合卡泊三醇软膏对此有改善作用。

关键词: 寻常型银屑病,消银汤,卡泊三醇软膏,细胞因子

Abstract:

Objective To estimate the efficacy of Xiaoyin decoction combined with calcipotriol ointment in patients with mild to moderate vulgaris psoriasis of blood heat type as well as their effects on the expression of interleukin （IL）-17, -22 and tumor necrosis factor （TNF） α. Methods Sixty patients with mild to moderate vulgaris psoriasis of blood heat type were enrolled in this study, and equally divided into 2 groups to be treated with Xiaoyin decoction and placebo respectively for 12 weeks. Calcipotriol ointment was applied in both groups of patients. Thirty healthy volunteers served as the controls. Bicolor flow cytometry was conducted to determine the proportion of peripheral blood Th17 cells, and enzyme linked immunosorbent assay （ELISA） to measure the serum levels of IL-17，IL-22 and TNF-α, in the controls and patients before and after treatment. Clinical efficacy was evaluated by psoriasis area and severity index （PASI） score. Results Increased proportion of Th17 cells and serum levels of IL-17，IL-22 and TNF-α were observed in the patients with psoriasis before treatment compared with the controls （all P ＜ 0.05）. After treatment, a significant decrease was noted in the proportion of Th17 cells （（8.32 ± 1.28）% vs. （14.24 ± 1.97）%, P < 0.05） and serum levels of IL-17，IL-22 and TNF-α in the Xiaoyin decoction group （all P < 0.05）, but not in the placebo group. The PASI score was significantly different between the Xiaoyin decoction and placebo group after treatment （1.83 ± 1.28 vs. 2.91 ± 1.42, P < 0.05）. The total response rate was 93.33% in the Xiaoyin decoction group, significantly higher than that in the placebo group （73.33%, P < 0.05）. Conclusions There is an abnormality in the proportion of Th17 cells and serum levels of IL-17, IL-22 and TNF-α, which may be ameliorated by the combined treatment with Xiaoyin decoction and calcipotriol ointment.