丹槐银屑浓缩丸联合阿维A对银屑病患者VEGF及受体FLT-1、KDR表达的影响

Effect of Danhuai Yinxue Concentrated Pill Combined with Acitretin on Expression of VEGF and Receptor FLT-1 and KDR in Patients with Psoriasis

目的:观察丹槐银屑浓缩丸联合阿维A对银屑病血管内皮生长因子(Vascular Endothelial Growthfactor,VEGF)及其受体1(Fms related Tyrosine-1,FLT-1)、受体2(Kinase Insert Domain-contaning Receptor,KDR)表达的影响。方法:回顾性调查十堰市太和医院皮肤科2014年1月以前收治的102例银屑病为对照组,按入院先后将2014年2月至2015年2月收治的306例银屑病病例分为丹槐组、阿维A组、联合治疗组。对照组采用免疫调节、皮质类固醇激素等药物对症治疗,阿维A组在对照组治疗基础上病损表皮涂抹阿维A软膏,丹槐组在对照组治疗基础上加服丹槐银屑浓缩丸,联合治疗组同时加用阿维A及丹槐银屑浓缩丸。检测治疗前后表皮病变组织VEGF蛋白及VEGF-mRNA表达,VEGF、FLT-1、KDR、表皮变组织真皮乳头血管密度(Skin Tissue Dermal Papillary Vascular Density,MVD),静脉血T淋巴细胞,并比较临床疗效。结果:联合治疗组总有效率达83.79%,VEGF蛋白质及mRNA、FLT-1、KDR、MVD表达均及T淋巴细胞明显降低,与阿维A及丹槐组比较,差异均有统计学意义(均P<0.05)。结论:丹槐银屑浓缩丸可降低VEGF过度表达,阻断VEGF与其受体结合,抑制病变组织皮下血管新生、重建,进而降低真皮乳头微血管的异常增生,阿维A抑制T细胞增殖介导的炎性反应,减轻银屑病的病理改变,两药联合应用起到协同作用,可增强疗效。

Objective：To observe the effect of Danhuai Yinxue Concentrated Pill combined with acitretin on expression of vascular endothelial growth factor（VEGF）and its receptor（FLT-1,KDR）of patients with psoriasis.Methods：A retrospective investigation for 102 cases in dermatological department of Shiyan Taihe Hospital before January 1,2014 was conducted as control group .Three hundred and six patients who received treatment in the hospital from February 2014 to February 2015 were collected and divided into Danhuai group ,acitretin group ,and joint treatment group .Patients in the control group were treated by immune regulative drugs or corticosteroids .Patients in acitretin group additionally adopted acitretin ointment on damaged skin , while patients in Danhuai group additionally adopted Danhuai Yinxue Concentrated Pill ,compared with the control group .The joint treatment group applied acitretin ointment and Danhuai Yinxue Concentrated Pill , in addition to treatment for the control group .The expression of VEGF protein and VEGF mRNA,VEGF receptor,FLT-1 and KDR,skin tissue dermal papillary vascular density （MVD）,venous blood T lymphocyte were detested and compared before and after the treatment .The clinical curative effects of all the groups were observed . Results：The total effective rate of the joint treatment group was 83.79%,and the VEGF protein and mRNA ,FLT 1 and KDR and MVD expression and T lymphocytes significantly decreased ,compared with acitretin group and Danhuai group （allP〈0.05）.The difference showed statistical significance .Conclusion：Danhuai Yinxue Concentrated Pill may reduce excessive VEGF expression , block the connection between VEGF and its receptors ,inhibit subcutaneous angiogenesis and reconstruction of damaged tissue to re-duce the abnormal growths of dermal papilla capillaries .Acitretin may suppress inflammatory reaction induced by T cells prolifera-tion,reduce the pathological changes in patients with psoriasis .The combination of Danhuai Yinxue Concentrated Pill and Acitretin has synergistic effects and enhance curative effects .