补肝益肾活血法治疗中重度斑秃临床观察

Clinical Observation of Liver-tonifying,Kidney-nourishing,and Blood-activating Method in Treatment of Moderate-to-severe Alopecia Areata

目的评价补肝益肾活血法治疗中重度斑秃的临床疗效并探究其对患者外周血CD4^+CD25^+调节性T细胞亚群的影响。方法选择中重度斑秃患者50例,根据就诊先后顺序将其随机分为治疗组和对照组各25例,对照组服用复方甘草酸苷片,治疗组给予补肝益肾活血之剂治疗,观察两组治疗前后斑秃严重程度评分(severity of alopecia tool,SALT)的变化,评价临床疗效,并利用流式细胞仪分析两组患者治疗前后外周血清CD4^+CD25^+调节性T细胞亚群的变化情况。结果两组患者治疗12周后,SALT评分均显著低于治疗前(P<0.05);两组患者治疗前后SALT评分差值比较,差异有统计学意义(P<0.05)。两组临床疗效的分布比较,差异有统计学意义(P<0.05)。两组患者血清CD4^+CD25^+调节性T细胞表达水平均较治疗前升高(P<0.05),但均未达到正常组水平。结论补肝益肾活血法能够有效治疗中重度斑秃,并可以提高患者外周血CD4^+CD25^+调节性T细胞水平,效果优于复方甘草酸苷。

Objective To investigate the clinical effect of liver-tonifying,kidney-nourishing,and blood-activating method in the treatment of moderate-to-severe alopecia areata and its effect on peripheral CD4+CD25+regulatory T cells.Methods A total of 50 patients with moderate-to-severe alopecia areata were randomly divided into treatment group and control group according to the order they visited the hospital,with 25 patients in each group.The patients in the control group were given compound glycyrrhizin tablets,and those in the treatment group were given liver-tonifying,kidney-nourishing,and blood-activating prescription.The Severity of Alopecia Tool(SALT)score was observed for both groups before and after treatment,clinical outcomes were evaluated,and flow cytometry was used to measure the changes in CD4+CD25+regulatory T cells in peripheral serum after treatment.Results After 12 weeks of treatment,both groups had a significant reduction in SALT score(P<0.05),and the treatment group had a significantly greater reduction than the control group(P<0.05).There was a significant difference in the distribution of clinical outcomes between the two groups(P<0.05).Both groups had a significant increase in the percentage of CD4+CD25+regulatory T cells in serum after treatment(P<0.05),which was still lower than the normal level.Conclusion The liver-tonifying,kidney-nourishing,and blood-activating method has a good clinical effect in the treatment of moderate-to-severe alopecia areata and can increase the percentage of peripheral CD4+CD25+regulatory T cells.It has a better clinical effect than compound glycyrrhizin tablets.