自拟疏风解毒方联合卡泊三醇软膏治疗银屑病的疗效及对免疫功能的影响

Efficacy of self-designed Shufeng Jiedu formula combined with calcipotriol on psoriasis and its influence on immune function

目的观察自拟疏风解毒方联合卡泊三醇软膏治疗银屑病的效果及对患者免疫功能的影响,为临床治疗银屑病提供参考。方法选取2019年2月—2022年11月瑞安市中医医院诊治的60例银屑病患者,应用随机数字表法分成2组,每组30例。对照组给予局部涂抹卡泊三醇乳膏^(+)窄谱中波紫外线(NB-UVB)照射干预,观察组在对照组基础上,口服自拟疏风解毒方治疗。2组治疗疗程均为8周。通过银屑病皮损面积与严重程度指数(PASI)评分评估临床效果,并对比2组患者治疗前后的中医证候积分、免疫功能(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平变化和安全性。结果治疗后,观察组总有效率为96.67%(29/30),明显高于对照组的73.33%(22/30),χ2=4.706,P=0.030;治疗后,观察组瘙痒剧烈、点状出血、皮疹增多积分均低于对照组(均P<0.01);治疗后,观察组PASI评分均低于对照组(均P<0.01);治疗后,观察组患者外周血CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均高于对照组[(52.86±6.13)%vs.(45.48±5.57)%,(53.42±5.76)%vs.(48.19±5.24)%,1.90±0.35 vs.1.62±0.39,t=4.880、3.679、2.927,均P<0.01];而CD8^(+)低于对照组[(28.25±5.35)%vs.(31.43±5.07)%,t=2.363,P=0.011]。结论自拟疏风解毒方联合卡泊三醇软膏治疗银屑病疗效显著,可有效降低PASI评分及中医证候积分,其机制可能与调节患者免疫功能有关,且安全性好。

Objective To observe the efficacy of self-designed Shufeng Jiedu formula combined with calcipotriol on psoriasis and its influence on immune function,and provide theoretical reference for clinical treatment of psoriasis.Methods A total of 60 patients with psoriasis treated in Ruian Hospital of Traditional Chinese Medicine from February 2019 to November 2022 were selected and randomly divided into two groups by random table method,with 30 cases in each group.The control group were treated with calcipotriol ointment combined with NB-UVB,and the observation group were treated with self-designed Shufeng Jiedu formula on the basis of the control group.Both groups had a treatment course of 8 weeks.The clinical efficacy was evaluated by the psoriasis skin lesion area and severity index(PASI),and the changes in traditional Chinese medicine syndrome scores,immune function(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))levels,and safety between two groups of patients before and after treatment were compared.Results After treatment,the total effective rate of the observation group was 96.67%(29/30),which was significantly higher than 73.33%(22/30)of the control group(χ^(2)=4.706,P=0.030);the score of severe itching,punctate bleeding and rash increase in the observation group were lower than those in the control group(all P<0.01);the PASI score index of the observation group were lower than that of the control group(all P<0.01);the levels of peripheral blood CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group[(52.86±6.13)%vs.(45.48±5.57)%,(53.42±5.76)%vs.(48.19±5.24)%,1.90±0.35 vs.1.62±0.39,t=4.880,3.679,2.927,all P<0.01],however,CD8^(+)was lower than the control group[(28.25±5.35)%vs.(31.43±5.07)%,t=2.363,P=0.011].Conclusion Self-designed Shufeng Jiedu formula combined with calcipotriol exert certain effect in treating of psoriasis,which can significantly improve the PASI score index and the main syndrome score.Its mechanism may be related to the regulation of immune function,and the safety is good.