世界中医药

目的:评价银屑灵片对寻常型进展期银屑病肥胖患者血清瘦素及Wnt家族成员5a(Wingless-type MMTV Integration Site Family,Wnt5a)的影响。方法:选取2017年3月至2017年6月在广东省中医院皮肤科门诊就诊的银屑病患者60例,按随机原则分为对照组和观察组,每组30例。对照组患者给予复方丙酸氯倍他索软膏外涂;观察组患者则给予银屑灵片口服及复方丙酸氯倍他索软膏外涂,连续用药4周。比较临床治疗的有效率,评估治疗前后皮损程度及身体质量指数(BMI),监测用药前后血清瘦素、Wnt5a水平。结果:观察组患者的有效率96.7%较对照组73.3%的有效率明显升高(P<0.05);治疗后观察组患者的PASI评分、BMI、Wnt5a水平显著低于对照组(P<0.05),而2组间瘦素水平变化差异无统计学意义(P>0.05)。结论:银屑灵片对寻常型进展期银屑病肥胖患者疗效确切,利于改善银屑病患者的皮损面积、缓解银屑病斑块严重程度,降低BMI,其机制可能与调控瘦素、Wnt5a水平以调节Th1/Th2细胞平衡,减轻机体慢性炎性反应状态有一定相关性。

English Summary:

To assess the influence of Yinxieling tablets on serum leptin and Wnt5a in patients of acute psoriasis vulgaris with obesity.Methods:Sixty cases were randomly divided into a control group of 30 cases and an observation group of 30 cases receive treatment in dermatology clinic of traditional chinese medicine hospital of guangdong province from January 2017 to May 2017.Patients in control group were treated with compound clobetasol propionate ointment for external use，while patients in the observation group were treated with Yinxieling tablets and compound clobetasol propionate ointment,4 weeks for treatment.The research was aim to compare the clinical effect of the two groups，evaluate the degree of skin lesion and BMI before and after treatment，and monitor the levels change of serum leptin and Wnt5a.Results:The effectiveness in the observation group is 96.7%,which was higher than that in the control group 73.3%(P<0.05);The PASI，BMI,and Wnt5a of the patients in the observation group were lower than those of the control group(P<0.05),but the level of leptin in both groups is not statistically different before and after treatment(P>0.05).Conclusion:The treatment with Yinxieling tablets was proved to be effective in acute psoriasis vulgaris with obesity，which can lower PASI,BMI and the level of Wnt5a.The mechanism may be associated with the regulation of Wnt5a levels in the blood to promote Th1/Th2 cytokines ratio balance and alleviate the body state of chronic inflammation.

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