基于TLR2介导的炎症通路探讨温清饮对湿热体质寻常性痤疮的疗效及作用机制

Clinical efficacy and mechanism of Wenqing Drink on acne vulgaris with damp-heat constitution based on TLR2-mediated inflammatory pathway

目的:观察温清饮治疗湿热体质寻常性痤疮(AV)的临床疗效,初步明确温清饮治疗湿热体质AV的部分机制。方法:将120例湿热体质AV患者随机分为空白组、观察组与对照组,每组40例,对照组采用异维A酸胶囊治疗,观察组采用温清饮方加减治疗,两组均治疗42d。比较3组患者治疗前、治疗结束后1d与治疗结束后90d的痤疮综合分级系统(GAGS)、卡迪夫痤疮指数(CADI)、医院焦虑抑郁量表(HADS)及湿热体质积分,Toll样受体2(TLR2)表达及各项炎症因子水平。结果:治疗结束后1、90d,观察组TLR2及各炎症因子水平均显著降低(P<0.05),GAGS、CADI、HADS及湿热体质评分均显著降低(P<0.05),且观察组均低于对照组(P<0.05)。观察组近、远期疗效总有效率为90.0%(36/40)、82.5%(33/40),分别高于对照组的85.0%(34/40)、67.5%(27/40)(P<0.05),两组患者均未发生不良反应。结论:温清饮可有效降低湿热体质AV皮损评分,调整患者体质,改善患者焦虑、抑郁水平,提升生活质量,并显著提高临床近期和远期疗效。

Objective: To observe the clinical efficacy of Wenqing Drink in the treatment of damp-heat constitution acne vulgaris(AV), and To clarify part of the mechanism. Methods: A total of 120 patients with AV with damp-heat were divided randomly into control group, observation group and blank group, 40 cases in each group. The control group was given Isotretinoin Capsules treatment, while the observation group using Wenqing Drink treatment, all two groups were treated for 42 days. The comprehensive global acne grading system(GAGS), Cardiff acne disability inde(CADI), hospital anxiety and depression scale(HADS), damp-heat constitution score, TLR2 receptor expression and inflammatory factors were compared before treatment, 1 day after treatment and 90 days after treatment. Results: One day after treatment and 90 days after treatment, the levels of TLR2 and inflammatory factors in the observation group decreased significantly(P<0.05), GAGS, CADI, HADS and damp-heat constitution score decreased significantly(P<0.05), and the observation group was lower than that in the control group(P<0.05). The short-term and long-term efficacy rates of the observation group were 90.0%(36/40) and 82.5%(33/40), which were higher than those of the control group, 85.0%(34/40)and 67.5%(27/40), respectively(P<0.05), and there were no adverse reactions in both groups. Conclusion: Wenqing Drink can significantly reduce the score of AV with damp-heat constitution lesions, balance the patient’s constitution, improve the level of anxiety and depression, enhance the quality of life, and further improve the short-term and long-term clinical efficacy.