祛银汤对血热证银屑病的疗效观察

目的观察清热凉血中药-祛银汤治疗血热证寻常型银屑病的临床疗效及其对外周血肿瘤坏死因子（TNF—α）、白细胞介素（IL-8）时相表达的影响。方法观察30例血热证寻常型银屑病患者予祛银汤口服治疗前后皮损面积和严重性指数（psoriasis area and severity index，PASI）评分、中医症状评分的变化，并采用酶联免疫吸附试验法（ELISA）检测治疗前、治疗后4周、8周血清TNF-α、IL-8的水平。结果祛银汤能明显改善寻常型银屑病的临床症状，治疗后PASI评分、各中医症状评分较治疗前均明显改善（P〈0．05）。治疗4周、8周后TNF—α、IL-8水平明显下降，与治疗前比较，差异均有统计学意义（P〈0．05），且TNF-α、IL-8分别与PASI评分呈正相关关系（r=0．46，P〈0．05；r=0．37，P〈0．05）。结论祛银汤可通过降低血清TNF—α、IL-8水平，从而起到治疗银屑病的作用；且两者与病情密切相关，可作为评价银屑病病情活动程度的参考指标之一。

Efficacy Observation of Quyintang in the Treatment of Psoriasis Differenti-ated as Blood Heat Pattern/Syndrome

Objective To observe the clinical efficacy on psoriasis vulgaris differentiated as blood heat pattern/syndrome treated with herbal medicine for clearing heat and cooling blood - - Quyintang and the impacts on the time phase expression of TNF - α and IL - 8. Methods Thirty cases of psoriasis vulgaris dif- ferentiated as blood heat pattern/syndrome were treated with oral administration of Quyintang. The changes in the score of psoriasis area and severity index（PASI） and the score of symptoms of traditional Chinese medi-cine（TCM） were observed before and after treatment. ELISA was adopted to detect the levels of serum TNF - α and IL - 8 before treatment and in 4 and 8 weeks after treatment separately. Results Quyintang relieved apparently the clinical symptoms of psoriasis vulgaris and improves PASI score and the score of the symptoms in TCM after treatment as compared with those before treatment（ P 〈 0.05 ）. The levels of TNF - α and IL - 8 were reduced apparently in 4 and 8 weeks of treatment, indicating the significant difference as compared with those before treatment（ P 〈 0.05 ） , and the positive correlation presented as compared with PASI score respectively（r=0. 46,P〈0. 05;r=0. 37,P〈0. 05）. Conclusion Quyintang reduces the levels of serum TNF - α and IL - 8 ,which plays the role in the treatment of psoriasis. These indexes are closely related to the condition of disease and can be taken as the reference for the assessment of the activity of psoriasis.