凉血消风散对寻常型银屑病血热证患者血清炎性因子及免疫功能的影响

Effect of Liangxue Xiaofeng Powder(凉血消风散)on Serum Inflammatory Factors and Immune Function in Patients with Psoriasis Vulgaris of Blood-heat Syndrome

目的观察凉血消风散治疗寻常型银屑病血热证患者的疗效并探讨期可能的机制。方法 116例寻常型银屑病血热证患者随机分为观察组和对照组各58例。对照组给予西医常规治疗,包括阿维A胶囊口服、复方氟米松软膏外用;观察组在西医常规治疗的基础上联合凉血消风散口服治疗,每日1剂,水煎服。两组均治疗4周。治疗前后进行银屑病皮损面积及严重程度指数(PASI)评分及中医症状总积分评价,治疗后判断临床疗效。治疗前后检测血清CC趋化因子配体20(CCL20)、白细胞介素17(IL-17)、肿瘤坏死因子α(TNF-α)、血管内皮生长因子(VEGF)、基质金属蛋白酶9(MMP-9)、转化生长因子β1(TGF-β1)水平及CD3^(+)、CD4^(+)/CD8^(+)、CD4^(+)水平。结果治疗后观察组PASI评分、中医症状总积分低于对照组(P<0.05)。观察组总有效率为94.83%(55/58),高于对照组的79.31%(46/58,P<0.05)。治疗后观察组血清CCL20、IL-17、TNF-α、VEGF、MMP-9、TGF-β1、CD3^(+)、CD4^(+)/CD8^(+)、CD4^(+)水平均低于对照组(P<0.05)。结论凉血消风散联合西药治疗寻常型银屑病血热证患者临床疗效优于单用西药,可改善临床症状、体征,其机制可能与减轻炎症反应、抗纤维化、调节免疫反应有关。

Objective To explore the effect of Liangxue Xiaofeng Powder(凉血消风散) on psoriasis vulgaris of blood-heat syndrome and to explore the possible mechanism. Methods A total of 116 psoriasis vulgaris patients of blood-heat syndrome were randomly divided into treatment group and control group with 58 cases in each group. The control group was given conventional Western medicine including oral acitretin capsules and external use of compound flumethasone ointment;the treatment group additionally received oral Liangxue Xiaofeng Powder, decocted in water, one dose daily. Both groups were treated for 4 weeks. Psoriasis area and severity index(PASI) score and total score of TCM symptoms were assessed before and after treatment, and the clinical effect was evaluated after treatment. The levels of serum CC chemokine-ligand 20(CCL20), interleukin 17(IL-17), tumor necrosis factor α(TNF-α), vascular endothelial growth factor(VEGF), matrix metalloproteinase 9(MMP-9), transforming growth factor β1(TGF-β1), CD3^(+), CD4^(+)/CD8^(+), and CD4^(+) were detected before and after treatment. Results After treatment, the PASI score and the total score of TCM symptoms in the treatment group were lower than those in the control group(P<0.05). The total effective rate in the treatment group was 94.83%(55/58), which was higher than 79.31%(46/58) in the control group(P<0.05). The levels of serum CCL20, IL-17, TNF-α, VEGF, MMP-9, TGF-β1, CD3^(+), CD4^(+)/CD8^(+) and CD4^(+) in the treatment group were significantly lower than those in the control group(P<0.05). Conclusion Liangxue Xiaofeng Powder combined with western medicine had more remarkable therapeutic effect than simple use of routine western medicine in improving clinical symptoms of psoriasis vulgaris patients with blood-heat syndrome. The mechanism may be related to the action of reducing inflammation, anti-fibrosis, and regulating immune response.