凉血活血汤配合常规西药治疗血热型银屑病合并冠心病的疗效观察及对患者皮肤屏障功能、血液流变学的影响

Observation on the Efficacy of Liangxue HuoXue Decoction with Conventional Western Medicine in the Treatment of Blood heat Psoriasis Combined with Coronary Heart Disease and the Effects on Skin Barrier Function and Blood Rheology of Patients

[目的]探究凉血活血汤配合常规西药治疗血热型银屑病并发冠心病的疗效,以及对患者皮肤屏障功能、血液流变学的影响。[方法]选取2019年11月至2021年12月血热型银屑病合并冠心病患者88例,随机分为两组,每组44例。对照组予以常规西药治疗,观察组予以凉血活血汤配合常规西药治疗。比较两组临床疗效、不良反应及治疗前后皮肤屏障功能、血液流变学指标、血清炎性因子白细胞介素-1(interleukin-1,IL-1)、IL-6、IL-8及肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)及皮损面积和严重程度指数(psoriasis area and severity index,PASI)、Barthel指数(Barthel index,BI)。[结果]观察组治疗总有效率(88.64%)较对照组(70.45%)高(P<0.05),观察组不良反应发生率(13.64%)与对照组(9.09%)差异无统计学意义(P>0.05)。治疗2、4周后,观察组角质层含水量、皮脂含量均较对照组高,经表皮水分丢失量、全血高切、低切黏度、红细胞比容、血浆黏度及IL-1、IL-6、IL-8、TNF-α水平较对照组低(P<0.05)。治疗4、12周后,观察组PASI评分较对照组低,BI较对照组高(P<0.05)。[结论]凉血活血汤配合常规西药治疗银屑病合并冠心病患者,可有效减轻机体炎症反应,改善皮肤屏障功能及血液流变学指标,效果颇佳,且安全性高。

[Objective]To investigate the efficacy of Liangxue Huoxue Decoction with conventional western medicine in the treatment of blood heat psoriasis complicated with coronary heart disease and the effects on skin barrier function and hemorheology of patients.[Methods]Eighty-eight patients with blood heat psoriasis combined with coronary heart disease from November 2019 to December 2021 were selected and randomly divided into two groups,with 44 patients in each group.The control group was treated with conventional western medicine,and the observation group was treated with Liangxue Huoxue Decoction together with conventional western medicine.The clinical efficacy,adverse reactions,as well as skin barrier function,hemorheological indicators,serum inflammatory factors interleukin-1(IL-1),IL-6,IL-8,and tumor necrosis factor-α(TNF-α),lesion area and severity index(PASI),and Barthel index(BI)were compared before and after treatment between the two groups.[Results]Compared with control group(70.45%),the total effective rate of treatment in observation group(88.64%)was higher(P<0.05),and there was no statistically significant difference in the incidence of adverse reactions between observation group and control group(P>0.05).After 2 weeks and 4 weeks of treatment,the stratum corneum water content and sebum content in observation group were higher than control group and the transepidermal water loss,whole blood high cut and low cut viscosity,erythrocyte specific volume,plasma viscosity and IL-1,IL-6,IL-8 and TNF-αlevel were lower than control group(P<0.05).After 4 weeks and 12 weeks of treatment,the PASI score was lower and the BI was higher in observation group than control group(P<0.05).[Conclusion]Liangxue Huoxue Decoction together with conventional western medicine can effectively reduce the inflammatory response of the body and improve the skin barrier function and hemorheological indicators in the treatment of patients with psoriasis combined with coronary heart disease,with good effect and high safety.