山海棠合剂治疗血热型寻常型银屑病疗效及对IL-12、IL-23的影响

发布时间：2018-05-31 04:43

本文选题：山海棠合剂 + 血热型　；参考：《云南中医学院》2017年硕士论文

【摘要】：目的:观察山海棠合剂治疗血热型寻常型银屑病的疗效及安全性,并从微观角度探讨药物作用机理,为山海棠合剂治疗寻常型银屑病的临床应用提供科学依据。方法:采用随机对照试验,把66例血热型寻常型银屑病患者随机分为试验组和对照组,每组33例,详细记录患者相关资料并检测血清IL-12和IL-23水平;同时选取30例健康志愿者检测血清IL-12和IL-23水平进行比较。试验组口服山海棠合剂,对照组口服阿维A胶囊;两组均外用丹皮酚软膏。每周复诊1次,连续用药8周后进行疗效判定并复查血清IL-12和IL-23水平。运用SPSS22.0软件对数据资料进行统计分析。结果:1.受试66例患者中,试验组脱落1例,对照组脱落3例,共收集有效病例62例。两组性别、年龄、病程、病情、血清IL-12和IL-23水平等基线资料具有可比性(P0.05)。2.疗程结束,试验组和对照组中医证候评分均较治疗前显著降低(P0.05),试验组优于对照组(P0.05)。3.疗程结束,试验组和对照组PASI评分均较治疗前显著降低(P0.05),两组比较差异无统计学意义(P0.05)。4.试验组和对照组治疗前血清IL-12和IL-23水平均显著高于健康志愿者(P0.05),疗程结束后均较治疗前显著降低(P0.05);疗程结束两组血清IL-12水平、试验组血清IL-23水平与健康志愿者比较差异无统计学意义(P0.05),对照组血清IL-23水平与健康志愿者比较差异仍有统计学意义(P0.05)。5.治疗7天后,试验组总有效率优于对照组(P0.05),治疗14天、21天、28天,两组总有效率比较差异无统计学意义(P0.05);疗程结束,试验组总有效率90.63%,愈显率71.88%;对照组总有效率83.33%,愈显率60.33%。试验组高于对照组,但两组比较差异无统计学意义(P0.05)。6.试验组和对照组均无严重不良反应发生,试验组有3例发生轻度腹痛、腹胀,减少服药次数后症状消失;对照组有6例服药后出现皮肤干燥、口腔黏膜干燥,未经处理,随用药时间推移自行缓解,3例服药期间出现转氨酶轻度升高,停药2个月后复查恢复至正常。7.疗程结束后随访3个月,试验组复发4例,对照组复发9例,两组比较差异有统计学意义(P0.05)。结论:山海棠合剂治疗血热型寻常型银屑病疗效确切,无明显不良反应,与西药阿维A胶囊相比具有起效较快、复发率低、不良反应较轻等优势。
[Abstract]:Objective: to observe the efficacy and safety of Shanhaitang mixture in treating psoriasis vulgaris with blood heat, and to explore the mechanism of drug action from microscopic point of view, and to provide scientific basis for clinical application of Shanhaitang mixture in the treatment of psoriasis vulgaris. Methods: 66 patients with psoriasis vulgaris of blood fever type were randomly divided into trial group and control group with 33 cases in each group. The relevant data and serum IL-12 and IL-23 levels were recorded in detail. Serum IL-12 and IL-23 levels were measured in 30 healthy volunteers. The experimental group was treated with Shanhaitang mixture and the control group with Avera capsule, and both groups were treated with paeonol ointment. The curative effect was evaluated and the serum IL-12 and IL-23 levels were reviewed after 8 weeks of continuous treatment. Use SPSS22.0 software to carry on the statistical analysis to the data. The result is 1: 1. Among 66 patients, 1 case in the test group and 3 cases in the control group. 62 effective cases were collected. The baseline data of sex, age, course of disease, condition, serum IL-12 and IL-23 levels were comparable between the two groups. At the end of the course of treatment, the scores of TCM syndromes in the test group and the control group were significantly lower than those before treatment, and the test group was superior to the control group. At the end of the course of treatment, the PASI scores of the test group and the control group were significantly lower than those of the control group before treatment. The difference between the two groups was not statistically significant. The levels of serum IL-12 and IL-23 in the experimental group and the control group were significantly higher than those in the healthy volunteers before treatment, and the levels of serum IL-12 in the two groups were significantly lower after the end of the course of treatment than before the treatment, and at the end of the course of treatment, the levels of serum IL-12 in the two groups were significantly decreased. There was no significant difference in serum IL-23 level between the experimental group and the healthy volunteers, but there was still significant difference in the serum IL-23 level between the control group and the healthy volunteers. After 7 days of treatment, the total effective rate in the experimental group was better than that in the control group (P 0.05), the total effective rate in the two groups was not significantly different from that in the control group (P 0.05), the total effective rate in the test group was 90.63 and 71.888.The total effective rate in the control group was 83.33 and the effective rate was 60.33. The experimental group was higher than the control group, but there was no significant difference between the two groups. There were 3 cases of mild abdominal pain and abdominal distention in the test group, and 6 cases of the control group had dry skin, dry oral mucosa and untreated skin after reducing the number of times of taking the medicine, and no serious adverse reactions occurred in the test group and control group, while in the control group, there were 3 cases with mild abdominal pain and abdominal distension. The level of transaminase increased slightly in 3 patients with spontaneous remission during medication, and returned to normal at 2 months after withdrawal. Three months after the end of the course of treatment, 4 cases of recurrence were found in the trial group and 9 cases in the control group. The difference between the two groups was statistically significant (P 0.05). Conclusion: Shanhaitang mixture is effective in treating psoriasis vulgaris of blood fever type and has no obvious adverse reaction. Compared with Avea capsule, it has the advantages of quick onset, low recurrence rate and mild adverse reaction.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R275.9

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