祛银汤联合紫外线治疗银屑病的疗效观察及对外周血骨桥蛋白与血管内皮生长因子的影响

The effect of the Chinese medical herb decoction qu yin tang combined with ultraviolet B phototherapy on psoriasis vulgaris, and the influence on osteopontin and vascular endothelial growth factor in serum

目的 观察祛银汤联合窄谱中波紫外线（NB-UVB）治疗寻常型银屑病的疗效,及对患者血清中骨桥蛋白（OPN）和血管内皮生长因子（VEGF）的影响.方法 共选取60例银屑病患者,将其随机分为治疗组及对照组,2组均每天口服祛银汤中药制剂,治疗组同时辅以NB-UVB照射,每周治疗3次,共治疗8周;另同期选取20例健康志愿者纳入健康组.于治疗前及治疗8周后采用酶联免疫吸附分析法（ELISA）检测各组对象血清中OPN及VEGF水平,选用银屑病皮损面积及严重性指数（PASI）对患者临床疗效进行评定.结果 2组患者分别经8周治疗后,发现治疗组PASI评分及临床疗效均显著优于治疗前及对照组水平;治疗前2组患者血清中OPN及VEGF水平均显著高于健康组,治疗8周后2组患者上述指标均明显降低（P〈0.05）,且以治疗组的降低幅度较显著,与对照组比较,组问差异均有统计学意义（P〈0.05）.结论 祛银汤联合NB-UVB治疗银屑病具有协同疗效,能进一步改善患者病情、减轻各种不良反应,同时还能下调血清中异常升高的OPN及VEGF水平,该联合疗法值得临床推广、应用.

Objective To observe the therapeutic efficacy of the Chinese medical herb decoction qu yin tang combined with narrow-band ultraviolet B （NB-UVB） phototherapy on psoriasis vulgaris, and to investigate its influ- ence on osteopontin （OPN） and vascular endothelial growth factor （VEGF） in serum. Methods Sixty patients with psoriasis were randomly divided into a treatment group and a control group. The treatment group was treated with qu yin tang and NB-UVB; the control group was treated with qu yin tang only. The levels of OPN and VEGF in serum were detected in both groups before and after treatment using an enzyme-linked immunosorbent assay （ ELISA ）. Twenty healthy persons＇ serum samples were taken as controls. At the same time, any changes in psoriasis area and severity index （PASI） scores in the two groups were recorded and compared. Results After 8 weeks of treatment, PASI scores and levels of OPN and VEGF had been reduced significantly in both groups, and there was a significant difference between the treatment group and the control group. Conclusions Chinese medical herbs combined with NB-UVB phototherapy is a safe and effective method for the treatment of psoriasis. The results suggested that OPN and VEGF may play an important role in the pathogenesis of psoirasis vulgaris.