消银汤联合窄谱中波紫外线治疗寻常型银屑病血热证疗效及其对外周血IL-17,IL-23,IL-6水平的影响

Efficacy of Xiaoyin Decoction Combined with Narrow Band Ultraviolet for Psoriasis Vulgaris of Blood-heat Type and Effect on Expression Levels of Interleukin-17,Interleukin-23 and Interleukin-6 of Peripheral Blood

目的:探讨消银汤联合窄谱中波紫外线(NB-UVB)治疗寻常型银屑病血热证疗效,及其对外周血白细胞介素(IL)-17,IL-23,IL-6表达水平的影响。方法:将60例寻常型银屑病血热证患者随机分为治疗组、对照组,各30例,治疗组予消银汤联合NB-UVB照射治疗,对照组仅予NB-UVB照射治疗,疗程8周。同时选取30例志愿者作为健康组。检测健康组以及银屑病患者治疗前后IL^(-1)7,IL-23,IL-6表达水平,并记录患者治疗前,治疗后4,8周的银屑病皮损面积和严重程度指数(PASI)评分。结果:治疗组临床疗效优于对照组(P<0.05);治疗组治疗后皮损面积和严重程度指数(PASI)评分明显低于对照组(P<0.01);治疗组和对照组治疗前血清IL^(-1)7,IL-23,IL-6水平均较健康组明显升高(P<0.01);治疗后两组IL^(-1)7,IL-23,IL-6与治疗前比较均明显降低(P<0.01);治疗组治疗后上述各指标均优于对照组(P<0.05,P<0.01)。治疗组和对照组IL^(-1)7,IL-23,IL-6与PASI评分呈正相关性。结论:消银汤联合NB-UVB治疗寻常型银屑病血热证较单一NB-UVB治疗效果好,二者发挥协同作用,其机制可能与降低患者血清Th17细胞相关因子IL^(-1)7,IL-23,IL-6水平有关。

Objective： To investigate efficacy of Xiaoyin decoction combined with narrow band ultraviolet （NB-UVB） in treatment of psoriasis vulgaris of blood-heat type and its effect on expression levels of interleukin-17 （IL-17）, interleukin-23 （IL-23） and interleukin-6 （IL-6） of peripheral blood. Method： The 60 patients with psoriasis vulgaris of blood-heat type were randomly divided into treatment group and control group, n=30 in each group. Treatment group was treated with Xiaoyin decoction combined with NB-UVB and control group was treated with NB-UVB alone. The treatment course was 8 weeks for both groups. Another 30 healthy volunteers served as the normal control group. Expression levels of IL-17, IL-23 and IL-6 in healthy control group and patients with psoriasis vulgaris were detected before and after treatment, and Psoriasis Area and Severity Index （PASI） scores were recorded respectively before treatment, 4 weeks after treatment and 8 weeks after treatment. Result： Effective rate was 83.3% in treatment group, higher than 56.7% in control group （P〈0.05）. PASI score was （3.30±1.13） in treatment group and （6.00±1.10） in control group after treatment, with statistically significant difference （P〈0.01）. Expression levels of IL-17, IL-23 and IL-6 in treatment group and control group were significantly higher than those of healthy control group before treatment （P〈0.01）;there was statistically significant difference in expression levels of IL-17, IL-23 and IL-6 before and after treatment in both groups （P〈0.01）. After treatment, there was statistically significant difference in above indicators between treatment group and control group （P〈0.05, P〈0.01）. There was positive correlation between serum levels of IL-17, IL-23, IL-6 and PASI scores in treatment group and control group. Conclusion： Xiaoyin decoction combined with NB-UVB had better effect than NB-UVB treatment alone, and mechanism may be associated with decreasing serum expression levels of IL-17, IL-23 and IL-6 in Th17 cells.