凉血活血汤治疗寻常型银屑病疗效研究

The mechanism of Liangxue Huoxue decoction in the treatment of psoriasis vulgaris

目的:探讨凉血活血汤调控神经生长因子(NGF)-蛋白激酶A(PKA)/环磷酸腺苷反应元件结合蛋白(CREB)信号通路治疗寻常型银屑病的机制。方法:选择进展期寻常型银屑病患者60例,随机分为对照组和观察组,每组30例。对照组给予曲安奈德乳膏和卡泊三醇软膏治疗,观察组在对照组基础上联合凉血活血汤治疗。治疗8周后,观察两组疗效、银屑病面积与严重性指数(PASI)及不良反应发生率,流式细胞术测定T淋巴细胞亚群,酶联免疫吸附法测定NGF水平,蛋白免疫印迹法测定TrkA、PKA及CREB蛋白表达。结果:观察组总有效率高于对照组(P<0.05)。两组PASI评分显著下降,且观察组低于对照组(均P<0.05)。治疗后,两组CD3^(+)及CD4^(+)水平显著升高,CD8^(+)、NGF、TrkA、PKA及CREB水平则显著降低(均P<0.05),且观察组改善优于对照组(均P<0.05)。结论:凉血活血汤治疗寻常型银屑病效果显著,可降低患者PASI评分,其机制可能与抑制NGF-PKA/CREB信号通路,调节T淋巴细胞亚群有关。

Objective:To examine the mechanism of Liangxue Huoxue decoction in the management of psoriasis vulgaris through the modulation nerve growth factor(NGF)-protein kinase A(PKA)/cyclic adenosine phosphate reaction element-binding protein(CREB)signaling pathway.Methods:A total of sixty patients diagnosed with advanced psoriasis vulgaris were randomly assigned to either the control group or the observation group,with 30 participants in each group.The control group received treatment with triamcinolone cream and carbotriol ointment,while the observation group received treatment with Liangxue Huoxue decoction in addition to the control group’s treatment.Following an 8-week treatment period,the effectiveness of the treatments,as well as the psoriasis area and severity index(PASI)and the occurrence of adverse reactions were assessed in both groups.T lymphocyte subsets were analyzed using flow cytometry,NGF levels were measured using enzyme-linked immunosorbent assay.TrkA,PKA,and CREB protein expressions were determined through Western blot.Results:The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).The PASI scores in both groups exhibited significant decreases,with the observation group showing lower scores compared to the control group(all P<0.05).Following treatment,the levels of CD3+and CD4+in both groups were significantly increased,while the levels of CD8+,NGF,TrkA,PKA and CREB were significantly decreased(all P<0.05),with the observation group demonstrating a more pronounced effect(all P<0.05).Conclusion:Liangxue Huoxue decoction has significant effect in the management of psoriasis vulgare by reducing PASI score,the mechanism behind which was related to the inhibition of NGF-PKA/CREB signaling pathway and the adjustment of T lymphocyte subsets.