退银汤联合NB-UVB治疗寻常型银屑病的疗效及对外周血IL-22表达水平的影响

Effect of Tuiyin Decoction combined with NB-UVB in the treatment of psoriasis vulgaris and the influence on expression levels of IL-22 in peripheral blood

目的:探讨退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外周血IL-22表达水平的影响。方法:120例中/重度寻常型银屑病患者分为治疗组、对照Ⅰ组、对照Ⅱ组。治疗组内服退银汤,2次/d,并予NB-UVB局部照射,2次/w;对照Ⅰ组单纯内服退银汤;对照Ⅱ组单纯使用NB-UVB局部照射,方法均同治疗组,三组疗程均为12周。另选志愿者40例作为健康对照组。分别于治疗前和治疗后第4、8、12周记录PASI评分,同时评价临床疗效,检测健康对照组以及银屑病患者治疗前后IL-22表达水平。结果:治疗后,治疗组PASI评分为(2.47±1.68)、对照Ⅰ组为(4.65±4.31)、对照Ⅱ组为(5.75±5.03),治疗组与对照Ⅰ组、对照Ⅱ组比较,差异均有统计学意义(P<0.01);治疗组有效率为95.0%、对照Ⅰ组为77.5%、对照Ⅱ组为70.0%,治疗组与对照Ⅰ组、对照Ⅱ组比较,差异均有统计学意义(P<0.05 or P<0.01);治疗组和对照Ⅰ组、对照Ⅱ组IL-22与治疗前比较,差异均有统计学意义(P<0.01);治疗后,治疗组与对照Ⅰ组、对照Ⅱ组比较IL-22差异均有统计学意义(P<0.01);治疗组、对照Ⅰ组、对照Ⅱ组IL-22与PASI评分呈正相关性。结论:退银汤联合NB-UVB治疗寻常型银屑病疗效显著,可能是通过降低患者血清中IL-22表达水平来发挥治疗银屑病的作用。

To investigate the curative effect of Tuiyin decoction combined with narrow-band ultraviolet B （NB-UVB） in the treatment of psoriasis vulgaris and the influence on the expression levels of IL-22 of peripheral blood. Methods ：120 patients with medium/severe psoriasis vulgaris were divided into treatment group, control group Ⅰ and control group Ⅱ. Treatment group were treated with Tuiyin decoction with oral administratian,2 times/d, with NB-UVB local irradiation,2times/w. Control group I were treated with Tuiyin decoction only, and control group Ⅱ were treated with NB-UVB local irradiation only, and the theraputic methods were the same with treatment group. All groups were treated for 12 weeks, and another 30 people are chosen as healthy control group. In 4th,8th, 12th week, before and after treatment, PASI scores were recorded respectively. Meanwhile, clinical curative effect were evaluated, and IL-22 levels of healthy control group and patients with pso- riasis were determinated. Results：After treatment,PASI score of treatment group was（2.47 ± 1.68） ,control group Ⅰ （4.65 ±4.31 ） ,control group Ⅱ （5.75 ±5.03）,and compared with two control groups, the difference had statistical significance （P 〈 0. 01 ）;The effective rate of treatment group was 95.0% ,control group 1 77.5% and control group Ⅱ 70.0%, compared with two control groups ,the difference had statis- tical significance （P 〈 0.05 or P 〈0.01 ） ; The difference of IL-22 levels of treatment group and levels of control group Ⅰ and Ⅱ, Compared with those before treatment, was statistically significant（ P 〈 0.01 ） ;after treatment, the difference of IL-22 levels had statistical significance （P 〈 0.01 ） ;IL-22 levels of treatment group,control group Ⅰ and Ⅱ were positively correlated with PASI scores. Conclusion：Effect of Tuiyin decoction combined with NB-UVB in the treatment of patients with psoriasis vulgaris is significant, possibly by reducing expression levels of IL-22 which are related in serum of patients.