凉血退银汤对寻常型银屑病进展期疗效及JAK/STAT信号通路的影响

Effect of Liangxue Tuiyin Decoction on Advanced Psoriasis Vulgaris and JAK/STAT Signaling Pathway

目的探讨凉血退银汤治疗寻常型银屑病进展期的效果及对JAK/STAT信号通路的影响。方法选择2019年3月—2020年7月收治的寻常型银屑病进展期(血热证)96例,根据治疗方法不同分为对照组和观察组,每组48例。对照组给予糠酸莫米松乳膏、卡波三醇软膏治疗,观察组在对照组基础上联合凉血退银汤治疗。比较2组疗效、中医证候评分、银屑病面积与严重性指数(PASI)、T淋巴细胞亚群、生活质量、JAK/STAT信号通路相关基因表达及不良反应发生率。结果观察组总有效率高于对照组(P<0.05)。治疗后,2组中医证候评分、PASI、皮肤病生活质量指数、CD8+水平以及JAK3、STAT3、Bcl-2基因表达均低于治疗前,且观察组低于对照组(P<0.05)。治疗后,2组CD3+、CD^(4+)水平以及p53基因表达均高于治疗前,且观察组高于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论凉血退银汤可提高寻常型银屑病进展期(血热证)患者疗效和生活质量,改善免疫功能。其作用机制与阻断JAK/STAT信号通路活性,并下调抑凋亡基因Bcl-2、上调促凋亡基因p53表达有关。

Objective To investigate the effect of Liangxue Tuiyin decoction in the treatment of advanced psoriasis vulgaris and its effect on JAK/STAT signaling pathway.Methods A total of 96 patients with advanced psoriasis vulgaris(blood heat syndrome)who were admitted from March 2019 to July 2020 were selected and divided into control group and observation group according to different treatment methods,with 48 cases in each group.The control group was given Mometasone Furoate cream and Carbotriol ointment,and the observation group was given Liangxue Tuiyin decoction on the basis of the control group.The efficacy,TCM syndrome score,psoriasis area and severity index(PASI),T lymphocyte subsets,quality of life,JAK/STAT signaling pathway-related gene expression and incidence of adverse reactions were compared between the two groups.Results The total effective rate in the observation group was higher than that in the control group(P<0.05).After treatment,TCM syndrome score,PASI,skin disease life quality index,CD^(8+)level and gene expression of JAK3,STAT3 and Bcl-2 in both groups were lower than those before treatment,and lower in the observation group than in the control group(P<0.05).After treatment,the levels of CD3+,CD^(4+)and p53 gene expression in both groups were higher than those before treatment,and higher in the observation group than in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Liangxue Tuiyin decoction can improve the efficacy and quality of life of patients with advanced psoriasis vulgaris(blood heat syndrome),and improve immune function.Its mechanism of action is related to blocking the activity of JAK/STAT signaling pathway,down-regulating the expression of the anti-apoptotic gene Bcl-2 and up-regulating the expression of the pro-apoptotic gene p53.