芩珠凉血合剂治疗血热证银屑病的随机对照临床研究

Qinzhu Liangxue Decoction in treatment of blood-heat type psoriasis vulgaris:a randomized controlled trial

目的:观察芩珠凉血合剂治疗血热证银屑病的临床疗效并探讨其部分作用机制。方法:58例辨证为血热证的寻常型银屑病患者,随机分为芩珠凉血合剂治疗组和西药复方氨肽素对照组,分别予以4周药物治疗。检测两组患者的血管内皮生长因子(vascular endothelial growth factor,VEGF)水平变化,问卷调查患者皮肤病生活质量(Dermatology Life Quality Index,DLQI)的差异,并采用银屑病面积严重程度指数(Psoriasis Areaand Severity Index,PASI)评分法观察其临床疗效。结果:芩珠凉血合剂治疗组总有效率为83.33%,西药对照组总有效率为64.28%,两组比较,差异有统计学意义(P<0.05)。两组患者DLQI评分在用药2周及用药4周后均下降(P<0.05);治疗组血清VEGF水平较治疗前降低(P<0.05),而对照组用药前后VEGF水平差异无统计学意义(P>0.05),两组治疗后VEGF水平比较,差异有统计学意义(P<0.05)。结论:芩珠凉血合剂能明显改善患者皮损状况和生活质量,其机制可能与下调患者血清VEGF水平,拮抗血管新生有关。

Objective： To explore the clinical efficacy of Qinzhu Liangxue Decoction （QZLXD）. a compound traditional Chinese herbal medicine, in patients with blood-heat type psoriasis vulgaris. Methods： Fifty-eight patients diagnosed with blood-heat type psoriasis vulgaris were randomly divided into two groups： QZLXD group （30 cases） and ampeptide group （28 cases）. Patients in both groups were treated for 4 weeks. Psoriasis Area and Severity Index （PASI） score, Dermatology Life Quality Index （DLQI） score and the level of serum vascular endothelial growth factor （VEGF） were obtained to evaluate the efficacy of the two treatments. Results： There was a better curative result in QZLXD group than in ampeptide group （P〈0.05）. The response rates in QZLXD and ampeptide groups were 83.33% and 64.28% respectively. DLQI score was also significantly improved during 4-weektreatment in QZLXDandampeptidegroups （P〈0.05）. There was no significant difference in VEGF level between QZLXD and ampeptide groups.Conclusion： QZLXD is remarkably advantageous in treatment of psoriasis vulgaris of blood-heat syndrome and improvement of patient＇s quality of life. The mechanism may be related to decrease in serum VEGF level and action against neogenesis of blood vessels.