窄谱中波紫外线配合活血解毒方对血瘀型银屑病患者血液流变学及血清Th1/Th2细胞因子和IL-17表达的影响

Effects of Narrow-band UVB and Huoxue Jiedu Recipe on Hemorheology and Serum Th1/Th2 Cytokine and IL-17 Expression in Patients with Blood Stasis Psoriasis

目的:探讨窄谱中波紫外线配合活血解毒方对血瘀型银屑病患者血液流变学及血清Th1/Th2细胞因子、白细胞介素-17(IL-17)表达的影响。方法:选取2017年8月-2019年10月于笔者医院就诊的血瘀型银屑病患者112例进行前瞻性随机对照研究,以计算机生成的随机数字表将患者分为研究组(n=56)和对照组(n=56)。对照组予以窄谱中波紫外线,研究组给予窄谱中波紫外线配合活血解毒方,均治疗2个月。对比两组疗效、不良反应与治疗前后银屑病面积与严重性指数(Psoriasis area and severity index,PASI)评分、皮肤病生活质量指数评分(Dermatology life quality index,DLQI)、血液流变学指标(全血黏度低切、全血黏度高切、红细胞压积、血沉)、血清免疫功能(CD4^(^(+))、CD8^(^(+))、CD4^(^(+))/CD8^(^(+)))、Th1/Th2细胞因子[白细胞介素-10(IL-10)、白细胞介素-4(IL-4)、干扰素-γ(IFN-γ)、白细胞介素-2(IL-2)]、IL-17水平。结果:研究组总有效率为91.07%,高于对照组76.79%,差异有统计学意义(P<0.05),两组不良反应发生率差异无统计学意义(P>0.05);两组治疗后PASI、DLQI评分较治疗前降低,且研究组低于对照组,差异有统计学意义(P<0.05);治疗后,两组全血黏度低切、全血黏度高切、红细胞压积、血沉均降低,研究组降低幅度较高,差异有统计学意义(P<0.05);治疗后,两组血清CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平、血清IL-10、IL-4、IFN-γ、IL-2、IL-17水平均明显改善,且研究组均优于对照组,差异有统计学意义(P<0.05)。结论:窄谱中波紫外线配合活血解毒方治疗血瘀型银屑病患者临床疗效显著,且安全性良好,可有效改善机体血液流变学及免疫状态,调节Th1/Th2、IL-17表达,进而促进患者皮损症状改善,提升生活质量。

Objective To investigate the effect of narrow-band UVB combined with Huoxue Jiedu Recipe on hemorheology and serum Th1/Th2 cytokine and interleukin-17(IL-17)expression in patients with blood stasis psoriasis.Methods A prospective randomized controlled study of 112 patients with blood stasis psoriasis in our hospital from August 2017 to October 2019 was selected.The patients were divided into a study group(n=56)and a control group(n=56)by a computer-generated random number table.The control group was given narrow-band UVB,and the study group was given narrow-band UVB in combination with Huoxue Jiedu Recipe,all treated for 2 months.Comparing the efficacy,adverse reactions and psoriasis area and severity index(PASI),dermatological quality of life index(DLQI)scores,hemorheological indicators(low blood viscosity cut,high blood viscosity cut,hematocrit,erythrocyte sedimentation rate),serum immune function(CD4^(^(+)),CD8^(^(+)),CD4^(^(+))/CD8^(^(+))),Th1/Th2 cytokines[interleukin-10(IL-10),interleukin-4(IL-4),interferon-γ(IFN-γ),interleukin-2(IL-2)],IL-17 levels of the two groups before and after treatment.Results The total effective rate of the study group was 91.07%,higher than that of the control group 76.79%(P<0.05),there was no significant difference in the incidence of adverse reactions between the 2 groups(P>0.05).After treatment,the PASI and DLQI scores of the two groups were lower than before treatment,and the study group was lower than the control group(P<0.05).After treatment,the low blood viscosity cut,high blood viscosity cut,hematocrit,and erythrocyte sedimentation rate of the two groups all decreased,and the reduction of the study group was higher(P<0.05).After treatment,the levels of serum CD4^(+),CD8^(+),CD4^(+)/CD8^(+),serum IL-10,IL-4,IFN-γ,IL-2,and IL-17 levels in the two groups were significantly improved,and the study group was better than the control group(P<0.05).Conclusion Narrow-band UVB combined with Huoxue Jiedu Recipe is effective in the treatment of patients with blood stasis psoriasis and has good safety,which can effectively improve the body's hemorheology and immune status,regulate the expression of Th1/Th2,and IL-17,thereby promoting the improvement of patients'skin lesion symptoms and improving the quality of life.