土槐丹四物汤联合复方秦柏洗剂治疗银屑病的机制研究

Effect of Tuhuai Dan Siwu Decoction(土槐丹四物汤)Combined with Compound Qinbai Lotion(复方秦柏洗剂)on Inflammatory Factors in Psoriasis

目的:观察口服土槐丹四物汤联合外用复方秦柏洗剂对小鼠阴道上皮细胞有丝分裂、咪喹莫特诱导的银屑病小鼠模型皮损及小鼠耳肿胀模型的影响,研究口服土槐丹四物汤联合外用复方秦柏洗剂对银屑病的治疗作用。方法:通过雌激素灌胃、背部外涂咪喹莫特乳膏与耳部外涂二甲苯溶液制作银屑病小鼠模型,分别给予不同药物进行干预,统计小鼠阴道上皮有丝分裂指数、小鼠背部皮肤PASI总评分、小鼠耳肿胀度及炎症因子表达水平。结果:复方秦柏洗剂组、土槐丹四物汤组、土槐丹四物汤+复方秦柏洗剂组、卡泊三醇组小鼠阴道上皮有丝分裂指数及阴道上皮中P-STAT3、STAT3光密度值均低于模型组(P<0.05);复方秦柏洗剂组小鼠阴道上皮中P-STAT3、STAT3光密度值高于卡泊三醇组(P<0.05);土槐丹四物汤+复方秦柏洗剂组小鼠阴道上皮有丝分裂指数及阴道上皮中P-STAT3、STAT3光密度值与卡泊三醇组比较,差异无统计学意义(P>0.05)。给药7 d后,甲氨蝶呤组、土槐丹四物汤组、复方秦柏洗剂组、土槐丹四物汤+复方秦柏洗剂组小鼠PASI总评分及血清STAT3、IFN-γ、IL-17、IL-23水平均低于模型组(P<0.05);土槐丹四物汤组、复方秦柏洗剂组小鼠PASI总评分及血清STAT3、IFN-γ、IL-17、IL-23水平均高于甲氨蝶呤组,差异均有统计学意义(P<0.05);土槐丹四物汤+复方秦柏洗剂组小鼠PASI总评分及血清STAT3、IFN-γ、IL-17、IL-23水平与甲氨蝶呤组比较,差异无统计学意义(P>0.05)。甲氨蝶呤组、土槐丹四物汤组、复方秦柏洗剂组、土槐丹四物汤+复方秦柏洗剂组小鼠耳肿胀度及耳组织IL-6、IL-17、IL-23、IFN-γ光密度值均低于模型组(P<0.05);土槐丹四物汤组、复方秦柏洗剂组小鼠耳肿胀度及耳组织IL-6、IL-17、IL-23、IFN-γ光密度值均高于甲氨蝶呤组,差异均有统计学意义(P<0.05);土槐丹四物汤+复方秦柏洗剂组小鼠耳肿胀度及耳组织IL-6、IL-17、IL-23、IFN-γ光密度值与甲氨蝶呤组比较,差异无统计学意义(P>0.05)。结论:口服土槐丹四物汤联合外用复方秦柏洗剂对银屑病具有治疗作用,其机制可能与抑制上皮细胞有丝分裂、降低炎症反应、抑制STAT3磷酸化、降低炎症因子水平有关。

Objective:To observe the effect of oral Tuhuai Dan Siwu decoction combined with topical compound Qinbai lotion on the mitosis of vaginal epithelial cells,imiquimod-induced psoriasis mouse model lesions and ear inflammation in mice,and to study the therapeutic effect of oral Tuhuai Dan Siwu decoction combined with topical compound Qinbai lotion on psoriasis.Methods:The mouse model of psoriasis was established by intragastric administration of estrogen,external application of imiquimod cream on the back and external application of xylene solution on the ear.Different drugs were given for intervention.The mitotic index of vaginal epithelium,total score of PASI on the back skin,degree of ear swelling and expression levels of inflammatory factors were counted.Results:Compound Qinbai lotion group,Tuhuai Dan Siwu decoction group,Tuhuai Dan Siwu decoction+compound Qinbai lotion group,Calcipotriol group showed lower mitotic index of vaginal epithelium and vaginal epithelium of P-STAT3 and STAT3 optical density values than model group(P<0.05);Compound Qinbai lotion showed higher vaginal epithelium P-STAT3 and STAT3 optical density value than Calcipotriol group(P<0.05);There was no significant difference in the mitotic index of vaginal epithelium and the optical density of p-STAT3 and STAT3 in vaginal epithelium between Tuhuai Dan Siwu decoction+compound Qinbai lotion group and Calcipotriol group(P>0.05).After seven days of administration,the Methotrexate group,Tuhuai Dan Siwu decoction group,compound Qinbai lotion group,Tuhuai Dan Siwu decoction+compound Qinbai lotion group showed lower total PASI score and serum STAT3,IFN-γ,IL-17 and IL-23 levels than model group(P<0.05).The Tuhuai Dan Siwu decoction group and compound Qinbai lotion group showed higher total PASI score and serum levels of STAT3,IFN-γ,IL-17 and IL-23 than Methotrexate group,and the difference was statistically significant(P<0.05).There was no significant difference in the total score of PASI and serum levels of STAT3,IFN-γ,IL-17 and IL-23 between Tuhuai Dan Siwu decoction+compound Qinbai lotion group and Methotrexate group(P>0.05).Methotrexate group,Tuhuai Dan Siwu decoction group,compound Qinbai lotion group,Tuhuai Dan Siwu decoction+compound Qinbai lotion group showed lower ear swelling degree and optical density values of IL-6,IL-17,IL-23 and IFN-γin ear tissue than model group(P<0.05);Tuhuai Dan Siwu decoction group and compound Qinbai lotion group showed higher ear swelling degree and optical density values of IL-6,IL-17,IL-23 and IFN-γin ear tissue than Methotrexate group(P<0.05).There was no statistically significant difference in mice ear swelling degree andoptical density values of IL-6,IL-17,IL-23 and IFN-γin ear tissue between Tuhuai Dan Siwu decoction+compound Qinbai lotion group and Methotrexate group(P>0.05).Conclusion:Oral Tuhuai Dansiwu Decoction combined with topical compound Qinbai lotion shows therapeutic effect on psoriasis,which may be related to the inhibition of epithelial cell mitosis,reduction of inflammatory response,inhibition of STAT3 phosphorylation,and reduction of inflammatory factors.