氧化苦参碱对寻常型银屑病患者的临床治疗作用以及VEGF水平和有丝分裂指数的影响

目的观察氧化苦参碱对寻常型银屑病患者血清血管内皮生长因子(VEGF)和皮肤细胞PASI有丝分裂指数的影响,以及其临床应用价值。方法收集我院2014年2月至2016年4月皮肤科诊治的寻常型银屑病患者86例,使用数字表法随机分为观察组和对照组,每组43例。对照组口服阿维A胶囊,25~30 mg/d初始剂量,25~50 mg/d维持量,同时外涂蒽林软膏,1次/d。观察组在对照组基础上加用氧化苦参碱胶囊,2粒/次,3次/d,8周为1个疗程。VEGF表达使用酶联免疫法(ELISA)测定,HE切片下显微镜计算有丝分裂指数。结果治疗前两组VEGF水平和有丝分裂指数比较差异无统计学意义(P>0.05),治疗后两组VEGF水平和有丝分裂指数均显著减低(P<0.01),且观察组VEGF(26.92±5.38)μg/L vs.(38.74±7.43)μg/L]和有丝分裂指数(15.43%±2.72%vs.19.62%±3.12%)均显著低于对照组(P<0.05)。观察组临床治疗有效率为88.4%(38/43),显著高于对照组的72.1%(31/43)(P<0.05)。观察组不良反应发生率为14.0%(6/43),对照组为11.6%(5/43),两组比较差异无统计学意义(P>0.05)。结论氧化苦参碱可以显著降低寻常型银屑病患者外周血VEGF水平和表皮细胞有丝分裂指数,临床治疗安全、疗效显著。

Effect of oxymatrine on VEGF and mitotic index in patients with psoriasis vulgaris and its efficacy

Objective To observe the effect of oxymatrine on vascular endothelial growth factor (VEGF) and PASI mitotic index in patients with psoriasis vulgaris and its clinical value.Methods Totally 86 patients with psoriasis vulgaris in our hospital from February 2014 to April 2016 were collected and randomly divided into observation group and control group,43 cases in each group.Control group was given A citretin capsule (25 ～30 mg/d as initial dose,25 ～50 mg/d as maintenance dose) + dithranol ointment(once daily).On the basis of control group,observation group was treated with oxymatrine capsules (2 capsules per time,three times a day) for 8 weeks.The VEGF expression was measured by ELISA assay,and the mitotic index was calculated by HE staining.Results There was no significant difference in VEGF expression and mitotic index between the two groups before treatment (P ＞ 0.05).After treatment,the VEGF expression (26.92 ± 5.38) μg/L vs.(38.74 ± 7.43) μg/L] and mitotic index (15.43％ ± 2.72％ vs.19.62％ ± 3.12％) in observation group were lower than those of control group (P ＜ 0.05).The clinical efficacy was 88.4％ (38/43) in observation group,which was higher than 72.1％ (31/43) in control group (P ＜0.05).The incidence of adverse reactions was 14.0％ (6/43) in observation group and 11.6％ (5/43) in control group,there being no significant difference between the two groups (P ＞ 0.05).Conclusion Oxymatrine can significantly reduce the VEGF expression and mitotic index in patients with psoriasis vulgaris,with significant clinical safety and efficacy.