窄波UVB联合凉血消风汤治疗血热型寻常型银屑病的临床和实验研究

发布时间：2018-04-15 01:12

本文选题：银屑病 + 血热　；参考：《天津医科大学》2012年硕士论文

【摘要】：目的：研究细胞因子IL-2、IFN-γ和IL-17在血热型寻常型银屑病中的水平；分析IL-2、IFN-γ和IL-17分别与银屑病皮损面积严重程度评分(PASI评分)的相关性；观察NB-UVB(窄谱微波紫外线)联合中药方剂凉血消风汤治疗血热型寻常型银屑病的疗效及对细胞因子IL-2、IFN-γ及IL-17水平的影响。探讨银屑病的发病机制并寻找有效的治疗方法。方法：对103例血热型寻常型银屑病和50例健康对照组进行研究,将103例血热型寻常型银屑病随机分为3组,A组应用凉血消风汤联合窄波UVB, B组单独应用窄波UVB, C组单独应用凉血消风汤。采用酶联免疫吸附试验ELISA (Enzyme linked immunosorbent assay)技术检测血热型寻常型银屑病患者和正常人血清中IFN-γ、IL-2和IL-17的水平,并对三组进行对比分析；分析A组、B组和C组治疗前后IFN-γ、IL-2和IL-17水平的变化,并对这三组的临床治疗效果进行对比,分析IFN-γ、IL-2和IL-17与PASI评分的相关性。结果： 1. ELISA检测结果显示血热型寻常型银屑病患者组和正常健康对照组均可检出IFN-γ、IL-2和IL-17；血热型寻常型银屑病患者组IFN-γ、IL-2和IL-17的水平明显高于正常对照组,差异有统计学意义(p0.05) 2. IFN-γ、IL-2和IL-17的水平与PASI呈正相关(p0.05),提示IFN-γ、IL-2和IL-17的水平与银屑病病情严重程度有密切的关系,有望作为评价银屑病病情活动程度的参考指标。 3.A组治疗后IFN-γ、IL-2和IL-17的水平较治疗前明显下降,差异有统计学意义(p0.05),且明显高于正常对照组,差异有统计学意义(p0.05)B组治疗后IFN-γ的水平明显较治疗前下降,差异有统计学意义(p0.05)；C组治疗后IL-2的水平明显较治疗前下降,差异有统计学意义(p0.05)； 4.A组与B组相比,IL-2和IL-17的水平显著下降,差异有统计学意义(p0.05)；A组与C组相比,IFN-γ和IL-17的水平下降的更明显,差异有统计学意义(p0.05)； 5.A组治疗后较B组和C组治疗PASI评分显著下降,差异有统计学意义(p0.05) 6. A组复发率较B组显著降低,差异有统计学意义(p0.05)；结论：IFN-γ、IL-2和IL-17在血热型寻常型银屑病发病中起重要作用,窄谱UVB联合凉血消风汤治疗银屑病优于单独应用窄谱UVB和单独应用中药方剂凉血消风汤,是一种好的治疗方法,值得推广。
[Abstract]:Objective: to study the level of cytokines IL-2tIFN- 纬 and IL-17 in psoriasis vulgaris, and to analyze the correlation between IL-2mIFN- 纬 and IL-17 and psoriasis area severity score (PASI).To observe the curative effect of NB-UVB (narrow spectrum microwave ultraviolet) combined with traditional Chinese medicine prescription Liangxue Xiaofeng decoction in treating psoriasis vulgaris of blood fever type and its effect on the levels of cytokine IL-2C IFN- 纬 and IL-17.To explore the pathogenesis of psoriasis and to find effective treatment.Methods: 103 cases of blood fever type psoriasis vulgaris and 50 cases of healthy control group were studied.103 cases of psoriasis vulgaris of blood fever type were randomly divided into three groups: group A was treated with Liangxue Xiaofeng decoction combined with narrow wave UVB, group B with narrow wave UVB alone, group C with Liangxue Xiaofeng decoction alone.The levels of IL-2 and IL-17 in serum of patients with blood-fever type vulgaris psoriasis and normal subjects were detected by enzyme linked immunosorbent assay (ELISA enzyme linked immunosorbent assay), and the changes of IFN- 纬 -IL-2 and IL-17 before and after treatment in group A and group C were analyzed.The clinical effects of these three groups were compared, and the correlation between IFN- 纬 IL-2, IL-17 and PASI score was analyzed.Results:1.The results of ELISA showed that both IFN- 纬 IL-2 and IL-17 were detected in patients with psoriasis vulgaris and normal controls, and the levels of IL-2 and IL-17 in patients with psoriasis vulgaris were significantly higher than those in normal controls (P 0.05).2.The levels of IL-2 and IL-17 were positively correlated with PASI, suggesting that the levels of IL-2 and IL-17 were closely related to the severity of psoriasis, and could be used as a reference index for evaluating the active degree of psoriasis.3. After treatment, the levels of IFN- 纬 IL-2 and IL-17 in group A were significantly lower than those before treatment, the difference was statistically significant (p0.05), and the level of IFN- 纬 in group B was significantly higher than that in group B (P 0.05), and the level of IFN- 纬 in group B was significantly lower than that before treatment.The level of IL-2 in group C was significantly lower than that before treatment, and the difference was statistically significant (P 0.05).4. The levels of IL-2 and IL-17 in group A were significantly lower than those in group B, the difference was statistically significant (P 0.05). The levels of IFN- 纬 and IL-17 in group A were significantly lower than those in group C (P 0.05).5.The PASI score of group A was significantly lower than that of group B and group C after treatment, and the difference was statistically significant (P 0.05).6.The recurrence rate in group A was significantly lower than that in group B (P 0.05).ConclusionsInterleukin-2 and IL-17 play an important role in the pathogenesis of psoriasis vulgaris of blood-heat type. Narrow spectrum UVB combined with Liangxue Xiaofeng decoction is superior to narrow spectrum UVB alone and traditional Chinese medicine prescription Liangxue xiaofeng decoction in the treatment of psoriasis. It is a good treatment method.It is worth popularizing.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R758.63

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