复方甘草酸苷联合NB-UVB对寻常型银屑病患者T淋巴细胞亚群及相关细胞因子的影响

Effect of compound glycyrrhizin combined with NB-UVB on T lymphocyte subsets and related cytokines in patients with psoriasis vulgaris

目的:探讨复方甘草酸苷联合窄谱中波紫外线(NB-UVB)对寻常型银屑病患者T淋巴细胞亚群及相关细胞因子的影响。方法:选取2015年3月~2016年3月收治的寻常型银屑病患者70例为研究对象,随机分为研究组和对照组,对照组采用NB-UVB光疗机进行全身照射治疗,起始剂量为0.3 J/cm2,以后每次增加0.2~0.3 J/cm^2,每周照射3次,研究组在对照组基础上静脉滴注复方甘草酸苷80mg^+5%葡萄糖250 m L,1次/d,两组治疗疗程均为4周;采用ELISA法测定血清IL-17、IL-22水平,流式细胞仪检测外周血T淋巴细胞亚群(CD4^+、CD8^+、CD4^+/CD8^+)变化情况,银屑病皮损面积和严重程度评分(PASI)进行治疗前后评分。结果:治疗后两组IL-17、IL-22均降低,与治疗前比较差异有统计学意义(P<0.05),研究组优于对照组,差异有统计学意义(P<0.05);治疗后两组CD4^+、CD4^+/CD8^+均升高,CD8^+降低,与治疗前比较差异有统计学意义(P<0.05),研究组优于对照组,差异有统计学意义(P<0.05);治疗后两组PASI评分降低,与治疗前比较差异有统计学意义(P<0.05),研究组优于对照组,差异有统计学意义(P<0.05)。结论:寻常型银屑病采用复方甘草酸苷联合NB-UVB进行治疗,可有效下调细胞因子水平,恢复T细胞免疫功能,改善PASI评分,值得临床推广。

Objective： To explore the effect of compound glycyrrhizin in combined with narrow band ultraviolet B（ NB-UVB）on T lymphocyte subsets and related cytokines in patients with psoriasis vulgaris. Methods： A total of 70 patients with psoriasis vulgaris who were admitted in our hospital from March,2015 to March,2016 were included in the study and randomized into the study group and the control group. The patients in the control group were given NB-UVB for whole body irradiation,with an initial dose of 0. 3 J /cm2,0. 2-0. 3 J / cm2 increased every time,3 times a week. On this basis,the patients in the study group were intravenously injected with compound glycyrrhizin（ 80 mg） -＋ 5% glucose（ 250 mL）,1 time a day. Four-week treatment was regarded as one course.ELISA was used to detect the serum IL-17 and IL-22 levels. FCM was used to detect the levels of peripheral blood T lymphocytes（ CD4-＋,CD8 -＋,CD4 -＋ / CD8 -＋）. PASI score before and after treatment was evaluated. Results： The levels of IL-17 and IL-22 after treatment in the two groups were significantly reduced when compared with before treatment（ P〈0. 05）,and the reduced degree in thestudy group was significantly superior to that in the control group（ P〈0. 05）. The levels of CD4 -＋ and CD4 -＋ / CD8 -＋ after treatment in the two groups were significantly elevated,but CD8 -＋ was significantly reduced when compared with before treatment（ P〈0. 05）,and those in the study group were significantly superior to those in the control group（ P〈0. 05）. PASI score after treatment in the two groups was significantly reduced when compared with before treatment（ P〈0. 05）,and the reduced degree in the study group was significantly superior to that in the control group（ P〈0. 05）. Conclusions： Compound glycyrrhizin in combined with NB-UVB in the treatment of psoriasis vulgaris can effectively down regulate the cytokine level,recover T cell immune function,and improve PASI score; therefore,it deserves to be widely recommended in the clinic.