益气解毒消银汤治疗寻常型银屑病疗效及对免疫机制的影响

Therapeutic Effect of Yiqi Jiedu Xiaoyin Decoction(益气解毒消银汤)on Psoriasis Vulgaris and Its Influence on Immune Mechanism

目的探讨益气解毒消银汤对寻常型银屑病的治疗效果及对免疫机制的影响。方法依据随机对照法将2016年11月—2019年11月来医院治疗的寻常型银屑病患者120例分为研究组和参照组,每组60例。参照组采用复方氟米松软膏治疗,研究组在参照组治疗的基础上,口服益气解毒消银汤治疗。两组均治疗8周。比较两组治疗前后血清中IL-17、IL-22、IL-23细胞因子含量,比较两组治疗前后外周血嗜酸性粒细胞P物质和NK1R水平,比较两组治疗前后临床评分变化情况和,制定疗效判定标准。结果研究组治疗疗效高于参照组(P<0.05);研究组治疗后中医证候瘙痒剧烈、点状出血、皮疹增多的证候积分低于参照组(P<0.05);研究组治疗后PASI评分指数较参照组低(P<0.05);研究组治疗后血清IL-17、IL-22和IL-23水平低于参照组(P<0.05);研究组治疗后外周血嗜酸性粒细胞P物质和NK1R水平低于参照组(P<0.05)。结论益气解毒消银汤可有效的改善患者的临床症状,降低PASI评分指数,调节患者体内的免疫炎症反应,降低血清嗜酸性粒细胞P物质及NK1R水平,和复方氟米松软膏联合应用,具有协同增效的作用,值得进一步研究探讨。

Objective To explore the therapeutic effect of Yiqi Jiedu Xiaoyin Decoction(益气解毒消银汤,YJXD)on psoriasis vulgaris and its influence on immune mechanism.Methods A total of 120 patients with psoriasis vulgaris treated in our hospital from November 2016 to November 2019 were divided into study group and control group,60 cases in each group.The control group was treated with Compound Flumisone Ointment,and the study group was treated with YJXD on the basis of the control group.Both groups were treated for 8 weeks.Before and after treatment,the TCM symptom score and PASI score index were compared between the two groups.The cytokine contents of IL-17,IL-22 and IL-23 in serum before and after treatment were compared.The levels of eosinophil substance P and NK1 R in peripheral blood before and after treatment were compared between the two groups,and the therapeutic effect was compared.Results The curative effect in the study group was higher than that of the control group(P<0.05).After treatment,TCM symptom scores of itching,dotted hemorrhage and skin rashes in the study group were lower than those of the control group(P<0.05).The PASI score index after treatment in the study group was lower than that of the control group(P 0.05).After treatment,the levels of IL-17,IL-22 and IL-23 in the study group were lower than those of the control group(P<0.05).The levels of peripheral eosinophil substance P and NK1 R in the study group after treatment were lower than those of the control group(P<0.05).Conclusion YJXD can reduce the PASI score index,regulate the immune inflammatory response in the patients and reduce the levels of substance P and NK1 R of eosinophils in the serum.It can be used in combination with Compound Flumisone Ointment,which has synergistic effect and is worth further study.