皮炎消净饮Ⅱ号联合窄谱中波紫外线对特应性皮炎患者细胞黏附分子及总IgE的影响

Influence of Piyan Xiaojin Decoction Ⅱ combining with narrow-band UVB exposure on cellular adhesion molecules expression and total IgE level in atopic dermatitis patients

目的:探讨皮炎消净饮Ⅱ号联合窄谱中波紫外线(NB-UVB)治疗特应性皮炎(AD)的临床疗效及对外周血细胞黏附分子及总IgE的调控。方法:131例患者随机分为治疗组(36例)、中药组(31例)、开瑞坦组(34例)及UVB组(30例)。治疗组采用皮炎消净饮Ⅱ号联合NB-UVB照射治疗,中药组服用皮炎消净饮Ⅱ号,开瑞坦组服用氯雷他定片,UVB组采用NB-UVB照射。2个月为1个疗程。使用SCORAD积分系统,对治疗前后AD患者皮损及临床严重度进行评估,同时用细胞-酶联免疫吸附试验(ELISA)法检测AD患者治疗前后细胞黏附分子(ICAM-1与VCAM-1)及总IgE水平。结果:治疗组总有效率为86.11%,高于其它对照组(中药组、开瑞坦组、UVB组)。各组患者治疗后SCORAD评分、血清ICAM-1及VCAM-1表达水平、总IgE均显著低于治疗前水平(P<0.01),且治疗组显著低于各对照组(P<0.05,P<0.01)。结论:皮炎消净饮Ⅱ号联合NB-UVB照射治疗AD,疗效确切、安全性高,其可能机制是通过调节ICAM-1、VCAM-l、总IgE在血清中的表达,从而抑制细胞间的黏附及炎症细胞的聚集,达到抗炎及免疫调节的目的。

Objective： The aim of the article is to discuss the clinical effectiveness observe the clinical effectiveness of Piyan Xiaojin Decoction-2 combining with narrow-band UVB （NB-UVB） exposure to treat atopic dermatitis （AD）, and to evaluate the serum level of ICAM-1 and VCAM-1 and total IgE before and after the treatment, therefore to investigate its pathogenesis and clinical significance. Methods： 36 AD patients were treated by combination of Piyan Xiaojin Decoction Ⅱ with NB-UVB exposure. The authors used SCORAD integral system to evaluate clinical severity of impaired skin before and after the treatment, meanwhile adopted cell-Enzyme-Linked Immunosorbent Assay （ELISA） to test cellular adhesion molecule （ICAM-1 and VCAM-1） and total IgE level of AD patient before and after the treatment. Results： In the 36 patients of experimental group, the total efficiency rate was 86.11%, which was higher than those in other control groups （Chinese medicine group, clarityne group, and UVB group）. The blood-serum level of ICAM-1, VCAM-1 and total IgE, and the SCORAD level in the patients after the experimental and control treatments were all lower than those before the treatment （P〈0.01）. Experimental group is lower than other control group. Conclusion： Piyan Xiaojin Decoction Ⅱ combining with exposure of NB-UVB is effective and safe in treating AD. The possible mechanism in it is modulating the expressions of ICAM-1, VCAM-1 and total IgE in blood serum, and suppressing the conglutination of cells and aggregation of inflammatory corpuscles, thus getting the effect of anti-inflammation and regulating immune system.