凉血退银汤治疗寻常型银屑病血热证的临床疗效及促进皮损愈合的作用

Clinical Curative Effect of Using Liangxue Tuyin Decoction in the Treatment of Psoriasis with Blood-heat Syndrome and Its Effect on Accelerating Skin Lesion

目的:观察凉血退银汤治疗寻常型银屑病血热证患者的中医证候、皮损面积及严重程度(PASI评分)及其促进皮损愈合作用(基质金属蛋白酶、血管内皮细胞生长因子表达水平)。方法:选择2015年3月至2018年3月我院寻常型银屑病患者300例,随机均分为观察组(凉血退银汤+维胺酯胶囊)和对照组(维胺酯胶囊)进行治疗,疗程4周,2个疗程后比较两组临床效果,T淋巴细胞分布情况以及MMP-2(基质金属蛋白酶-2)、MMP-9(基质金属蛋白酶-9)及VEGF(血管内皮细胞生长因子)表达水平。结果:治疗后,观察组和对照组治疗有效率分别为93.33%和85.33%(P<0.05),两组临床疗效差异有统计学意义(P<0.05);两组中医证候积分、PASI评分、CD8^+、Th1/Th2均明显降低(P<0.05),两组CD4^+、CD4^+/CD8^+明显升高(P<0.05),且两组治疗后差异有统计学意义(P<0.05);两组皮损中VEGF、MMP-2、MMP-9阳性率降低(P<0.05),且两组差异有统计学意义(P<0.05);经Pearson相关系数分析VEGF、MMP-2、MMP-9与中医证候积分和PASI评分均呈明显正相关性(P<0.05);两组不良反应差异无统计学意义(P>0.05)。结论:凉血退银汤治疗寻常型银屑病血热证患者能改善T淋巴细胞亚群分布,调节机体免疫状态,降低皮损中VEGF、MMP-2、MMP-9,从而促进皮损愈合,提高治疗效果。

Objective: To study on the TCM syndrome,Area and Severity of Pain ( PASI) in patients with psoriasis vulgaris syndrome treated by Liangxue Tuiyin Decoction and its effect on promoting skin lesion ( Matrix metalloproteinases and Vascular endothelial growth factor). Methods: From March 2015to March 2018,300cases of patients with blood-heat syndrome of psoriasis vulgaris were randomly divided into observation group ( Liangxue Tuyin Decoction and Vitamine Capsules) and controlled group ( Vitamine Capsules),and a course was 4weeks. And after 2courses,the clinical efficacy,distribution of T lymphocytes and expression levels of MMP-2,MMP-9and VEGF were compared between the two groups. Results: After treatment,the effective rates of treatment were 93. 33% and 85. 33% respectively in the observation group and the controlled group ( P<0. 05), and the difference in clinical efficacy between the two groups was statistically significant ( P<0. 05). The TCM syndromes scores, PASI score,and levels of CD8^+ and Th1 /Th2were significantly decreased ( P<0. 05) while the levels of CD4^+ and CD4^+/CD8^+ were significantly increased in the two groups ( P<0. 05),and there was a significant difference between the two groups after treatment ( P<0. 05). The positive rates of VEGF,MMP-2and MMP-9in skin lesions were decreased in the two groups ( P< 0. 05),and the difference between the two groups was statistically significant ( P<0. 05). Pearson correlation coefficient showed that VEGF,MMP-2and MMP-9were positively correlated with TCM syndromes scores and PASI score ( P<0. 05). There was no significant difference in adverse reactions between the two groups ( P>0. 05). Conclusions: Using Liangxue Tuyin Decoctionin the treatment of patients with blood-heat syndrome of psoriasis vulgaris can improve the distribution of T-lymphocyte subsets,regulate the body's immune status,and reduce VEGF,MMP-2and MMP-9in skin lesions,promotes skin lesion healing and treatment effects.