火针联合刺络拔罐干预稳定期轻度寻常型银屑病血瘀证

Effect of Fire Acupuncture Combined with Puncture and Cupping on Mild Psoriasis Vulgaris with Blood Stasis Syndrome in Stable Stage

目的:观察火针治疗局部皮损联合背腧穴刺络拔罐干预稳定期轻度寻常型银屑病血瘀证的临床疗效并探讨其可能的作用机制。方法:将60例稳定期轻度银屑病血瘀证患者随机分为治疗组和对照组,每组30例。治疗组30例患者给予火针联合刺络拔罐,2周1次;对照组30例患者给予外涂卡泊三醇乳膏,每日2次。60例患者共治疗8周,记录并比较治疗前后两组稳定期轻度寻常型银屑病血瘀证患者银屑病皮损面积及严重程度指数(psoriasis area and severity index,PASI)、视觉模拟评分法(visual analogue scale,VAS)、皮肤病生活质量指标调查表(skin disease quality of life questionnaire indicators,DLQI)评分、临床治疗有效率,同步检测患者血清中白细胞介素-17A(interleukin-17A,IL-17A)、IL-23表达情况。结果:两组患者治疗后PASI评分、VAS评分、DLQI评分,均较治疗前明显降低(P<0.00),且治疗组患者各项评分指标均较对照组降低更明显(P<0.00);两组临床有效率比较,差异有统计学意义(P<0.00);治疗组患者血清中IL-17A、IL-23水平较治疗前明显降低(P<0.00),对照组患者血清中IL-17A、IL-23水平无明显变化(P>0.05)。结论:火针联合刺络拔罐干预稳定期轻度寻常型银屑病血瘀证疗效安全可靠,操作简单,未发现明显不良反应,治疗银屑病的作用机制可能与下调银屑病患者血清中IL-17A、IL-23的表达有关。

Objective:To observe the clinical efficacy of fire acupuncture combined with acupuncture and cupping at back acupoints in the treatment of mild psoriasis vulgaris with blood stasis syndrome in stable stage and to explore its possible mechanism.Methods:60 patients of mild psoriasis vulgaris with blood stasis syndrome in stable stage were randomly divided into treatment group and control group,30 cases in each group.30 patients in the treatment group were given fire acupuncture combined with acupuncture and cupping,once every two weeks.30 patients in the control group were given external application of calcipotriol cream,twice a day.All 60 patients were treated for 8 weeks.Before and after treatment,the psoriasis area and severity index(PASI),visual analogue scale(VAS),skin disease quality of life questionnaire indicators(DLQI)and clinical effective rate were recorded and compared of mild psoriasis vulgaris with blood stasis syndrome in stable stage were compared between the two groups.The serum levels of interleukin-17 A(IL-17 A)and IL-23 were detected simultaneously.Results:The PAI score,VAS score and DLQI score of 60 patients in the two groups were significantly lower than that before treatment(P<0.00),while the scores of the treatment group were significantly lower than those in the control group(P<0.00).The total effective rate of the two groups was statistically significant(P<0.00).The expression of IL-17 A and IL-23 in the serum of 30 patients in the treatment group was significantly lower than that before treatment(P<0.00),while the expression of IL-17 A and IL-23 in the serum of 30 patients in the control group had no significant change(P>0.05).Conclusion:The therapeutic effect of fire acupuncture combined with puncture and cupping in the treatment of mild psoriasis vulgaris with blood stasis syndrome in stable stage is safe,reliable,simple,affordable,and no obvious side effects are found.The mechanism of action of fire acupuncture combined with puncture and cupping in the treatment of psoriasis vulgaris may be related to the down-regulation of the expression of IL-17 A and IL-23 in the serum of patients with psoriasis vulgaris.