三仁润肤汤外洗联合卡泊三醇搽剂治疗头皮银屑病血燥证的疗效观察

Clinical Observation of Sanren Runfu Decoction(三仁润肤汤)Combined with Capotriol Liniment in Scalp Psoriasis with Blood Dryness Syndrome

目的:观察三仁润肤汤外洗联合卡泊三醇搽剂治疗头皮银屑病血燥证的临床疗效及其对患者血清炎症相关因子和血管新生水平的影响。方法:选取60例符合标准的头皮银屑病血燥证患者,随机分为对照组和治疗组,每组30例。对照组在温水外洗头部后使用卡泊三醇搽剂外搽治疗,治疗组在三仁润肤汤外洗头部后使用卡泊三醇搽剂外搽治疗,连续治疗8周。比较两组患者治疗前后的临床疗效,观察两组患者头皮严重程度指数(PSSI评分)、皮肤病生活质量指数(DLQI)、瘙痒视觉模拟评分(VAS)、中医证候评分,检测两组患者治疗前后血清白细胞介素-12(IL-12)、IL-23、肿瘤坏死因子-α(TNF-α)、血管内皮生长因子(VEGF)、血小板-内皮细胞黏附分子(PECAM-1/CD31)、碱性成纤维细胞生长因子(bFGF)表达水平。结果:对照组脱落1例,易除1例;治疗组脱落1例。治疗8周后,治疗组患者临床疗效优于对照组(P<0.05)。治疗组总有效率为86.21%(25/29),对照组总有效率为78.57%(22/28)。两组患者治疗后PSSI、DLQI、VAS、中医证候评分均较治疗前显著降低(P<0.05),且治疗组均显著低于对照组(P<0.05);两组患者治疗后血清IL-12、IL-23、TNF-α、VEGF、CD31、bFGF表达水平均降低,且治疗组患者治疗后血清IL-12、IL-23、TNF-α、VEGF、CD31、bFGF表达水平均低于对照组(P<0.05)。结论:三仁润肤汤外洗联合卡泊三醇搽剂能显著提高治疗头皮银屑病血燥证临床疗效,降低炎症相关因子IL-12、IL-23、TNF-α的表达,抑制血管新生相关指标VEGF、CD31、bFGF分泌,从而减轻炎症反应,抑制新生血管形成,有效减小患者皮损面积,减轻皮肤瘙痒,缓解症状,提升生活质量。

Objective:To observe the clinical efficacy of Sanren Runfu decoction combined with carpotriol liniment in the treatment of scalp psoriasis with blood dryness syndrome and its effect on serum inflammatory factors and angiogenesis.Methods:Totally 60 patients with scalp psoriasis of blood dryness syndrome were randomly divided into control and treatment groups,30 cases in each group.Warm water was used to wash the head in the control group before carbotriol.In the treatment group,Sanren Runfu decoction was used to wash the head before carbotriol.The treatment was maintained for eight weeks.The clinical efficacy,scalp severity index(PSSI score),dermatosis quality of life index(DLQI),itching visual analogue score(VAS)and TCM syndrome score were compared between the two groups before and after treatment.The levels of serum interleukin-12(IL-12),interleukin-23(IL-23),tumor necrosis factor-α(TNF-α),vascular endothelial growth factor(VEGF),platelet-endothelialcell adhesion molecule(Platelet-endothelial-cell-adhesion-molecule-1,PECAM-1/CD31)and basic fibroblast growth factor(bFGF)were evaluated before and after treatment.Results:In the control group,one case fell off and one case was removed.One case fell off in the treatment group.After 8 weeks of treatment,the treatment group showed better clinical efficacy than control group(P<0.05).The total effective rate was 86.21%(25/29)in treatment group and 78.57%(22/28)in control group.The scores of PSSI,DLQI,VAS and TCM syndrome decreased after treatment in two groups(P<0.05),and the treatment group showed lower scores than control group after treatment(P<0.05).The serum IL-12,IL-23,TNF-α,VEGF,CD31 and bFGF decreased in the two groups after treatment and the treatment group showed lower serum IL-12,IL-23,TNF-α,VEGF,CD31 and bFGF than control group(P<0.05).Conclusion:Sanren Runfu decoction external washing combined with capotriol liniment can significantly improve the clinical efficacy of scalp psoriasis(blood dryness syndrome),reduce the expression of inflammation-related factors(IL-12,IL-23 and TNF-α),and inhibit the secretion of angiogenesis-related indexes(VEGF,CD31 and bFGF),so as to reduce inflammatory reaction,inhibit neovascularization,effectively reduce the area of skin lesions,relieve skin pruritus,relieve symptoms and improve the quality of life of patients.