清热凉血法治疗血热型银屑病的疗效及对血清P物质、血管内皮生长因子的影响

Clinical Effect of Heat-clearing and Blood-cooling Therapy in Treatment of Psoriasis with Blood-Heat Syndrome and Its Effect on Serum Substance P and Vascular Endothelial Growth Factor

目的 探讨清热凉血法治疗血热型银屑病的临床疗效及对血清P物质(substance P,SP)、血管内皮生长因子(vascular endothelial growth factor,VEGF)的影响。方法 将43例血热型银屑病患者随机分为观察组(22例)和对照组(21例),在外用尿素乳膏的基础上,观察组予以口服清热凉血方剂,对照组予以口服复方氨肽素片,疗程均为8周。比较两组患者治疗前后银屑病面积与严重性指数(psoriasis area and severity index,PASI)、四条目瘙痒问卷(four-item itch questionnaire,FIIQ)评分、血清SP和VEGF水平,并评估临床疗效和不良反应发生率。结果 观察组临床疗效显著优于对照组(P<0.05)。两组治疗后PASI、FIIQ评分、SP水平、VEGF水平均较治疗前显著降低(P<0.05),且观察组降低程度较对照组更为显著(P<0.05)。与对照组比较,观察组的不良反应发生率更低(P<0.05)。结论 清热凉血法能有效治疗血热型银屑病,缓解瘙痒,降低血清SP和VEGF水平,且不良反应发生率低。

Objective To investigate the clinical effect of heat-clearing and blood-cooling therapy in the treatment of psoriasis with blood-heat syndrome and its effect on serum substance P (SP) and vascular endothelial growth factor (VEGF). Methods A total of 43 patients with psoriasis with blood-heat syndrome were randomly divided into observation group with 22 patients and control group with 21 patients. In addition to the external application of urea cream, the patients in the observation group were given oral administration of heat-clearing and blood-cooling prescription, and those in the control group were given oral administration of compound amino-polypeptide tablets;the course of treatment was 8 weeks for both groups. The two groups were compared in terms of psoriasis area and severity index (PASI), four-item itch questionnaire (FIIQ) score, and serum levels of SP and VEGF, and clinical efficacy and the incidence rate of adverse reactions were evaluated for both groups. Results The observation group had a significantly better treatment outcome than the control group ( P<0.05 ). Both groups had significant reductions in PASI, FIIQ score, and the serum levels of SP and VEGF after treatment ( P<0.05 ), and the observation group had significantly greater reductions than the control group ( P<0.05 ). Compared with the control group, the observation group had a significantly lower incidence rate of adverse reactions ( P<0.05 ). Conclusion Heat-clearing and blood-cooling therapy has a marked clinical effect in the treatment of psoriasis with blood-heat syndrome and can alleviate itching and reduce the serum levels of SP and VEGF with a low incidence rate of adverse reactions.