中医辨证分型治疗寻常型银屑病117例临床观察

Clinical efficacy of traditional Chinese medicine syndrome differentiation in treatment of psoriasis vulgaris: an analysis of 117 cases

目的:观察中医辨证分型治疗寻常型银屑病的临床疗效及对Th1/Th2相关细胞因子水平的影响,探讨中医辨证分型与Th1/Th2相关细胞因子水平的关系。方法:将166例寻常型银屑病患者随机分为两组,治疗组117例采用中医辨证分型治疗,对照组49例予双土饮治疗。结果:治疗组、对照组痊愈率分别为77.68%、46.67%,总有效率分别为95.54%、80.00%,两组比较,差异有统计学意义(P<0.05)。细胞因子检测显示:治疗组治疗前后各项指标与15例正常人比较,差异有统计学意义(P<0.05);治疗前后组内比较,差异亦有统计学意义(P<0.05)。血热风盛型各项指标治疗前后比较,差异有统计学意义(P<0.05);血瘀热结型患者IL-4、IL-8治疗前后比较,差异有统计学意义(P<0.05),而TNF-α治疗前后比较,差异无统计学意义(P>0.05);血虚风燥型IL-8治疗前后比较,差异有统计学意义(P<0.05),而TNF-α、IL-4治疗前后比较,差异无统计学意义(P>0.05)。结论:中医辨证分型治疗寻常型银屑病能显著降低患者体内异常升高的TNF-α、IL-8、IL-4水平,有较好的临床疗效。

Objective： To observe the clinical efficacy of traditional Chinese medicine（ TCM） syndrome differentiation in the treatment of psoriasis vulgaris and the changes in levels of Th1 / Th2- related cytokines,and to investigate the association between TCM syndrome differentiation and levels of Th1 / Th2- related cytokines. Methods： A total of166 patients with psoriasis vulgaris were randomized into two groups. The 117 patients in the treatment group received the treatment of TCM syndrome differentiation,and the 49 patients in the control group received Shuangtu Decoction. Results： The cure rate was 77. 68% in the treatment group and 46. 67% in the control group,and the overall response rate was 95. 54% in the treatment group and 80. 00% in the control group; both cure rate and overall response rate showed significant differences between the two groups（ both P 0. 05）. The measurement of cytokines showed that there were significant differences in each indicator between the treatment group and 15 healthy controls before and after treatment（ P 0. 05）; the treatment group showed significant changes in these indicators after treatment（ P 0. 05）. The patients with blood heat and dominant wind showed significant changes in the indicators after treatment（ P 0. 05）; those with blood stasis and heat accumulation showed significant changes in the levels of interleukin- 4（ IL- 4） and interleukin- 8（ IL- 8）（ P 0. 05） but no significant change in the level of tumor necrosis factor- α（ TNF- α）（ P 0. 05） after treatment; those with blood deficiency and wind dryness showed a significant change in the level of IL- 8（ P 0. 05） but no significant changes in the levels of TNF- α and IL- 4（ P 0. 05） after treatment. Conclusion： TCM syndrome differentiation in the treatment of psoriasis vulgaris can significantly reduce the abnormally elevated levels of TNF- α,IL- 8,and IL- 4,and has good clinical efficacy.