| 引用本文:程静1，张慧丽1，孙占学2.莪仙化斑汤对斑块型银屑病患者白细胞介素-23、白细胞介素-17A及血管内皮生长因子的影响[J].世界中医药,2022,(24):. |
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| 莪仙化斑汤对斑块型银屑病患者白细胞介素-23、白细胞介素-17A及血管内皮生长因子的影响 |
| Effects of Exian Huaban Decoction on IL-23，IL-17A，and VEGF in Patients with Plaque Psoriasis |
| 投稿时间：2021-01-19 |
| DOI：10.3969/j.issn.1673-7202.2022.24.021 |
| 中文关键词: 斑块型银屑病 莪仙化斑汤 血热瘀阻证 IL-23/Th17轴 作用机制 白细胞介素-23 白细胞介素-17A 血管内皮生长因子 |
| English Keywords:Plaque psoriasis Exian Huaban Decoction Blood-heat and blood-stasis syndrome IL-23/Th17 axis Mechanism IL-23 IL-17A VEGF |
| 基金项目:国家中医药管理局中医药行业科研专项（2015468001）——中医药治疗慢性病临床疗效研究（一）；2019年度北京市丰台区卫生健康系统科研项目（2019-81） |
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| 中文摘要: |
| 目的:观察莪仙化斑汤治疗血热瘀阻型斑块型银屑病患者的临床疗效及对白细胞介素23（IL-23）、白细胞介素-17A（IL-17A）、血管内皮生长因子（VEGF）的影响。方法:选取2018年12月至2020年12月北京中医药大学东方医院皮肤科确诊的血热瘀阻型斑块型银屑病患者60例作为研究对象，按照随机数字表法分为观察组与对照组，每组30例。2组患者基础治疗均外用卡泊三醇软膏，并给予患者健康教育及生活指导。观察组加用莪仙化斑汤，对照组加用复方青黛胶囊，疗程均为4周。观察2组的临床疗效，治疗前后皮损面积和病情严重程度指数（PASI）评分、皮肤病生命质量指数（DLQI）评分、瘙痒等级视觉模拟评分法（VAS）评分、IL-23/Th17轴相关炎症介质水平变化并进行比较，随访3个月后比较2组复发情况。结果:观察组总有效率86.67%，优于对照组（63.33%）（P<0.05）；观察组在改善PASI评分、DLQI评分、VAS评分，及下调外周血IL-23、IL-17A及VEGF水平方面较对照组更具优势（P<0.05）；观察组复发率7.69%，较对照组复发率15.79%明显降低（P<0.05）。结论:莪仙化斑汤可以改善血热瘀阻型斑块型银屑病患者临床症状、体征及生命质量，临床疗效确切，复发率低，其机制可能是通过调节IL-23/Th17轴相关炎症介质水平，从而有效治疗斑块型银屑病。 |
| English Summary: |
| To observe the clinical efficacy of Exian Huaban Decoction in the treatment of plaque psoriasis patients with blood-heat and blood-stasis syndrome and its effects on interleukin-23(IL-23)，interleukin-17A(IL-17A)，and vascular endothelial growth factor(VEGF).Methods:Sixty plaque psoriasis patients with blood-heat and blood-stasis syndrome admitted to the Dermatology Department of Dongfang Hospital affiliated to Beijing University of Chinese Medicine from December 2018 to December 2020 were enrolled and divided into an observation group(n=30) and a control group(n=30) according to the random number table method.All patients received calcipotriol ointment for basic treatment，as well as health education and life guidance.The patients in the observation group received additional Exian Huaban Decoction，while those in the control group received additional Fufang Qingdai Capsules.The treatment lasted four weeks.The clinical efficacy，the improvement of Psoriasis Area and Severity Index(PASI)，Dermatology Life Quality Index(DLQI)，Visual Analogue Scale(VAS) scores，levels of inflammatory factors related to IL-23/Th17 axis before and after treatment，and recurrence rate after three months of follow-up were observed and compared between two groups.Results:The total effective rate of the observation group was 86.67%，higher than 63.33% of the control group(P<0.05).The observation group was superior to the control group in improving PASI score，DLQI score，VAS score，and down-regulating the levels of IL-23，IL-17A，and VEGF in peripheral blood(P<0.05).The recurrence rate of the observation group was 7.69%，lower than 15.79% of the control group(P<0.05).Conclusion:Exian Huaban Decoction can significantly improve the clinical symptoms，signs，and quality of life of plaque psoriasis patients with blood-heat and blood-stasis syndrome，with definite clinical efficacy and low recurrence rate.The mechanism may be attributed to the regulation of inflammatory factors related to the IL-23/Th17 axis，thereby treating plaque psoriasis. |
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