CAJ | 학술논문

目的：观察基础治疗、窄谱UVB联合中药药浴治疗寻常型银屑病的临床疗效。方法选取寻常型银屑病患者94例，采取随机数字表法将其分为2组，实验组采取基础治疗、窄谱中波紫外线（ NB-UVB）联合中药药浴治疗，对照组仅采取基础治疗联合NB-UVB治疗。分别在治疗前和治疗8周后采用酶联免疫吸附试验（ELISA）检测2组患者的血清IFN-γ、IL-2和IL-17、VEGF水平，采用免疫组化染色法检测2组皮损Ki-67和CD3的表达水平，采取银屑病面积和严重程度性指数（ PASI）、皮肤病生活质量表（ DQOLs）评价2组患者治疗前和治疗8周后的生活质量和临床疗效。结果在治疗8周后，2组患者IFN-γ、IL-2、IL-17和VEGF的水平较治疗前明显下降（P均＜0.01），且实验组显著低于对照组（P均＜0．01）；2组患者皮损Ki-67和CD3的表达水平显著低于治疗前（ P均＜0．01），且实验组显著低于对照组（ P均＜0．01）；2组PASI评分、DQOLs积分显著低于治疗前（P均＜0．01），且实验组显著低于对照组（P＜0．01）。治疗8周后实验组有效率显著高于对照组（ P＜0．01）。结论 IFN-γ、IL-2和IL-17、VEGF、Ki-67和CD3在寻常型银屑病的发病机制中有重要作用，采取基础治疗、NB-UVB联合中药药浴治疗寻常型银屑病具有显著的临床疗效，且不增加不良反应发生率，有较高的临床应用价值。
목적：관찰기출치료、착보UVB연합중약약욕치료심상형은설병적림상료효。방법선취심상형은설병환자94례，채취수궤수자표법장기분위2조，실험조채취기출치료、착보중파자외선（ NB-UVB）연합중약약욕치료，대조조부채취기출치료연합NB-UVB치료。분별재치료전화치료8주후채용매련면역흡부시험（ELISA）검측2조환자적혈청IFN-γ、IL-2화IL-17、VEGF수평，채용면역조화염색법검측2조피손Ki-67화CD3적표체수평，채취은설병면적화엄중정도성지수（ PASI）、피부병생활질량표（ DQOLs）평개2조환자치료전화치료8주후적생활질량화림상료효。결과재치료8주후，2조환자IFN-γ、IL-2、IL-17화VEGF적수평교치료전명현하강（P균＜0.01），차실험조현저저우대조조（P균＜0．01）；2조환자피손Ki-67화CD3적표체수평현저저우치료전（ P균＜0．01），차실험조현저저우대조조（ P균＜0．01）；2조PASI평분、DQOLs적분현저저우치료전（P균＜0．01），차실험조현저저우대조조（P＜0．01）。치료8주후실험조유효솔현저고우대조조（ P＜0．01）。결론 IFN-γ、IL-2화IL-17、VEGF、Ki-67화CD3재심상형은설병적발병궤제중유중요작용，채취기출치료、NB-UVB연합중약약욕치료심상형은설병구유현저적림상료효，차불증가불량반응발생솔，유교고적림상응용개치。
Objective It is to observe the clinical curative effect of foundation treatment combined with narrow -band UVB ( NB-UVB) and traditional Chinese medicine bath in the treatment of psoriasis vulgaris .Methods 94 patients with psoriasis vulgaris were selected and randomly divided into two groups , patients received basic therapy combined with NB -UVB and tra-ditional Chinese medicine medicated bath treatment in experimental group , and received basic therapy combined with NB -UVB in control group.Before and 8 weeks after treatment, the levels of serum IFN-γ, IL-2 and IL-17, VEGF were de-tected by enzyme linked immunosorbent assay of both groups;and the levels of Ki-67 and CD3 in skin? lesion were detected by immunohistochemistry method;the quality of life and clinical curative effect were evaluated according the psoriasis area and severity index ( PASI) and dermatology quality of life scales ( DQOLs) .Results After 8 weeks of treatment, the levels of IFN-γ, IL-2, IL-17 and VEGF of both gorups were decreased significantly than before treatment (P<0.01), and which of ex-perimental group was significantly lower than that of control group (P<0.01); the expression levels of Ki -67 and CD3 le-sions was significantly lower than before treatment (P<0.01), and which of experimental group was significantly lower than that of control group (P<0.01);the scores of PASI and DQOLs in the two groups were significantly lower than before treat-ment (P<0.01), and which of experimental group was significantly lower than that of control group (P<0.01).The effec-tive rate in experimental group was significantly higher than that in control group ( P<0 .01 ) .Conclusion IFN-γ, IL-2 and IL-17, VEGF, Ki-67 and CD3 have an important role in the pathogenesis of psoriasis vulgaris , the basic treatment combined with NB-UVB and traditional Chinese medicine bath in treatment of psoriasis vulgaris has significant clinical effica -cy, and does not increase the incidence of adverse reactions , have high value in clinical application .