菝葜槐花凉血汤对老年银屑病患者外周血辅助性T细胞/调节性T细胞平衡及其相关细胞因子表达的影响

Effects of a Baqia Huaihua Liangxue decoction on peripheral blood T helper 17 cells/Tregulatory cells balance and the expression of related cytokines in elderly patients with psoriasis

目的探讨菝葜槐花凉血汤对老年银屑病患者外周血辅助性T细胞/调节性T细胞(Th17/Treg)平衡及其相关细胞因子表达的影响。方法选取2018年9月至2019年12月我院诊治的124例老年银屑病患者,采用数字奇偶法将其分为观察组与对照组,各62例。全部接受常规治疗、物理治疗,观察组联合菝葜槐花凉血汤治疗,分别于治疗前、治疗2个月后,检测两组Th17、Treg及Th17/Treg、白细胞介素(IL)-17(IL-17)IL-22、IL-23;使用银屑病皮损面积和严重程度指数量表(PASI)评估两组皮损严重程度;评估两组中医证候积分;治疗期间观察不良反应。结果治疗2个月后观察组Th17及Th17/Treg值分别为(1.0±0.1)%、(0.2±0.1),小于对照组(2.4±0.9)%、(0.6±0.2),Treg值为(5.3±1.1)%,大于对照组的(4.3±1.0)%(均P<0.05);观察组IL-17.IL-22及IL-23水平为(22.1±3.5)ng/L、(44.8±4.4)ng/L、(43.7±5.2)ng/L,均低于对照组(35.6±4.0)ng/L、(49.9±5.1)ng/L、(52.5±5.4)ng/L(均P<0.05);观察组PASI评分及中医症候积分为(2.9±1.0)分、(3.2±1.9)分,均低于对照组(6.1±2.3)分、(7.6±2.1)分(均P<0.05);两组治疗期间均无不良反应发生。结论老年银屑病患者经接莫槐花凉血汤治疗效果确切,有助于稳定患者外周血Th17/Treg平衡状态,抑制相关细胞因子表达,患者皮损程度减轻,且治疗期间无不良反应发生。

Objective To investigate the effects of a Baqia Huaihua Liangxue decoction on peripheral blood T helper 17 cells/Tregulatory cells(Th17/Treg)balance and the expression of related cytokines in elderly patients with psoriasis.Methods A total of 124 elderly patients diagnosed with psoriasis and receiving treatment at our hospital from September 2018 to December 2019 were divided into the observation group and the control group according to the parity number table,with 62 cases in each group.All patients underwent conventional treatment and physical therapy,and,in addition,the observation group was treated with a Baqia Huaihua Liangxue decoction for 2 months.The blood indexes including levels of Th17,Treg,Th17/Treg,and Th17/Treg-related cytokines such as interleukin-17(IL-17),IL-22 and IL-23 in the two groups were measured before treatment and 2 months after treatment.The psoriasis area and severity index(PASI)was used to evaluate the severity of skin damage in the two groups.The traditional Chinese medicine(TCM)syndrome scores were evaluated and compared between the two groups.Adverse reactions during treatment were monitored and recorded.Results After 2 months of treatment,the Th17 and Th17/Treg levels were lower[(1.0±0.1)%vs.(2.4±0.9)%,0.2±0.1 vs.0.6±0.2,all P<0.05]and Treg levels were higher in the observation group than in the control group[(5.3±1.1)%vs.(4.3±1.0)%,P<0.05].Levels of IL-17,IL-22 and IL-23 were lower in the observation group than in the control group after 2 months of treatment](22.1±3.5)ng/L-us.(35.6±4.0)ng/L,(44.8±4.4)ng/L vs.(49.9±5.l)ng/L,(43.7±5.2)ng/L-vs.(52.5±5.4)ng/L,all P<0.05].The PASI score and TCM syndrome score were lower in the observation group than in the control group after 2 months of treatment[(2.9±1.0)vs.(6.1±2.3),(3.2±1.9)vs.(7.6±2.1)all P<0.05].No adverse reaction occurred in the two groups during treatment.Conclusions The Baqia Huaihua Liangxue decoction has a clear therapeutic effect in elderly patients with psoriasis.It can stabilize peripheral blood Th17/Treg balance»inhibit the expression of related cytokines,reduce the degree of skin damage and has no adverse reaction during treatment.