健脾解毒汤治疗脾虚湿盛证银屑病的临床研究

Clinical study on Jianpijiedu decoction in treatment of psoriasis vulgaris with spleen deficiency type

目的探讨健脾解毒汤治疗脾虚湿盛证银屑病的临床疗效及其部分作用机制。方法 58例辨证为脾虚湿盛证的寻常型银屑病患者,按随机数字表分为健脾解毒汤治疗组(30例)和阿维A胶囊对照组(28例),分别予以4w药物治疗,采用银屑病面积严重程度指数(Psoriasis Area and Severity Index,PASI)评分法观察其临床疗效。问卷调查皮肤病患者治疗前后的生活质量(Dermatology Life Quality Index,DLQI),并检测治疗组患者及正常对照组的肿瘤坏死因子(Tumor Necrosis Factor,TNF-α)水平变化。结果治疗组总有效率为76.67%,对照组总有效率为78.57%,两组比较差异无统计学意义(P>0.05)。两组患者DLQI评分在用药4w后均下降(P<0.05);治疗组血清TNF-α水平较治疗前降低(P<0.05),但较正常组仍偏高。结论健脾解毒汤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TNF-α水平调节免疫、改善炎症有关。

Objective To explore the clinical efficacy of JianpiJiedu Decoction（JPJDD）,a compound traditional Chinese herbal medicine,inpatients with spleen deficiency syndrome type psoriasis vulgaris.Methods Fifty-eight patients diagnosed with spleen deficiency syndrome type psoriasis vulgaris were randomly divided into two groups ： JPJDD group（30cases） and Acitretin capsule group（28cases）.Patients in both groups were treated for 4weeks,Psoriasis Area and Severity Index（PASI） score,Dermatology Life Quality Index（DLQI） score and the level of Tumor Necrosis Factorα（TNF-α） were obtained to evaluate the efficacy of the two treatments.Results There was a better curative result in Acitretin capsule group than in JPJDD group,but there wan no significant difference between two groups（P 0.05）.The response rates in JPJDD and Acitretin capsule group were 76.67%and 78.57%respectively.DLQI score was also significantly improved during 4week treatment in JPJDD and Acitretin capsule group（P 0.05）.There was significant difference in TNF-αlevel before and after treatment in JPJDD group.Conclusion PJDD is remarkably advantageous in treatment of psoriasis vulgaris of spleen deficiency syndrome syndrome and improvement of patients quality of life.The mechanism may be related to decrease in serum TNF-αlevel.