复方青黛胶囊对寻常性银屑病Th1/Th2平衡漂移影响的研究

Effect of Compound Qingdai Capsule on Th1/Th2 Shift in Patients with Psoriasis Vulgaris

目的:观察复方青黛胶囊对于进展期寻常性银屑病患者皮损及血清中Th1/Th2漂移相关因子的影响,同时分析其与皮损指数之间的相关性。方法:选取2019年10月至2020年10月黑龙江中医药大学附属第一医院收治的进展期寻常性银屑病患者80例作为研究对象,按照随机数字表法分为观察组(n=38)和对照组(n=42)。观察组口服复方青黛胶囊,对照组口服复方甘草酸苷片,分别对2组患者红斑、浸润、鳞屑及皮损面积进行评价,采用银屑病皮损面积和严重程度指数(PASI)评价整体临床疗效;采用酶联免疫吸附测定法分别对血清Th1细胞分泌因子白细胞介素-2(IL-2)、γ干扰素、肿瘤坏死因子-α(TNF-α)和Th2细胞分泌因子IL-4、IL-10进行测定;分析银屑病皮损面积和严重程度指数(△PASI)与Th1/Th2漂移相关各因子变化量之间的相关性。结果:复方青黛胶囊可以显著降低患者皮损的红斑、浸润、鳞屑(P<0.01),减少皮损面积(P<0.01),改善PASI及△PASI(P<0.05);复方青黛胶囊可以显著下调Th1细胞、上调Th2细胞分泌因子的含量(P<0.01);经复方青黛胶囊干预的银屑病患者,其△PASI与各漂移因子变化量之间存在正相关性(P<0.05)。结论:复方青黛胶能够改善进展期寻常性银屑病患者的皮损,其机制可能与纠正了Th1/Th2偏向于Th1方向的漂移相关。

Objective:To observe the effect of Compound Qingdai Capsule on skin lesions and Th1/Th2 shift related factors in serum of patients with advanced psoriasis vulgaris,and analyze the correlation between the factors and skin lesion index.Methods:A total of 80 patients with advanced psoriasis vulgaris treated in the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from October 2019 to October 2020 were included and divided into an observation group(n=38)and a control group(n=42)by random number table.The observation group took Compound Qingdai Capsule while the control group took Compound Glycyrrhizin Tablets.The areas of erythema,infiltration,scale and skin lesions in the two groups were detected,and Psoriasis Area and Severity Index(PASI)was used to evaluate the overall clinical efficacy.The serum levels of Th1 cell secretory factors IL-2,IFN-γ,TNF-αand Th2 cell secretory factors IL-4 and IL-10 were measured by enzyme linked immunosorbent assay(ELISA).The correlation between△PASI and the changes of Th1/Th2 shift related factors was analyzed.Results:Compound Qingdai Capsule alleviated the erythema,infiltration and scale state of skin lesions in patients(P<0.01),reduced the lesion area(P<0.01),and improved the PASI and△PASI score(P<0.05).The Compound also down regulated the content of secretory factors of Th1 cells and up regulated that of Th2 cells(P<0.01).There was a positive correlation between△PASI and the changes of Th1/Th2 shift related factors in patients intervened by Compound Qingdai Capsule(P<0.05).Conclusion:Compound Qingdai Capsule could improve the skin lesions of patients with advanced psoriasis vulgaris,and its mechanism might be related to shifting Th1/Th2 balance towards Th1.