积雪草煎剂联合曲尼司特治疗纤维生成异常性皮肤病临床研究

Clinical Study on Centella Decoction Combined with Tranilast in the Treatment of Fiber Formation Abnormal Skin Disease

目的:观察积雪草煎剂联合曲尼司特治疗纤维生成异常性皮肤病的临床疗效。方法:96例纤维生成异常性皮肤病患者按随机数字表法平均分为对照组和观察组。对照组48例予以曲尼司特治疗,观察组48例在对照组治疗基础上给予积雪草煎剂。比较两组患者临床相应指标、血清学指标及基质金属蛋白水平,同时比较临床疗效及并发症状况。结果:对照组有效率72.92%低于观察组有效率91.67%,差异具有统计学意义(P<0.05);与治疗前比较,两组治疗后临床相应指标、血清学指标及基质金属蛋白水平均发生变化,观察组治疗后温哥华瘢痕量表评分、瘢痕厚度、瘢痕面积、疼痛视觉模拟评分及瘙痒视觉模拟评分低于对照组,观察组治疗后转化生长因子-β1(transforming growth factor-β1,TGF-β1)、白细胞介素-6(interleukin-6,IL-6)、血管内皮生长因子(vascular endothelial growth factor,VEGF)低于对照组,碱性成纤维细胞生长因子(basic fibroblast growth factor,b FGF)高于对照组,观察组治疗后基质金属蛋白酶-2(matrix metallo preteinases-2,MMP-2)MMP-2、MMP-9水平低于对照组,MMP-2水平高于对照组,差异具有统计学意义(P<0.05);两组间不良反应轻微,可以耐受,对研究未产生影响。结论:积雪草煎剂联合曲尼司特治疗纤维生成异常性皮肤病疗效确切,能降低成纤维细胞TGF-β1,增加b FGF合成,减少IL-6表达。

Objective ：To explore the clinical efficacy and safety of Centella Decoction combined with Tranilast in the treatment of fi- ber formation abnormal skin disease. Methods：96 patients with fiber formation abnormal skin disease of dermatological department in our hospital were selected and randomly divided into 2 groups,48 cases in the control group received Tranilast,48 cases in the experiment group received more with Centella Decoction, clinical indexes, serum indexes, matrix metal protein levels, the clinical efficacy and complications were compared after the treatment. Results ： The effective rate of control group （72.92%） was lower than the experiment group（91.67% ）, with statistical significance （P 〈 0.05 ）, compared with before treatment,2 groups of clinical, serological index and the corresponding index matrix metal protein level changed, compared with the control group, VSS score, scar thickness, scar area,pain VAS pruritus score and VAS score in the experiment group were lower, TGF-β1, IL-6 and VEGF were lower, bFGF was higher, MMP-2 and MMP-9 levels in the experiment group were lower, TIMP-2 was higher, all with statistical significance（P 〈 0.05 ）. Adverse reactions in the two groups were mild and can be tolerated. Couclusion：Centella decoction com- bined with tranilast in the treatment of fiber formation abnormal skin disease had a curative effect, and it can reduce fiber cell TGF-β1,increase the synthesis of bFGF,reduce the expression of IL-6.