养血透邪法治疗静止期银屑病(血燥证)的临床疗效评价及对血清IL-17的影响

The clinical effect of nourishing blood and expelling pathogenic factors therapy and its influence to the level of serum IL-17 expressions in the treatment of psoriasis vulgaris of blood-dryness syndrome

目的探讨养血透邪法治疗静止期银屑病(血燥证)的临床疗效及对血清白介素(interleukin,IL)-17表达水平的影响。方法采用简单排序随机分组法,将符合纳入标准的银屑病患者120例,随机分为养血宣透方治疗组和阿维A胶囊对照组,每组60例,疗程均为8周。观察两组患者治疗后在银屑病临床体征面积和严重程度指数(PASI)、中医证候积分的变化,并采用酶联免疫吸附试验(ELISA)法检测两组患者治疗后血清IL-17表达水平的变化,评价其临床疗效。结果治疗组和对照组总有效率分别为83.33%和86.67%,两组综合疗效相当,差异无统计学意义(P>0.05)。两组治疗8周后,PASI评分、中医证候评分、血清IL-17水平较治疗前均下降,且均具有统计学意义(P<0.05);在改善中医证候评分方面治疗组优于对照组(P<0.01);在降低PASI评分及下调血清IL-17水平方面,两组比较差异无统计学意义(P>0.05)。结论养血透邪法治疗静止期银屑病(血燥证)疗效确切,其作用机制可能与下调血清IL-17的表达水平有关。

Objective To evaluate the efficacy of nourishing blood and expelling pathogenic factors therapy for psoriasis vulgaris with blood-dryness syndrome and its influence on the expression of serum interleukin17(IL-17).Methods Simple random grouping method was used,120 cases of psoriasis were randomly divided into the control group(n=60)and the observation group(n=60).The control group was given the Acitretin Capsule and the observation group was treated with Yangxue Xuantou Decoction.The treatment period was 8 weeks.Psoriasis area and severity index(PASI),TCM syndrome integral,and the levels of IL-17 observed after the treatment in the two groups.Results The total effective rate of the observation group and the control group was 83.33%and 86.67%respectively,the total effective rate were comparable in two groups(P>0.05).After the treatment,PASI scores,TCM syndrome integral and the levels of IL-17 were all significantly reduced in the two groups(P<0.05),the score of improving TCM syndrome was superior in treatment group to control group(P<0.01),in terms of reductions PASI scores and the levels of IL-17,the difference between the two groups was no statistically significant(P>0.05).Conclusion Nourishing blood and expelling pathogenic factors therapy is effective for psoriasis with blood-dryness syndrome.The mechanism may be related to the davn-regulation of serum IL-17 expression.