消银汤联合走罐疗法对气滞血瘀型银屑病患者p38MAPK/Th17信号通路相关细胞因子的影响

Effects of Xiaoyin Decoction(消银汤)Combined with Walking Cupping Therapy on Cytokines Related to p38MAPK/Th17 Signaling Pathway in Patients with Psoriasis of Qi Stagnation and Blood Stasis Type

目的探讨消银汤联合走罐疗法对气滞血瘀型银屑病患者丝裂原活化蛋白激酶p38抗体(p38 mitogen-activated protein kinase,p38MAPK)/辅助性T细胞17(T helper cell 17,Th17)信号通路相关细胞因子的影响。方法将2018年6月—2021年6月在江西省皮肤病专科医院门诊就诊的90例气滞血瘀型银屑病患者纳入研究,按随机数字表法分为观察组、对照1组和对照2组,各30例。观察组患者给予消银汤联合走罐疗法治疗,对照1组患者口服消银汤治疗,对照2组患者给予走罐疗法治疗。比较3组患者的治疗效果、不良反应及复发情况,比较3组患者治疗前后的中医证候积分、p38MAPK基因相对表达量、白细胞介素-17(Interleukin-17,IL-17)、白细胞介素-22(Interleukin-22,IL-22)、白细胞介素-23(Interleukin-23,IL-23)、全血高切黏度、全血低切黏度、血浆黏度。结果观察组总有效率显著高于对照1组和对照2组(P<0.05);3组治疗后红斑、鳞屑、浸润、瘙痒程度显著低于治疗前,且观察组显著低于对照1组和对照2组(P<0.05);3组治疗后p38MAPK基因相对表达量、IL-17、IL-22、IL-23显著低于治疗前,且观察组显著低于对照1组和对照2组(P<0.05);3组治疗后全血高切黏度、全血低切黏度、血浆黏度显著低于治疗前,且观察组显著低于对照1组和对照2组(P<0.05);3组不良反应总发生率比较差异无统计学意义(P>0.05),观察组复发率显著低于对照1组和对照2组(P<0.05)。结论消银汤联合走罐疗法可抑制气滞血瘀型银屑病患者p38MAPK/Th17信号通路相关细胞因子的表达,减轻炎症反应,提高免疫功能,同时缓解患者症状及改善血液流变学效果较好,复发率低。

Objective To investigate the effect of Xiaoyin Decoction(消银汤)combined with walking cupping therapy on cyto⁃kines related to mitogen-activated protein kinase p38 antibody(p38MAPK)/helper T cell 17(Th17)signaling pathway in pa⁃tients with psoriasis of Qi stagnation and blood stasis type.Methods Ninety patients with psoriasis of Qi stagnation and blood sta⁃sis type who were hospitalized in the outpatient department of Dermatology Hospital of Jiangxi Province from June 2018 to June 2021 were selected as the study subjects.They were randomly divided into observation group,control group 1 and control group 2,with 30 cases in each group.The patients in the observation group were given Xiaoyin Decoction combined with walking cup⁃ping therapy,those in the control group 1 were given Xiaoyin Decoction orally,and those in the control group 2 were given the walking cupping therapy.The treatment effects,adverse reactions and recurrence of the three group were compared.The TCM syndrome score,p38MAPK gene relative expression,interleukin-17(IL-17),interleukin-22(IL-22),interleukin-23(IL-23),whole blood high shear viscosity,whole blood low shear viscosity and plasma viscosity were compared before and after treatment.Results The total effective rate of the observation group was significantly higher than that of control group 1 and control group 2(P<0.05).The degree of erythema,scaling,infiltration and itching in the three groups after treatment were significant⁃ly lower than those before treatment,and the degree of the observation group was significantly lower than that in the control group 1 and control group 2(P<0.05).The relative expression levels of p38MAPK gene,IL-17,IL-22 and IL-23 in the three groups after treatment were significantly lower than those before treatment,and the levels of the observation group were signifi⁃cantly lower than those in control group 1 and control group 2(P<0.05).The whole blood high shear viscosity,whole blood low shear viscosity and plasma viscosity after treatment in the three groups were significantly lower than those before treatment,and those of the observation group were significantly lower than those of the control group 1 and the control group 2(P<0.05).There was no significant difference in the total incidence of adverse reactions among the three groups(P>0.05),and the recurrence rate in the observation group was significantly lower than that in the control group 1 and control group 2(P<0.05).Conclusion Xiaoyin Decoction combined with walking cupping therapy can inhibit the expressions of p38mapk/th17 signal pathway related cy⁃tokines in patients with psoriasis of Qi stagnation and blood stasis type,reduce inflammatory reaction,improve immune function,alleviate symptoms and improve hemorheology,with good effect and low recurrence rate.