土苓饮治疗寻常型银屑病血热证的临床疗效观察及对外周血IL-17、IL-23、TNF-α水平的影响

Therapeutic Effect of Tuling Yin for Treatment of Psoriasis Vulgaris with Blood Heat Syndrome and Its Influence on Levels of IL-17,IL-23 and TNF-α in Peripheral Blood

【目的】观察土苓饮治疗寻常型银屑病血热证患者的临床疗效及对患者血清白细胞介素17(IL-17)、白细胞介素23(IL-23)、肿瘤坏死因子α(TNF-α)水平的影响。【方法】将60例寻常型银屑病血热证患者随机分为治疗组和对照组,每组各30例。2组患者均给予外涂尿素乳膏的常规治疗,在此基础上,对照组给予复方青黛胶囊口服治疗,治疗组给予土苓饮口服治疗,疗程为8周。观察2组患者治疗前后银屑病皮损面积及严重程度指数(PASI)评分和血清IL-17、IL-23、TNF-α水平的变化情况,并评价2组患者的疗效和安全性。【结果】(1)治疗8周后,治疗组的总有效率为96.7%(29/30),对照组为83.3%(25/30),治疗组的疗效明显优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者PASI评分和血清IL-17、IL-23、TNF-α水平均较治疗前明显降低(P<0.01),且治疗组对PASI评分和血清IL-17、IL-23、TNF-α水平的降低作用均明显优于对照组,差异均有统计学意义(P<0.05或P<0.01)。(3)治疗期间,对照组2例、治疗组1例患者出现胃肠道不适症状,经停药后症状消失,未见其他毒副反应;同时,2组患者治疗前后的血、尿、大便常规和肝肾功能检查均未见异常改变。【结论】土苓饮治疗寻常型银屑病血热证患者,疗效好且安全性高,同时能明显降低患者血清IL-17、IL-23、TNF-α水平。

Objective To observe the clinical effect of Tuling Yin for the treatment of psoriasis vulgaris with blood heat syndrone and its influence on the levels of interleukin 17(IL-17),interleukin 23(IL-23)and tumor necrosis factor alpha(TNF-α)in the serum. Methods Sixty psoriasis vulgaris patients with blood heat syndrome were randomly divided into treatment group and control group,30 cases in each group. The patients in the two groups were treated with external application of urea cream,and additionally the control group was treated with oral use of compound Qingdai Capsules and the treatment group was treated with oral use of Tuling Yin. The treatment for the two groups covered 8 weeks. Before and after treatment,the scores of Psoriasis Area and Severity Index(PASI)and the serum levels of IL-17,IL-23 and TNF-α in the two groups were measured. After treatment,the clinical efficacy and safety of the two groups were compared. Results(1)After treatment for 8 weeks,the total effective rate of the treatment group was 96.7%(29/30),significantly higher than 83.3%(25/30)in the control group,and the difference was statistically significant(P < 0.05).(2)After treatment,PASI scores and serum levels of IL-17,IL-23 and TNF-α in the two groups were significantly lower than those before treatment(P < 0.01),and the treatment group had stronger effect on decreasing the PASI scores and serum levels of IL-17,IL-23 and TNF-αthan the control group, the difference being statistically significant(P < 0.05 or P < 0.01).(3)During the treatment, 2 cases from the control group and one case from the treatment group had the gastrointestinal discomforts,and the disorders of the two groups disappeared after suspension of the medication. No other toxic or side effect was found in the two groups. No abnormal changes were found in the routine test for the blood,urine and stool,or in the hepatic and renal function examination. Conclusion The application of Tuling Yin for the treatment of psoriasis vulgaris patients with blood heat syndrome is effective and safe,and it can obviously reduce the serum levels of IL-17,IL-23 and TNF-α.