消银方治疗血热证型银屑病患者的疗效及对外周血Th1/Th2平衡的影响

目的 观察凉血化瘀的消银方治疗血热证银屑病患者的疗效及其对血清细胞因子的影响，探讨凉血化瘀法治疗银屑病的作用机制。方法 观察32例寻常型银屑病患者治疗前后皮损面积和严重性指数（PASI）评分、中医症状评分的变化及采用ELISA法检测治疗前后血清Th1细胞因子α肿瘤坏死因子(TNF-α)、Th2细胞因子白细胞介素10(IL-10)水平的变化。结果 治疗4周后，总有效率为65.63% (21/32例)，治疗8周后，总有效率为75.00% (24/32例)；治疗后PASI评分、各中医症状改善率均高于治疗前（P<0.05）。治疗后TNF-α水平下降，与治疗前比较，差异有统计学意义(P<0.05)，而IL-10差异无统计学意义 (P>0.05)，PASI评分与银屑病患者TNF-α分泌水平呈正相关性(r= 0.3709，P<0.05)。结论 凉血化瘀法可通过降低血清 TNF-α水平，从而起到治疗银屑病的作用。

Effect of Xiaoyin Recipe in Treatment of Psoriasis Patients of Blood-Heat Syndrome Type and Its Impact on Peripheral Th1/Th2 Equilibrium

OBJECTIVE: To explore the mechanism of Chinese medicinal therapy for cooling blood and removing stasis (CBRS) in treating psoriasis of blood-heat syndrome type by observing its clinical efficacy and impact on serum level of cytokines. METHODS: Changes of psoriasis area and severity index (PASI) scores, scores of syndrome and serum levels of tumor necrosis factor alpha (TNF-alpha, Th1 cytokine) and interleukin-10 (IL-10, Th2 cytokine) in 32 psoriatic patients before and after treatment were observed. RESULTS: The total effective rate after 4 weeks of treatment and 8 weeks of treatment was 65.63% (21/32 cases) and 75.00% (24/32 cases) respectively. Scores of PASI and syndrome all improved after treatment (P < 0.05). And comparison of TNF-alpha level before and after treatment also showed significant difference (P < 0.05) , whereas that of IL-10 was insignificant (P > 0.05). Moreover, a positive correlation was found between PASI scores and secreting level of TNF-alpha in patients with psoriasis (r = 0.3709, P < 0.05). CONCLUSION: Chinese therapy for CBRS could play its effect in treating psoriasis by way of reducing TNF-alpha level.