养血化斑汤治疗斑块型银屑病血燥证

Yangxue Huaban Decoction in Treating Blood Dryness Syndrome of Plaque Type Psoriasis

摘要:

目的: 观察养血化斑汤治疗斑块型银屑病血燥证的疗效及其对外周血肿瘤坏死因子-α(TNF-α)和血管内皮细胞生长因子(VEGF)的影响. 方法: 门诊纳入115例斑块型银屑病血燥证患者,随机分为治疗组和对照组,治疗组78例给予养血化斑汤治疗,对照组37例给予消银胶囊治疗,疗程8周;观察两组治疗前后银屑病皮损面积和严重程度指数评分(PASI)及中医症状变化;并采用酶联免疫吸附试验法(ELISA)检测治疗组治疗前后血清TNF-α和VEGF的水平. 结果: 养血化斑汤和消银胶囊能够显著改善斑块型银屑病血燥证PASI评分和中医症状(P< 0.05),两组总有效率比较无差异,但在改善中医症状方面,治疗组优于对照组(P< 0.05);斑块型银屑病血燥证患者血清TNF-α和VEGF水平较健康人群显著升高(P< 0.01),养血化斑汤治疗后显著下降,其中TNF-α恢复到了正常水平(P< 0.05). 结论: 养血化斑汤对改善斑块型银屑病血燥证PASI评分和中医症状有良好疗效,其机制可能与拮抗TNF-α和VEGF从而抑制炎症及血管增生有关.

Abstract:

Objective: The aim of this study was to observe the clinical efficacy of Yangxue Huaban decoction (YXHB) and its effecton serum tumor necrosis factor-α(TNF-α) and vascular endothelial growth factor(VEGF) in treating the blood dryness syndrome of plaque type psoriasis. Method: In this study, one hundred and fifteen patients with the blood dryness syndrome of plaque type psoriasis were randomly divided into the treatment group and the control group. The 78 patients in the treatment group were treated with YXHB and the 37 patients in the control group were treated with Xiaoying capsule (XY). The changes in the score of psoriasis area, severity index (PASI) and the symptoms of traditional Chinese medicine were observed before and after treatment in two groups respectively. The levels of TNF-α and VEGF in serum of psoriastic patients before and after treatment in the treatment group were detected with enzyme-linked immunosorbnent assay (ELISA), with 30 healthy serum samples as healthy controls. The period of treatment was 8 weeks. Result: YXHB and XY apparently improved PASI score and the symptoms in TCM after treatment as compared with those before treatment (P< 0.05). The total effective rate of YXHB was 78.2%, with no significant difference compared with that of control group. YXHB relieved TCM symptoms much better than XY. Compared with healthy controls, the levels of TNF-α and VEGF with psoriastic patients were higher (P< 0.05). And comparison of TNF-α and VEGF levels before and after treatment also showed significant differences (P< 0.05). Conclusion: YXHB was effective in the treatment of the blood dryness syndrome of plaque type psoriasis. It reduced the levels of serum TNF-α and VEGF, which is partly responsible for the clinical efficacy.