润肤保湿软膏对血虚风燥证银屑病皮肤屏障功能干预作用及机制的研究

目的：探寻润肤保湿软膏对银屑病血虚风燥型皮肤屏障功能的影响及作用机制。方法60例血虚风燥型银屑病患者随机分为两组，治疗组30例使用润肤保湿软膏治疗，对照组30例使用尿素软膏治疗，4周后依据 PASI 评分法判定疗效；使用Soft5.5皮肤六参数测试仪，对用药前后患者皮损角质层含水量、皮肤中油脂水平及 pH 值进行测定，通过薄层层析、BIO-RAD Ge1Doc 凝胶成像系统、Quantity One 软件分析及 RT-PCR、 Western blot 的方法检测分析治疗前、后皮损神经酰胺（ Cer ）、水通道蛋白（ AQP-3）的含量；比较分析两组间及组内的临床疗效及各项指标变化，探寻润肤保湿软膏对血虚风燥型银屑病皮肤屏障功能的干预作用及机制。结果两组治疗后均有一定临床疗效，治疗组明显优于对照组（P<0.05）；两组治疗后皮脂含量、角质层含水量均高于治疗前（P<0.05），而 pH 值治疗组明显低于治疗前（P<0.05），对照组 pH 值无明显改变（P>0.05）；治疗后两组水通道蛋白（AQP-3）、神经酰胺（Cer）的含量高于治疗前（P<0.05）；治疗组治疗后皮脂含量、pH 值、AQP-3、Cer 较对照组治疗后改善显著，差异有统计学意义（ P<0.05）。结论润肤保湿软膏对血虚风燥型银屑病患者皮肤的屏障功能有显著调节及修复作用，有可能是通过神经酰胺和水通道蛋白对皮肤屏障功能进行修复。

Effect of Skin-Moistening Lotion on Skin Barrier Functions of Psoriasis Patients with Blood Deficiency and Wind Dryness Syndrome and its Mechanism of Action

〔Abstract〕 Objective To investigate the effect of skin-moistening lotion on skin barrier functions of psoriasis patients with blood deficiency and wind dryness syndrome and its mechanism of action. Methods Sixty psoriasis patients with blood deficiency and wind dryness syndrome were randomly divided into two groups, thirty cases in treatment group were treated by the skin-moistening lotion and the other thirty patients in control group were treated by the urea frost. The healing effect was evaluated according to the PASI method after 4 weeks. The moisture of horny layer of patients' skin injury, fat level and pH value were determined before and after treatments. The Cer and AQP-3 level were analyzed by using the following methods including thin-layer chromatography, BIO-RAD Ge1Doc gelatin imaging system, Quantity One software, RT-PCR and Western blot. The clinical efficacy and indicator changes were compared between the two groups to investigate the intervention action of skin-moistening lotion on skin barrier functions of psoriasis patients with blood deficiency and wind dryness syndrom and its mechanism of action. Results The clinical efficacy of the two groups is both good after treatments, but the treatment effect for the treatment group is superior to the comparison group (P<0.05). The moisture of horny layer of patients' skin injury and fat levelafter treatment is higher than that of before treatment (P<0.05). The pH value for the treatment group is lower than that of before treatment (P<0.05), while there is no change for the pH value of the comparison group (P>0.05). After treatments, the Cer and AQP-3 level of the two groups are higher than that before treatment (P<0.05), and the fat level, pH value, Cer and AQP-3 level of the treatment group are enhanced more than that of the comparison group. The difference has statistical significance (P<0.05). Conclusion The skin-moistening lotion shows distinct regulation and restoration actions on on skin barrier functions of psoriasis patients with blood deficiency and wind dryness syndrome, which may be realized through the ceramide and aquaporin protein.