紫丹银屑颗粒联合窄谱中波紫外线治疗血虚风燥证寻常型银屑病的临床分析

Clinical Analysis of Zidan Yinxie Particles Combined Narrow Band Ultraviolet Treat Psoriasis Vulgaris Disease

目的:观察紫丹银屑颗粒联合窄谱中波紫外线治疗血虚风燥证寻常型银屑病的临床疗效及对血清白介素-17(IL-17),IL-22和IL-23的影响。方法:将符合条件的116例患者采用随机按数字表法分成对照组和观察组各58例。对照组采用窄谱中波紫外线(NB-UVB)治疗。观察组在对照组治疗的基础上加用紫丹银屑颗粒,4 g/次,3次/d。两组疗程均为8周。所有患者进行3个月随访,记录复发情况。于治疗前、治疗后和治疗结束后1,2,3个月进行皮损面积和严重程度指数(PASI)评分;记录复发时间。进行治疗前后皮肤病生活质量指数(DLQI)和瘙痒程度视觉模拟(VAS)评分,检测治疗前后IL-17,IL-22,IL-23水平。结果:治疗后观察组PASI,DLQI和VAS评分均低于对照组(P<0.05,P<0.01);观察组临床有效率为93.1%,对照组为84.48%,观察组高于对照组,但差异无统计学意义;在治疗后3个月的随访期间,观察组复发率为40.74%,低于对照组的63.26%(P<0.05);观察组平均复发时间长于对照组(P<0.05);治疗后观察组血清IL-17,IL-22,IL-23水平均低于对照组(P<0.01)。结论:紫丹银屑颗粒联合窄谱中波紫外线治疗血虚风燥证寻常型银屑病,能减轻皮损和瘙痒,提高患者的生活质量,并能稳定病情,降低复发率,同时可调节血清IL-17,IL-22,IL-23等辅助性T细胞17(TH17)细胞因子。

Objective： To observe the clinical effect of Zidan Yinxie granules combined with narrowband ultraviolet in treating psoriasis vulgaris and its influence to serous interleukin-17（ IL-17）,interleukin-22（ IL-22） and interleukin-23（ IL-23）. Method： One hundred and sixteen patients were randomly divided into control group（ 58 cases） and observation group（ 58 cases） by random number table. Patients in control group received narrow-band ultraviolet（ NB-UVB）. Based on the treatment of control group,patients in observation group added Zidan Yinxie granules,4 g / time,3 times / day. Courses of treatment in two groups were both 8 weeks. All the patient had a 3 mouths follow-up to record the relapse. Scores of skin injury area and psoriasis area and severity index（ PASI） were graded before the treatment and at the first,second and third month after treatment. And recurrences were also recorded. Before and after treatment,scores of dermatology life quality index（ DLQI） and itch degree for visual analogue scale（ VAS） were graded. And levels of IL-17,IL-22 and IL-23 were detected.Result： After treatment,the PASI,DLQI and VAS scores in observation group were inferior to these in control group（ P 〈 0. 05,P 〈 0. 01）. The effective rate was 84. 48% in control group,which was superior to that was93. 1% in observation group. There was no statistically significant difference in two groups. The recurrence rate was 40. 74% in observation group,which was less than the data was 63. 26% in control group（ P 〈 0. 05） during3 months follow-up period. The average recurrence time in observation group was more than that in control group（ P 〈 0. 05）. Levels of serum IL-17,IL-22,IL-23 in observation group were lower than these standards in control group after therapy（ P 〈 0. 01）. Conclusion： Zidan Yinxie granules combined with narrow-band ultraviolet can relieve skin injury and pruritus,improve quality of life,make disease to be stabilized and reduce recurrence rate,its mechanism of action may related to regulating helper T cell 17（ TH17） factors.