祛毒止痒汤治疗寻常型银屑病的临床价值研究

Clinical Value of Paidu Zhiyang Decoction Against Psoriasis Vulgaris

目的:观察祛毒止痒汤在寻常型银屑病治疗中的价值及对血清脂质过氧化物(LPO)、丙二醛(MDA)、血管内皮生长因子(VEGF)水平的影响。方法:选取2018年2月至2020年2月北京市隆福医院收治的寻常型银屑病患者92例作为研究对象,采用随机数字表法将患者分为观察组和对照组,每组46例。对照组患者口服盐酸西替利嗪片,10 mg/次,1次/d,外涂哈西奈德乳膏,2次/d。观察组在对照组治疗的基础上,口服祛毒止痒汤治疗。2组均按疗程治疗14 d。比较2组治疗前后皮损、瘙痒、鳞屑、肌肤甲错和心烦证候积分,比较2组治疗前后银屑病皮损面积及严重程度指数(PASI)、皮肤病生活质量指数量表(DLQI)和5-D瘙痒量表评分变化,比较2组治疗前后血清VEGF、MDA和LPO水平变化;随访1年,比较2组复发时间和复发率,比较2组疗效。结果:观察组治疗总有效率为89.13%,对照组治疗总有效率为71.74%。观察组治疗总有效率高于对照组(P<0.05);2组治疗后皮损、瘙痒、鳞屑、肌肤甲错和心烦证候积分较治疗前降低,且观察组降低幅度优于对照组(P<0.05);2组治疗后PASI、DLQI和5-D瘙痒量表评分较治疗前降低,且观察组降低幅度优于对照组(P<0.05);2组治疗后血清VEGF、MDA和LPO水平较治疗前降低,且观察组降低幅度优于对照组(P<0.05);观察组平均复发时间高于对照组,复发率低于对照组(P<0.05)。结论:在西药常规治疗的基础上,口服祛毒止痒汤辅助治疗,可显著降低寻常型银屑病(血热证)患者的中医证候积分,缓解患者的氧化应激损伤,抑制微血管增生,降低复发率,延长复发时间,提高治疗效果。

Objective:To investigate the clinical value of Qudu Zhiyang Decoction(QDZY)in the treatment of psoriasis vulgaris and its effects on serum LPO,MDA,and VEGF levels.Methods:Ninety-two patients with psoriasis vulgaris admitted to Beijing Longfu Hospital from February 2018 to February 2020 were divided into an observation group and a control group according to a random number table,with 46 cases in each group.The patients in the control group received cetirizine hydrochloride tablets by oral administration,10 mg/time,once a day,and halcinonide cream by external application,twice a day.The patients in the observation group were orally administered with QDZY on the basis of the therapeutic protocol of the control group.The course of treatment was 14 days in both groups.The scores of skin lesions,pruritus,scale,onychomycosis,and irritability of the two groups were compared before and after treatment.The scores of PASI,DLQI,and 5-D itch scale were compared between the two groups before and after treatment.The changes of serum VEGF,MDA,and LPO levels were compared between the two groups before and after treatment.The patients were followed up for one year,and the recurrence time and recurrence rate of the two groups were compared.The treatment efficacies of the two groups were compared.Results:The total effective rate of the observation group was 89.13%,higher than 71.74%of the control group(P<0.05).After treatment,the scores of skin lesions,pruritus,scale,onychomycosis,and irritability in the two groups were lower than those before treatment,and the reduction in the observation group was superior to that in the control group(P<0.05).After treatment,the scores of PASI,DLQI,and 5-D itch scale in the two groups were lower than those before treatment,and the reduction in the observation group was superior to that in the control group(P<0.05).After treatment,the levels of serum VEGF,MDA,and LPO in the two groups were lower than those before treatment,and the reduction in the observation group was superior to that in the control group(P<0.05).The average recurrence time of the observation group was longer than that of the control group,and the recurrence rate was lower than that of the control group(P<0.05).Conclusion:On the basis of conventional treatment with western medicine,oral QDZY as adjuvant treatment can significantly reduce the syndrome score of traditional Chinese medicine(TCM)in patients with psoriasis vulgaris(blood heat syndrome),relieve oxidative stress injury,inhibit microvascular hyperplasia,reduce recurrence rate,prolong recurrence time,and improve treatment efficacy.