楮芍凉血汤加减治疗寻常型银屑病的效果及对免疫功能、辅助性T淋巴细胞17相关因子的影响

Influence of Modified Chushao Liangxue Decoction on immune function and Th17-related factors in psoriasis vulgaris

目的观察楮芍凉血汤加减治疗寻常型银屑病的临床疗效和对免疫功能、辅助性T淋巴细胞17(Th17)相关因子的影响。方法选取2020年2月至2021年12月在本院接受治疗64例进行期PV患者,采用随机数字表法将患者分为对照组和观察组各32例。对照组患者接受常规西药治疗,观察组接受楮芍凉血汤加减治疗,治疗周期为6周。所有研究对象均检测外周血T淋巴细胞亚群、分离单个核细胞(PBMC)情况,分析PBMC中Thl7细胞相关因子白细胞介素17(IL-17)、IL-22、维甲酸相关孤儿受体γ(ROR-γ)mRNA、干扰素γ(INF-γ)mRNA相对表达量,并对比临床总疗效。结果治疗6周后,观察组总有效治疗30例(93.75%),对照组总有效治疗24例(75.00%),2组总疗效差异具有统计学意义(P<0.05)。治疗6周后,2组患者T淋巴细胞指标CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均升高,CD8^(+)及Th17相关因子IL-17、IL-22、RORC mRNA、INF-γmRNA相对表达量均降低,组内不同时点和组间同时点比较差异均具有统计学意义(P<0.05)。结论楮芍凉血汤可有效治疗寻常型银屑病,且作用机制与T淋巴细胞亚群分布及Thl7细胞相关因子有关,可以提高机体免疫功能,以此减少不良症状,提高临床疗效。

Objective To observe the clinical efficacy of modified Chushao Liangxue Decoction for psoriasis vulgaris(PV)and its on immune function and T helper cell 17(Th17)-related factors.Methods A total of 64 patients with progressive PV treated in our hospital from February 2020 to December 2021 were randomly1:1assigned to control group(conventional Western medicine)or observation group(Modified Chushao Liangxue Decoction).The treatment period was 6 weeks,and the peripheral blood T lymphocytes subsets,isolated peripheral blood mononuclear cell(PBMC)were detected,aim to analyze the expression of interleukin-17(IL-17),IL-22,retinoic acid receptor-related orphan receptor gamma(ROR-γ)mRNA,interferon gamma(INF-γ)mRNA in PBMC,and assess the curative effect.Results After 6-week of treatment,the overall effective rate in the observation group was better than that in the control group(93.75%[30/32]vs 75.00%[24/32],P<0.05).After 6-week of treatment,CD3^(+),CD4^(+),CD4^(+)/CD8^(+)T lymphocytes in the both groups were significant increased than those before treatment,while CD8^(+),IL-17,IL-22,ROR-γ mRNA,INF-γ mRNA were significant decreased.The inter-group differences were significant at different time points(P<0.05).Conclusion Modified Chushao Liangxue Decoction has effective therapeutic effects in PV patients,it can improve immune function,reduce adverse symptoms,and improve clinical efficacy.Its mechanism may be related to the distribution of T lymphocyte subsets and Th17-related factors.