凉血养阴法对寻常型银屑病患者外周血VEGF和OPN表达的影响

Effect of Liangxue Yangyin Method on the Expression of Vascular Endothelial Growth Factor and Osteopontin in Patients with Psoriasis Vulgaris

目的观察凉血养阴法对寻常型银屑病患者的临床疗效及外周血血管内皮细胞生长因子(VEGF)和骨桥蛋白(OPN)表达的影响,探讨凉血养阴法治疗银屑病的作用机制。方法选取70例寻常型银屑病患者,随机分为治疗组(银屑平丸)和对照组(复方青黛丸)各35例。分别予以口服银屑平丸和复方青黛丸,疗程均为8周,同时设立20名健康体检者作对照。观察2组患者治疗前后的银屑病面积及严重程度指数(PASI)评分,同时采用酶联免疫吸附法(ELISA)检测2组患者治疗前后外周血VEGF和OPN含量变化,并与相应的PASI评分作相关性分析。结果 2组治疗后PASI积分均有明显下降,治疗组下降较对照组明显;治疗组总有效率为85.71%,对照组总有效率为58.82%,治疗组疗效优于对照组;2组患者治疗前外周血VEGF和OPN含量明显高于正常人,治疗后2组外周血VEGF和OPN均有下降,且治疗组较对照组下降更明显;银屑病外周血VEGF和OPN与其相应PASI呈正相关,但VEGF和OPN无明显相关性。结论凉血养阴法治疗寻常型银屑病安全,疗效确切;寻常型银屑病患者外周血中VEGF和OPN表达异常,银屑平丸纠正异常表达的VEGF和OPN的水平,从而达到治疗银屑病的目的。

Objective To observe the effects of Liangxue Yangyin method on psoriasis vulgaris and its impact on VEGF and OPN in serum. To investigate the possible mechanism of Yinxiebing pill in treating psoriasis vulgaris. Methods 70 patients with psoriasis vulgaris were assigned equally in a single-blind, randomized way to the treatment group （Yinxiebing pill） and the control group （Xiaoyin Keli）. 35 patients in the treatment group were treated with Yinxiebing pill and the other 35 in the control group were treated with Xiaoyin Keli. The therapeutic course for these two groups was eight weeks. Besides, a normal control group including 20 healthy volunteers was set up. The PASI in different groups was observed and scored before and after treatment to evaluate the therapeutic effectiveness. The levels of osteopontin （OPN） and vascular endothelial growth factor （VEGF） in serum of psoriastic patients before and after treatment were detected with enzyme-linked immunosorbnent assay （ELISA）, and 20 healthy serum samples were taken as healthy controls. Moreover, the correlation was analysed between PASI scores and VEGF, OPN concentration in serum that measured by ELLISA. Results The PASI scores were significantly decreased after treatment in both groups, but the decrement in treatment group was more significant than that in control group. The total clinical effective rates in treatment group and control group were 85.71% and 58.82%, respectively. The comparison between groups showed that the total effective rate in treatment group was significantly superior to that in control group. The levels of VEGF and OPN in serum in two patient groups before treatment was obviously higher than those in the healthy control. After treatment, the levels of VEGF and OPN in serum were significantly decreased in both groups, with the changes in treatment group were more significant than those in control group. There was a positive correlation between the level of VEGF or OPN and PASI scores of psoriastic patients, but there was not a correlation between VEGF and OPN. Conclusion Yinxiebing pill is effective and safe in the treatment of psoriastic vulgaris. There is abnormal VEGF and OPN in periheral blood of psoriastic patients. Yinxiebing pill can correct abnormal VEGF and OPN, so as to achieve a therapeutic effect.