CAJ | 학술논문

目的探讨消银汤联合卡泊三醇软膏治疗进展期血热型轻/中度(PASI评分＜10)寻常性银屑病疗效和对IL-17、IL-22、TNF-α水平影响.方法 60例进展期血热型轻/中度寻常性银屑病患者分为治疗组及对照组,每组各30例.治疗组予消银汤口服；对照组予安慰剂口服,2组同时外用卡泊三醇软膏；另选志愿者30例作为健康对照组；疗程12周.记录治疗前、后PASI评分,检测治疗前、后Th17细胞、TNF-α、IL-22、IL-17水平.结果治疗前,与健康对照组相比,治疗组及对照组在Th17细胞水平及血清IL-17、IL-22和TNF-α水平差异有统计学意义(P＜0.05),治疗组及对照组水平高于健康对照组；治疗后,上述指标与治疗前比较,差异有统计学意义(P＜0.05).治疗组治疗后PASI评分为(1.83±1.28),对照组为(2.91±1.42),差异有统计学意义(P＜0.05).治疗组总有效率为93.33％,与对照组总有效率73.33％比较差异有统计学意义(P＜0.05).治疗组在PASI评分,治疗总有效率及细胞因子水平改善方面优于对照组.结论 Th17细胞及血清IL-17、IL-22和TNF-α水平在轻/中度寻常性银屑病患者存在异常,消银汤联合卡泊三醇软膏对此有改善作用.
목적 탐토소은탕연합잡박삼순연고치료진전기혈열형경/중도(PASI평분＜10)심상성은설병료효화대IL-17、IL-22、TNF-α수평영향.방법 60례진전기혈열형경/중도심상성은설병환자분위치료조급대조조,매조각30례.치료조여소은탕구복；대조조여안위제구복,2조동시외용잡박삼순연고；령선지원자30례작위건강대조조；료정12주.기록치료전、후PASI평분,검측치료전、후Th17세포、TNF-α、IL-22、IL-17수평.결과 치료전,여건강대조조상비,치료조급대조조재Th17세포수평급혈청IL-17、IL-22화TNF-α수평차이유통계학의의(P＜0.05),치료조급대조조수평고우건강대조조；치료후,상술지표여치료전비교,차이유통계학의의(P＜0.05).치료조치료후PASI평분위(1.83±1.28),대조조위(2.91±1.42),차이유통계학의의(P＜0.05).치료조총유효솔위93.33％,여대조조총유효솔73.33％비교차이유통계학의의(P＜0.05).치료조재PASI평분,치료총유효솔급세포인자수평개선방면우우대조조.결론 Th17세포급혈청IL-17、IL-22화TNF-α수평재경/중도심상성은설병환자존재이상,소은탕연합잡박삼순연고대차유개선작용.
Objective To estimate the efficacy of Xiaoyin decoction combined with calcipotriol ointment in patients with mild to moderate vulgaris psoriasis of blood heat type as well as their effects on the expression of interleukin (IL)-17,-22 and tumor necrosis factor (TNF) α.Methods Sixty patients with mild to moderate vulgaris psoriasis of blood heat type were enrolled in this study,and equally divided into 2 groups to be treated with Xiaoyin decoction and placebo respectively for 12 weeks.Calcipotriol ointment was applied in both groups of patients.Thirty healthy volunteers served as the controls.Bicolor flow cytometry was conducted to determine the proportion of peripheral blood Th17 cells,and enzyme linked immunosorbent assay (ELISA) to measure the serum levels of IL-17,IL-22 and TNF-α,in the controls and patients before and after treatment.Clinical efficacy was evaluated by psoriasis area and severity index (PASI) score.Results Increased proportion of Th17 cells and serum levels of IL-17,IL-22 and TNF-α were observed in the patients with psoriasis before treatment compared with the controls (all P ＜ 0.05).After treatment,a significant decrease was noted in the proportion of Th17 cells ((8.32 ± 1.28)％ vs.(14.24 ± 1.97)％,P ＜ 0.05) and serum levels of IL-17,IL-22 and TNF-α in the Xiaoyin decoction group (all P ＜ 0.05 ),but not in the placebo group.The PASI score was significantly different between the Xiaoyin decoction and placebo group after treatment (1.83 ± 1.28 vs.2.91 ± 1.42,P ＜ 0.05).The total response rate was 93.33％ in the Xiaoyin decoction group,significantly higher than that in the placebo group (73.33％,P ＜ 0.05).Conclusions There is an abnormality in the proportion of Th17 cells and serum levels of IL-17,IL-22 and TNF-α,which may be ameliorated by the combined treatment with Xiaoyin decoction and calcipotriol ointment.