青黛膏联合NB-UVB治疗寻常型银屑病(血热型)效果及对血清炎症因子和免疫功能的影响

Effect of Qingdai Cream(青黛膏)Combined with NB-UVB on Serum Inflammatory Factors and Immune Function in Patients with Psoriasis Vulgaris(Blood-Heat Type)

目的观察青黛膏联合NB-UVB对寻常型银屑病(血热型)患者血清炎症因子和免疫功能的影响。方法选取2018年1月—2019年12月就诊于医院符合纳入标准的寻常型银屑病患者72例,随机均分为对照组和治疗组,对照组皮损外涂卡泊三醇软膏联合NB-UVB照射,治疗组皮损处外用青黛膏联合NB-UVB照射,共治疗8周。观察并比较两组患者治疗前后血清炎症因子和免疫功能水平变化,并对两组患者的临床疗效和不良反应进行比较。结果2例患者试验期间自行放弃治疗、治疗过程中2例患者多次未能按时用药,均按脱落病例处理,实际符合要求的患者为68例。对照组和治疗组的总有效率分别为76.48%、94.12%,与对照组比较,治疗组的总有效率显著上调,差异具有统计学意义(χ^(2)=4.221,P=0.040)。治疗前两组患者的血清中IL-17及VEGF水平差异无统计学意义(t=-0.174、-0.564,P=0.863、0.576)。治疗8周后,治疗组病人的各上述指标相较于对照组显著下调(t=3.114、2.357,P=0.034、0.022)。治疗前两组病人的免疫功能相关指标差异均无无统计学意义(t=-0.790、-0.621、0.491、-0.625,P=0.432、0.537、0.625、0.534)。治疗8周后,治疗组外周血中CD_(3)^(+)、CD_(4)^(+)以及CD_(4)^(+)/CD_(8)^(+)水平相较于对照组显著上调,差异具有统计学意义(t=-5.363、-3.498、-3.237,P=0.000、0.001、0.002);而CD_(8)^(+)水平相较于对照组显著下调,差异具有统计学意义(t=2.477,P=0.016)。两组患者治疗过程中生命体征平稳,且均未发生药物相关不良反应及过敏反应。结论青黛膏联合NB-UVB治疗寻常型银屑病(血热型)能够显著提高临床疗效,改善患者症状,其机制可能与降低血清中炎症因子和调节免疫功能有关,且无不良反应增加,使用方便、价格低廉,临床适宜推广。

Objective To observe the effect of Qingdai Cream(青黛膏)combined with narrow bound ultra violet B light(NB-UVB)on serum inflammatory factors and immune function in patients with psoriasis vulgaris(blood-heat type).Methods A total of 72 patients with psoriasis vulgaris who met the inclusion criteria in the hospital from January 2018 to December 2019 were selected and randomly divided into the control group and the treatment group.The skin lesions of the control group were coated with calcipotriol ointment.The skin lesions of the treatment group were treated with Qingdai Cream combined with NB-UVB irradiation for a total of 8 weeks.The changes of serum inflammatory factors and immune function levels before and after treatment between the two groups were observed and compared,and the clinical efficacy and adverse reactions of the two groups were compared.Results Two patients gave up the treatment during the trial period,and two patients failed to take medication on time for many times during the treatment.They were all handled as dropped cases.The actual number of patients who met the requirements was 68.The total effective rate of the control group and the treatment group were 76.48% and 94.12%,respectively.Compared with that of the control group,the total effective rate of the treatment group was significantly increased,and the difference was statistically significant(x^(2)=4.221,P=0.040).There was no significant difference in serum levels of IL-17 or VEGF between the two groups before treatment(t=-0.174,-0.564,P=0.863,0.576).After 8 weeks of treatment,the above indicators of the patients in the treatment group were significantly lower than those in the control group(t=3.114,2.357,P=0.034,0.022).Before treatment,there was no significant difference in immune function-related indicators between the two groups(t=-0.790,-0.621,0.491,-0.625,P=0.432,0.537,0.625,0.534).After 8 weeks of treatment,the levels of CD_(3)^(+),CD_(4)^(+),and CD_(4)^(+)/CD_(8)^(+) in the peripheral blood of patients in the treatment group were significantly increased compared with those in the control group,and the difference was statistically significant(t=-5.363,-3.498,-3.237,P=0.000,0.001,0.002)and the CD_(8)^(+) level was significantly down-regulated compared with that of the control group,and the difference was statistically significant(t=2.477,P=0.016).The vital signs of the two groups were stable during the treatment,and there were no drug-related adverse reactions or allergic reactions.Conclusion Qingdai Cream combined with NB-UVB in the treatment of psoriasis vulgaris(blood-heat type)can significantly improve the clinical efficacy and the symptoms of patients.Its mechanism may be related to the reduction of inflammatory factors in serum and the regulation of immune function,and there is no increase in adverse reactions.It is easy to use.It is cheap and suitable for clinical promotion.