透表和营解毒方治疗血热型银屑病的临床研究

目的?观察透表和营解毒方治疗血热型银屑病患者的临床疗效，及对血清IL-23/Th17轴相关细胞因子表达水平的影响。方法?入组60例血热型银屑病患者和15名健康对照组。治疗组和对照组各为30例，分别予中药透表和营解毒方、阿维A胶囊口服治疗，以PASI积分评定疗效，观察健康人及银屑病患者治疗前后PASI积分、中医证候积分的变化及血清白细胞介素-17A（IL-17A）、白细胞介素-17F（IL-17F）、白细胞介素-26（IL-26）表达水平。结果?血热型银屑病患者血清中IL-17A、IL-17F、IL-26水平显著高于健康人，差异具有显著统计学意义（P＜0.01），治疗后均明显下降（P<0.01）;治疗组优于对照组（P<0.01）。2组患者经治疗后PASI积分、中医证候积分较治疗前均下降（P＜0.01），治疗组优于对照组（P＜0.05~0.01）。2组治疗后不良反应发生率有显著性差异（P＜0.01）。结论?银屑病的发生及病情严重程度与IL-23/Th17轴相关细胞因子的高表达有关；透表和营解毒方治疗血热型银屑病疗效确切，可能是通过调节IL-23/Th17轴相关因子水平而发挥治疗作用。 

Clinical Study on Treatment of Blood-Heat Psoriasis with Toubiao Heying Jiedu Recipe

OBJECTIVE?To observe the clinical effect of Toubiao Heying Jiedu recipe on patients with blood-heat psoriasis and its effect on the expression level of IL-23/Th17 axis-related cytokines in serum， so as to explore its mechanism of action. METHODS?60 patients with blood-heat psoriasis and 15 healthy controls were enrolled in the study. 30 cases in the treatment group and 30 cases in the control group were treated by oral administration of traditional Chinese medicine(TCM)， Toubiao Heying Jiedu recipe and avia A capsule respectively. The therapeutic effect was evaluated by PASI score， the level of IL-17A， IL-17F and IL-26 in serum of healthy people and psoriasis patients before and after treatment and the TCM score changes were observed. RESULTS?The levels of IL-17A， IL-17F and IL-26 in serum of patients with blood-heat psoriasis were significantly higher than those of healthy people， and the difference was statistically significant(P<0.01). After treatment， the levels of IL-17A， IL-17F and IL-26 were significantly decreased (P<0.01). The treatment group was better than the control group (P<0.01). After treatment， PASI scores and TCM syndrome scores of the two groups were decreased (P<0.01). Moreover， the decrease in the treatment group was more obvious than that in the control group， and the difference was statistically significant (P<0.05， P<0.01). There was a significant difference in the incidence of adverse reactions between the two groups after treatment (P<0.01). CONCLUSION?The occurrence and severity of psoriasis are related to the high expression of IL-23/Th17 axis related cytokines. Toubiao Heying Jiedu recipe have definite therapeutic effect on blood-heat psoriasis， which may play a therapeutic role by adjusting the level of IL-23/Th17 axis related factors.