乌藤消银方治疗血瘀风燥型银屑病临床研究

目的：观察乌藤消银方治疗血瘀风燥型银屑病的临床疗效及对血脂、血清脂蛋白的影响。方法：将63例血瘀风燥型银屑病患者按随机、单盲、对照临床设计分为中药组33例和对照组30例,中药组给予乌藤消银方治疗,对照组给予复方氨肽素片治疗,两组治疗8周后,观察两组患者的临床疗效、治疗前后银屑病皮损面积和严重程度指数（PASI）、皮肤病生活质量指数（DLQI）、中医证候评分、血脂（TG、CHOL、HDL-C、LDL-C）及LP（a）水平变化,并观察疗程结束后随访转归情况。结果：中药组有效率为66.67%,对照组有效率为60.00%,两组比较差异无统计学意义（P〉0.05）,中药组复发率低于对照组;两组患者治疗后PASI积分均较治疗前下降（P〈0.01）,两组间比较差异无统计学意义（P〉0.05）;两组DLQI指数积分均较治疗前降低,中药组较对照组积分改善明显（P〈0.05）;中药组治疗后血脂及LP（a）降低,尤以TG降低显著（P〈0.01）;中药组可明显改善瘙痒、抑郁心烦及失眠等中医证候。结论：乌藤消银方治疗血瘀风燥型银屑病疗效显著,且能改善患者生活质量,复发率较低,其部分作用机制可能和调节血脂及LP（a）水平有关。

Blood Stasis and Wind Dry-type Psoriasis Clinical Studies Wuteng Xiaoyin Treatment

Objective ： To observe clinical effects of Wuteng Xiaoyin Decoction in treating blood stasis wind dryness psoriasis and the influence on blood lipids and LP（a） level. Methods：A randomized, single blind controlled clinical design was used to divide 63 cases of blood stasis wind dryness psoriasis into Chinese medicine （CM） group of 33 cases and a control group of 30 cases. Patients in both groups were treated for 8 weeks ,Psoriasis Area and Severity Index（PASI） score, Dermatology Life Quality Index（DLQI） score,CM syndrome score, the level of blood lipids（ TG, CHOL, HDL-C, LDL-C） and LP（a） were obtained to evaluate the efficacy of the two treatments. The sequelae were observed at the end of the treatment and at follow-ups. Results ： The effective rate of CM group and control group were 66.67 % and 60% respectively, but there were no significant difference between two groups （P 〉 0.05 ）. The recurrence rate of CM group was lower than the control group. PASI score all decreased than that before treatment（ P 〈 0. 01 ）, no significant difference between two groups （P 〉 0.05 ）. DLQI score all decreased than that before treatment, but the CM group improved more obviously （P 〈 0.05 ）. CM group could improve blood lipids and LP（a） level significantly, especially the TG level and also could obviously improve TCM Syndromes such as itching, insomnia and depression. Conclusion： Wuteng Xiaoyin Decoction was effective and safe in treating blood stasis wind dryness psoriasis. It had a lower recurrence rate and could improve the life quality of patients. Some of its mechanism may be related to the regulation of lipid and LP（a） metabolism.