摘要
目的:观察化痰散瘀汤治疗斑块型银屑病(痰瘀互结证)的临床疗效及临床作用机制。方法:将皮肤科斑块型银屑病(痰瘀互结证)患者80例按随机数字表法分为观察组与对照组各40例。对照组予阿维A胶囊+糠酸莫米松软膏治疗,观察组在此基础上予化痰散瘀汤治疗。观察两组患者中医证候评分(皮损颜色、皮损肥厚浸润、瘙痒、肌肤甲错),银屑病皮损面积和严重程度指数(psoriasis area and severity index,PASI)评分,皮肤病生活质量指数调查表(dermatology life quality index,DLQI)评分,血清免疫细胞因子干扰素γ(interferonγ,IFN-γ)、白细胞介素4(interleukin 4,IL-4)、白细胞介素17A(interleukin 17A,IL-17A)、白细胞介素10(interleukin-10,IL-10)、白细胞介素22(interleukin-22,IL-22)改善状况,并统计临床疗效及不良反应发生情况。结果:两组治疗后皮损颜色、皮损肥厚浸润、瘙痒、肌肤甲错积分均明显降低(P<0.05),且观察组治疗后中医证候积分明显低于对照组(P<0.05)。两组治疗后PASI及DLQI评分均明显降低(P<0.05),且观察组明显低于对照组(P<0.05)。两组治疗后血清IFN-γ、IL-17A、IL-22水平均明显降低(P<0.05),IL-4及IL-10水平均明显升高(P<0.05),且观察组上述指标改善情况均优于对照组(P<0.05)。观察组总有效率[92.5%(37/40)]明显高于对照组[75.0%(30/40)](P<0.05)。两组治疗期间均未出现明显不良反应。结论:化痰散瘀汤能有效改善斑块型银屑病(痰瘀互结证)患者皮损状况,缓解瘙痒等临床症状,有助于提高生活质量,其可能与调节IFN-γ、IL-4、IL-17A、IL-10、IL-22等免疫细胞因子,纠正患者机体紊乱的免疫机能有关。
Objective:To survey therapeutic effects of resolving-phlegm eliminating-stasis decoction in the treatment of plaque psoriasis of phlegm and blood stasis intermingling pattern and the related clinical mechanism.Methods:Eighty patients were allocated to the observation group and the control group in light of random number table method.The control group was treated by acitretin capsules and mometasone furoate cream,and the observation group took resolving-phlegm eliminating-stasis decoction based on the therapy.To observe syndrome integrals(skin lesion color,hypertrophic infiltration of skin lesions,pruritus,squamous and dry skin),PASI scores,DLQI scores,serum immune cytokines such as IFN-γ,IL-4,IL-17A,IL-10 and IL-22 between both groups,to perform statistical analysis of clinical effects and the incidence of adverse reaction.Results:After the treatment,the scores of skin lesion color,hypertrophic infiltration of skin lesions,pruritus,squamous and dry skin lowered noticeably in both groups(P<0.05),and syndrome integrals of the observation group were lower than these of the control group obviously(P<0.05).PASI and DLQI scores reduced remarkably in both groups after the treatment(P<0.05),and the observation group was lower than the control group obviously(P<0.05).The levels of IFN-γ,IL-17A and IL-22 decreased apparently in both groups after the treatment(P<0.05),the levels of IL-4 and IL-10 increased remarkably(P<0.05),and the improvements of the indexes of the observation group were better than these of the control group(P<0.05).Total effective rate of the observation group was[92.5%(37/40)],clearly higher than[75.0%(30/40)]of the control group(P<0.05).No obvious adverse reaction occurred in both groups during therapeutic periods.Conclusion:Resolving-phlegm eliminating-stasis decoction could effectively improve skin lesions and alleviate pruritus in the treatment of plaque psoriasis of phlegm and blood stasis intermingling pattern,help lift quality of life,possibly related to regulating the immune cytokines includi
作者
代昌波
张军
马一平
DAI Changbo;ZHANG Jun;MA Yiping(Suzhou Hospital of Traditional Chinese Medicine,Suzhou 215007,China;Dermatology,Zunyi Hospital of Traditional Chinese Medicine,Zunyi 563099,China;Institute of Dermatology,Chinese Academy of Medical Sciences,Nanjing 210042,China)
出处
《西部中医药》
2023年第8期74-77,共4页
Western Journal of Traditional Chinese Medicine
基金
2018年度苏州市中医医院院级青年课题项目(YQN2018008)。
关键词
银屑病
斑块型
痰瘀互结证
化痰散瘀汤
皮损
皮肤瘙痒
免疫紊乱
psoriasis,plaque
phlegm and blood stasis intermingling pattern
resolving-phlegm eliminatingstasis decoction
skin lesions
pruritus
immune disorder
