中西医结合治疗寻常型银屑病疗效观察

Clinical Observation of combination treatment of Chinese traditional and Western Medicine on psoriasis vulgaris

目的观察基础治疗、窄谱UVB联合中药药浴治疗寻常型银屑病的临床疗效。方法选取寻常型银屑病患者94例,采取随机数字表法将其分为2组,实验组采取基础治疗、窄谱中波紫外线(NB-UVB)联合中药药浴治疗,对照组仅采取基础治疗联合NB-UVB治疗。分别在治疗前和治疗8周后采用酶联免疫吸附试验(ELISA)检测2组患者的血清IFN-γ、IL-2和IL-17、VEGF水平,采用免疫组化染色法检测2组皮损Ki-67和CD3的表达水平,采取银屑病面积和严重程度性指数(PASI)、皮肤病生活质量表(DQOLs)评价2组患者治疗前和治疗8周后的生活质量和临床疗效。结果在治疗8周后,2组患者IFN-γ、IL-2、IL-17和VEGF的水平较治疗前明显下降(P均<0.01),且实验组显著低于对照组(P均<0.01);2组患者皮损Ki-67和CD3的表达水平显著低于治疗前(P均<0.01),且实验组显著低于对照组(P均<0.01);2组PASI评分、DQOLs积分显著低于治疗前(P均<0.01),且实验组显著低于对照组(P<0.01)。治疗8周后实验组有效率显著高于对照组(P<0.01)。结论 IFN-γ、IL-2和IL-17、VEGF、Ki-67和CD3在寻常型银屑病的发病机制中有重要作用,采取基础治疗、NB-UVB联合中药药浴治疗寻常型银屑病具有显著的临床疗效,且不增加不良反应发生率,有较高的临床应用价值。

Objective It is to observe the clinical curative effect of foundation treatment combined with narrow- band UVB （ NB - UVB） and traditional Chinese medicine bath in the treatment of psoriasis vulgaris. Methods 94 patients with psoriasis vulgaris were selected and randomly divided into two groups, patients received basic therapy combined with NB - UVB and traditional Chinese medicine medicated bath treatment in experimental group, and received basic therapy combined with NB - UVB in control group. Before and 8 weeks after treatment, the levels of serum IFN - γ, IL -2 and IL - 17, VEGF were detected by enzyme linked immunosorbent assay of both groups; and the levels of Ki -67 and CD3 in skin？ lesion were detected by immunohistoehemistry method ; the quality of life and clinical curative effect were evaluated according the psoriasis area and severity index （PASI） and dermatology quality of life scales （DQOLs）. Results After 8 weeks of treatment, the levels of IFN - γ IL- 2, IL- 17 and VEGF of both gorups were decreased significantly than before treatment （P 〈 0.01 ） , and which of experimental group was significantly lower than that of control group （P 〈0. 01 ） ; the expression levels of Ki - 67 and CD3 lesions was significantly lower than before treatment （P 〈 0.01 ） , and which of experimental group was significantly lower than that of control group （P 〈0. 01 ） ; the scores of PASI and DQOLs in the two groups were significantly lower than before treatment （ P 〈 0.01 ） , and which of experimental group was significantly lower than that of control group （P 〈 0.01 ）. The effective rate in experimental group was significantly higher than that in control group （P 〈 0.01 ）. Conclusion IFN -γ, IL - 2 and IL- 17, VEGF, Ki -67 and CD3 have an important role in the pathogenesis of psoriasis vulgaris, the basic treatment combined with NB - UVB and traditional Chinese medicine bath in treatment of psoriasis vulgaris has significant clinical efficacy, and does not increase the incidence of adverse reactions, have high value in clinical application.