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.