走罐疗法治疗血瘀证斑块状银屑病对外周血CD_(4)^(+)T淋巴细胞亚群的影响

Effects of moving cupping therapy on the peripheral blood CD_(4)^(+)T cell subsets of plaquetype psoriasis in blood stasis syndrome

目的:观察走罐疗法对血瘀证斑块状银屑病外周血CD4+T淋巴细胞亚群表达的影响。方法:收集2019年1月至12月就诊于新疆维吾尔自治区中医医院皮肤科门诊及病房住院的60例血瘀证斑块状银屑病患者,随机分为两组,治疗组与对照组各30例,治疗组以普连乳膏为润滑剂进行走罐疗法,对照组采用NB-UVB联合普连乳膏外用治疗,共治疗4周。观察并分析两组患者治疗前后银屑病面积和严重程度指数(PASI)评分变化,并使用流式细胞仪检测两组患者治疗前后外周血CD4+T淋巴细胞亚群的变化。结果:两组治疗后PASI评分、CD4+T淋巴细胞亚群百分比的改变均显著优于治疗前(P<0.01),且治疗组PASI评分、CD4+T淋巴细胞亚群百分比的改变显著优于对照组(P<0.01),治疗后治疗组总有效率为93.33%(28/30)显著优于对照组70.00%(21/30)(P<0.05)。结论:走罐疗法治疗寻常型斑块状银屑病(血瘀证)疗效显著,推测其作用机制可能是通过抑制Th1、Th17、Th22的诱导、分化,从而减少致炎因子的激活释放,使银屑病皮损局部炎症反应免疫应答下调,从而改善皮损的角化过度与浸润程度,达到治疗的目的。

Objective: To observe the effects of moving cupping therapy on the peripheral blood CD4+ T cell subsets of plaque-type psoriasis in blood stasis syndrome. Methods: Sixty patients with plaque psoriasis who attended the outpatient and inpatient departments of the Department of Dermatology of the Traditional Chinese Medical Hospital Affiliated to Xinjiang Medical University between January 2019 and December 2019 were collected as study subjects. They were randomly divided into two groups, and there were 30 cases each in the treatment and control groups, with the treatment group using cup moving therapy(Pulian cream as a lubricant) and the control group using Narrowband UVB(NB-UVB) and Pulian cream for 4 weeks, separately. The changes of PASI scores after and before treatment were observed and analyzed in the two groups, the changes of peripheral blood CD4+ T cell subsets before and after treatment were detected and analyzed by flow cytometry in both groups. Results: The PASI scores and CD4+ T cell percentage were significantly better after treatment than before the treatment in the two group(P<0.01). The difference in PASI and CD4+ T cell percentage in the treatment group were significantly better than those in the control group(P<0.01). The total effective rate was 93.33%(28/30) in the treatment group, which was superior to 70.00%(21/30) of the control group(P<0.05). Conclusion: Moving cupping therapy has good effect on plaque-type psoriasis in blood stasis syndrome. The mechanism of action may be related with inhibiting the induction and differentiation of Th1, Th17 and Th22, thus reducing the activation and release of inflammatory factors and down-regulating the local inflammatory response immune response in psoriatic lesions, improving the hyperkeratosis and infiltration of the lesions and achieving the therapeutic goal.