中医情志疗法对银屑病患者神经-内分泌-免疫网络调节临床研究

Clinical Study on the Regulation of Nerve-Endocrine-Immune Network in Psoriasis Patients by Mmotional Therapy of TCM

目的探讨中医情志疗法对银屑病患者神经-内分泌-免疫网络的调节作用。方法收集寻常型银屑病患者60例,按照随机数字表法分为对照组和治疗组,各30例。对照组患者予常规药物(卤米松软膏、卡泊三醇软膏、复方甘草酸苷片)治疗,治疗组在此基础上联合"言语开导法"、"移情易性法"、"以情胜情法"等中医情志疗法。4周为1个疗程,两组患者均治疗3个疗程。评价两组患者皮损面积和严重指数(PSAI)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分,检测血清神经肽Y(NPY)、皮质醇及白介素-2(IL-2)水平,并进行疗效评价。结果治疗后,治疗组与对照组患者PASI、HAMA、HAMD评分均有不同程度下降[PASI:(5.15±1.35)分比(12.25±2.45)分,(9.22±1.68)分比(12.86±2.30)分,P均<0.05;HAMA:(9.50±3.10)分比(18.75±4.29)分,(15.48±3.88)分比(18.05±4.56)分,P均<0.05;HAMD:(11.40±3.99)比(21.15±4.71)分,(18.83±3.56)分比(21.40±4.43)分,P均<0.05],治疗组与对照组患者血清NPY、皮质醇、IL-2水平均下降[NPY:(111.43±18.19)ng/L比(155.09±17.30)ng/L,(136.76±15.10)ng/L比(156.45±18.80)ng/L,P均<0.05;皮质醇:(141.72±13.09)ng/L比(187.30±14.65)ng/L,P均<0.05;IL-2:(74.55±13.94)ng/L比(135.68±15.28)ng/L,(101.53±12.58)ng/L比(134.79±15.07)ng/L,P均<0.05],治疗组上述指标改善更明显(P均<0.05)。治疗组临床治疗总有效率90.0%(27/30)明显高于对照组的60.0%(18/30)(P<0.05)。结论中医情志疗法联合西医常规治疗可明显改善寻常型银屑病患者皮损情况,改善患者焦虑、抑郁情绪,调节神经-内分泌-免疫网络系统,从而提高临床疗效。

Objective To investigate the regulatory effect of emotional therapy of traditional Chinese medicine on nerve-endocrine-immune network in patients with psoriasis.Methods Sixty patients with psoriasis vulgaris were randomly divided into control group and treatment group,with 30 cases in each group.Patients in the control group were treated with conventional drugs(halometasone ointment,carbotriol ointment,compound glycyrrhizin tablets),while those in the treatment group were combined with emotional therapy of TCM such as"speech enlightening method","empathy method"and"emotion winning method".Four weeks is a course of treatment,and both groups were treated for three courses of treatment.Psoriasis area and severity index(PASI),Hamilton anxiety rating scale(HAMA),Hamilton depression scale(HAMD),serum neuropeptide Y(NPY),cortisol and interleukin 2(IL-2)were evaluated and tested.Results After treatment,PASI,HAMA and HAMD scores of patients in the treatment group and the control group decreased in different degrees,i.e.,PASI:[(5.15±1.35)vs(12.25±2.45),(9.22±1.68)vs(12.86±2.30),P<0.05,respectively];HAMA:[(9.50±3.10)vs(18.75±4.29),(15.48±3.88)vs(18.05±4.56),P<0.05,respectively];HAMD:[(11.40±3.99)vs(21.15±4.71),(18.83±3.56)vs(21.40±4.43),P<0.05,respectively].The levels of serum NPY,cortisol and IL-2 decreased in both treatment group and control group,i.e.,NPY:[(111.43±18.19)vs(155.09±17.30)ng/L,(136.76±15.10)vs(156.45±18.80)ng/L,P<0.05,respectively];cortisol:[(141.72±13.09)vs(187.30±14.65),P<0.05];IL-2:[(74.55±13.94)vs(135.68±15.28)ng/L,(101.53±12.58)vs(134.79±15.07)ng/L,P<0.05,respectively].The improvement of the above indexes was more obvious in the treatment group(P<0.05,respectively).The total effective rate of the treatment group was 90.0%(27/30),which was significantly higher than that of the control group(60.0%,18/30)(P<0.05).Conclusion Traditional Chinese medicine emotional therapy combined with western medicine routine treatment can obviously improve the skin lesions of patients with psoriasis vulgaris,improve the anxiety and depression of patients,and regulate the nerve-endocrine-immune network system,thus improving the clinical efficacy.