生地土茯苓汤联合卡泊三醇软膏治疗寻常型银屑病临床研究

Clinical Study on the Treatment of Psoriasis Vulgaris with Radix Rehmanniae and Rhizoma Smilacis Glabrae Decoction Combined with Capotriol Ointment

目的:观察生地土茯苓汤联合卡泊三醇软膏治疗寻常型银屑病的临床疗效。方法:将82例寻常型银屑病患者按照随机数字表法分为对照组和观察组,每组各41例。对照组给予卡泊三醇软膏治疗,观察组在对照组治疗的基础上给予生地土茯苓汤治疗。比较两组患者不良反应发生率及治疗前后中医证候积分、皮损面积、炎性因子水平[可溶性程序性死亡蛋白-1(soluble programmed death-1,sPD-1)、白细胞介素(interleukin, IL)-17A、IL-23]变化情况。结果:两组患者治疗后皮疹、鳞屑、口干及舌脉评分低于本组治疗前,且观察组低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后银屑病面积和严重性指数(psoriasis avea and severity index, PASI)评分于本组治疗前,且观察组低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后sPD-1、IL-17A及IL-23水平低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P<0.05)。结论:生地土茯苓汤配合卡泊三醇软膏治疗寻常型银屑病,可改善患者的临床症状,减少皮损面积,降低炎性反应。

Objective:To observe the clinical efficacy of Radix Rehmanniae and Rhizoma Smilacis Glabrae Decoction combined with Ca⁃potriol Ointment on psoriasis vulgaris.Methods:A total of 82 patients with psoriasis vulgaris were randomly divided into the control group and the observation group according to random number table method,with 41 cases in each group.The control group was treated with Capotriol Ointment,while the observation group was treated with Radix Rehmanniae and Rhizoma Smilacis Glabrae Decoction on the basis of the control group.The incidence of adverse reactions,the changes of TCM syndrome scores,skin lesion area,and inflamma⁃tory factor levels[including soluble programmed death protein⁃1(sPD⁃1),interleukin⁃17A,IL⁃23]before and after treatment were compared.Results:After treatment,the scores of rash,scales,dry mouth,and tongue pulse in the two groups of patients were lower than those of the same group before treatment,and the observation group′s above indexes were lower than those of the control group,and all the differences were statistically significant(P<0.05);The psoriasis area and severity index(PASI)scores were higher than those of the same group before treatment,and the observation group′s above indexes were lower than those of the control group,and all the differ⁃ences were statistically significant(P<0.05);The levels of sPD⁃1,IL⁃17A,and IL⁃23 were lower than those of the same group before treatment,and the observation group′s above indexes were lower than those of the control group,and all the differences were statistically significant(P<0.05).Conclusion:Radix Rehmanniae and Rhizoma Smilacis Glabrae Decoction combined with Capotriol Ointment can improve the clinical symptoms of patients with psoriasis vulgaris,reduce the area of skin lesions,and lower inflammatory reactions.