红蓝光联合中药丹参酮治疗中重度寻常痤疮的疗效及对外周血IL-8和TNF-α表达的影响

Effect of Red-Blue Light combined Tanshinone on moderate or severe acne vulgaris and the effects on levels of IL-8 and TNF-α in peripheral blood

目的探讨红蓝光联合中药丹参酮治疗中重度寻常痤疮的临床疗效及对外周血白细胞介素(IL)-8和肿瘤坏死因子-α(TNF-α)表达水平的影响。方法将90例中重度寻常痤疮患者随机分为联合组、对照Ⅰ组、对照Ⅱ组,每组30例。另选30例健康体检者作为健康组。联合组给予红蓝光联合丹参酮治疗,对照Ⅰ组单独给予红蓝光治疗,对照Ⅱ组单独给予丹参酮胶囊口服,同时3组患者皮损处均外用克林霉素磷酸酯凝胶,早晚各1次,疗程均为8周。分别于治疗前和治疗后2,4,8周记录病情积分,同时评价临床疗效;检测对照组及3组痤疮患者治疗前后IL-8和TNF-α的表达水平。结果治疗后,联合组病情积分明显低于对照组Ⅰ组和对照组Ⅱ组(P均<0.01),总有效率明显高于对照Ⅰ组和对照Ⅱ组(P均<0.05),对照Ⅰ组和对照Ⅱ组比较差异无统计学意义;联合组IL-8和TNF-α,对照Ⅰ组IL-8,对照Ⅱ组TNF-α水平均较治疗前显著下降(P均<0.05),且与健康组比较差异无统计学意义(P均>0.05);对照Ⅰ组TNF-α及对照Ⅱ组IL-8水平治疗后较治疗前也明显下降(P均<0.01),但仍明显高于健康组(P均<0.01)。结论红蓝光联合丹参酮治疗中重度寻常痤疮安全且有效,其机制可能与下调患者血清中IL-8和TNF-α的表达水平有关。

Objective It is to approach the clinical effect of Red-Blue Light combined Tanshinone in the treatment of moderate or severe acne vulgaris,then observe the influence on the levels of IL- 8 and TNF- α in the peripheral blood. Methods A total of 90 patients with moderate to severe acne vulgaris were randomly divided into combined group,control groupⅠ and control group Ⅱ,30 cases in each. And 30 cases of healthy people in the same period were selected as healthy group. The patients were treated by Red-Blue Light combined with Tanshinone in combined group,and with Red-Blue Light alone in control groupⅠ,and with Tanshinone alone in control group Ⅱ. All 90 patients in three groups were topically applied clindamycin phosphate gel twice a day for a course of 8 weeks. The symptoms grades before and after treatment 2,4,8 weeks respectively were recorded and the curative effect at the same time were evaluated,and then the expression level of IL- 8 and TNF- α of the healthy control group and the patients of acne vulgaris before and after treatments was checked. Results The symptom grades of combined group were significantly lowered than those of control group Ⅰ and control group Ⅱ（ all P〈0. 01）,and the effective rates were significantly higher than those of control groupⅠ and control group Ⅱ（ all P〈0. 05）,there was no significant difference between control group Ⅰ and control group Ⅱ. The expression levels of IL- 8 and TNF- α of the combined treatment group,and IL- 8 of control group Ⅰ and TNF- α of control group Ⅱ after treatment were significantly lower than those before treatment（ all P〈0. 01）,and had no significant difference compared with those of healthy group（ all P〈0. 05）. The expression level of IL- 8 in the control group Ⅰ and TNF- α in the control group Ⅱ were significantly lower than those before treatment（ P〈0. 01）,and had no significant difference compared with those of healthy control group（ P〈0. 05）. The expression level of TNF- α of the control group Ⅰ and IL- 8 of the control group Ⅱ were significantly lower than those before treatment（ all P〈0. 01）,but still higher than those of healthy group（ all P〈0. 01）. Conclusion The curative effect of Red-Blue Light combined Tanshinone in the treatment of moderate or severe acne vulgaris was safe and effective,maybe they take effects by adjusting the expression level of IL- 8 and TNF- α in the peripheral blood.