清热解毒汤联合维A酸乳膏哈西奈德溶液治疗血热型寻常型银屑病的效果及对患者皮损情况和炎症反应的影响

Efficacy of Qingrejiedu decoction combined with vitamin Aacid creamHascinide solution in the treatment blood heat type psoriasis vulgaris and its effect on skin lesions and inflammatory response of patient

目的探讨清热解毒汤联合维A酸乳膏哈西奈德溶液治疗血热型寻常型银屑病的效果及对患者皮损情况、炎症反应的影响。方法选取2020年1月至2021年3月于济南市钢城区人民医院就诊的61例寻常型银屑病患者作为研究对象,采用随机信封法分为观察组(n=31)与对照组(n=30)。对照组采用维A酸乳膏哈西奈德溶液治疗,观察组在对照组的基础上联合清热解毒汤治疗。比较两组治疗前后中医证候积分、皮损面积和严重程度指数(PASI)评分、临床疗效及炎症因子[白细胞介素(IL)-2、IL-10、IL-4、IL-17及肿瘤坏死因子-α(TNF-α)]水平。结果治疗后,两组鳞屑、乏力困倦、红斑、瘙痒评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组PASI评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组TNF-α、IL-4、IL-17、IL-2、IL-10水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组经表皮水分丢失量少于治疗前,角质层含水量及皮脂含量均多于治疗前,且观察组经表皮水分丢失量少于对照组,角质层含水量及皮脂含量均多于对照组,差异有统计学意义(P<0.05)。结论清热解毒汤联合维A酸乳膏哈西奈德溶液能进一步增强血热型寻常型银屑病患者的治疗效果,改善患者皮损情况及皮肤屏障功能,抑制患者炎症因子表达水平,值得临床推广应用。

Objective To investigate the efficacy of Qingrejiedu decoction combined with vitamin A acid cream Hascinide solution in the treat-ment blood heat type psoriasis vulgaris and its effect on skin lesions and inflammatory response of patient.Methods A total of 61 patients with pso-riasis vulgaris who were treated in People's Hospital of Gangcheng District from January 2020 to March 2021 were selected as the research subjects,and they were divided into the observation group(n=31)and the control group(n=30)by random envelope method.The control group was treated with tretinoin cream halcyonide solution,and the observation group was additionally treated with Qingrejiedu decoction on the basis of the control group.The Traditional Chinese Medicine syndrome score,psoriasis area and severity index(PASI)score,clinical efficacy and levels of inflammatory factors(interleukin[IL]-2,IL-10,IL-4,IL-17 and tumor necrosis factor-α[TNF-α])before and after treatment were compared between the two groups.Results After treatment,the scales,fatigue and sleepiness,erythema and pruritus scores of the two groups were lower than those before treatment,and the observation group was lower than those in the control group,the differences were statistically significant(P<0.05).After treat-ment,PASI scores of the two groups were lower than before treatment,and observation group was lower than control group,the differences were sta-tistically significant(P<0.05).The total effective rate in the observation group was higher than that in the control group,and the difference was sta-tistically significant(P<0.05).After treatment,the levels of TNF-α,IL-4,IL-17,IL-2 and IL-10 of the two groups were lower than those before treat-ment,and the observation group was lower than those the control group,the differences were statistically significant(P<0.05).After treatment,the transepidermal water loss was less than before treatment,and the cuticle water content and sebum content were more than before treatment,and the transepidermal water loss in the observation group was less than that in the control group,and the cuticle water content and sebum content were more than those in the control group,the differences were statistically significant(P<0.05).Conclusion Qingrejiedu decoction combined with vitamin A acid cream Hascinide solution can further enhance the therapeutic effect of patients with psoriasis vulgaris with blood heat,improve skin lesions and skin barrier function,and inhibit the expression level of inflammatory factors in patients,which is worthy of clinical promotion and application.