清热凉血方治疗血热证银屑病的临床观察及对外周血miR-21表达的调控研究

Clinical effect and regulation of peripheral-blood mir-21 expression of Qingre Liangxue Decoction on psoriasis patients with blood heat syndrome

目的:观察清热凉血方治疗血热证银屑病的临床疗效,探讨其对外周血miR-21表达的调控。方法:采用随机对照分组试验,42例中医辨证为血热证银屑病的患者随机分为治疗组23例,口服清热凉血方,联合交替外用糖皮质激素软膏和钙泊三醇软膏;对照组19例,交替外用糖皮质激素软膏和钙泊三醇软膏。4周后观察两组临床疗效。治疗前后对病情严重程度进行中医证候评分和PASI评分;采用荧光定量PCR检测外周血miR-21表达情况。结果:治疗组治疗后皮损PASI评分、中医证候评分及外周血miR-21水平跟对照组比较有显著性差异(P<0.01);miR-21表达水平与血热证银屑病患者PASI评分和中医证候具有正相关性(r值分别为0.72和0.66)。结论:清热凉血方对外周血miR-21的下调作用可能是其治疗银屑病的作用机制之一。

Objective： To observe the clinical effect and the regulation of peripheral-blood miR-21 expression of Qingre Liangxue Decoction on psoriasis patients with blood heat syndrome. Methods： Forty-two cases of psoriasis patients were randomly divided into two groups. In the control group（19 cases）, psoriasis patients were treated externally with glucocorticoid ointment and calcipotriol ointment alternately. In the treatment group（23 cases）, patients were treated with Qingre Liangxue Decoction orally and the mentioned ointments externally. Before and after 4 weeks of clinical observation, the severity of disease was evaluated by TCM syndrome and PASI score, and the peripheral-blood miR-21 level was determined by fluorescent quantitation PCR. Results： The TCM syndrome, PASI score and the peripheral-blood miR-21 level of the psoriasis patients after the treatment in the clinical group were significantly difference to those in the control group（P〈0.01）. The peripheral-blood miR-21 level was positively correlated with the PASI score and TCM syndrome in psoriasis patients with blood-heat syndrome（r=0.72, r=0.66）. Conclusion： The down-regulation of peripheral-blood miR-21 might be one of the mechanisms of Qingre Liangxue Decoction in the treatment of psoriasis.