【摘要】 目的:研究中医自然疗治疗静止期寻常性银屑病的临床疗效、心理疗效及作用机制。方法:80例静止期寻常性银屑病患者随机分为观察组50例和对照组30例,观察组采用中医自然疗法,对照组采用阿维A疗法;分别检测治疗前、治疗8周、随访4周3个时点银屑病皮损面积和严重程度指数(PASI)、皮肤共聚焦激光扫描显微镜(CLSM)下的皮损棘层厚度和真皮浅层血管计数、外周血肿瘤坏死因子α(TNF-α)和白介素6(IL-6)及鳞状细胞癌相关抗原(SCCA)的水平、症状自评量表(SCL-90)总均分。结果:治疗8周时,两组PASI、棘层厚度、真皮浅层血管计数、TNF-α、IL-6、SCCA及SCL-90较治疗前均显著下降(P<0.05),观察组TNF-α、SCL-90均显著低于对照组(P<0.05)。随访4周时,观察组PASI、棘层厚度、TNF-α、IL-6、SCL-90、复发率均显著低于对照组(P<0.05)。结论:对于静止期寻常性银屑病,中医自然疗法的疗效和阿维A基本一致;中医自然疗法在降低复发率、心理治疗方面比阿维A更具优势,其优势可能与降低TNF-α和IL-6表达、改善患者情感有关。更多还原

【Abstract】 Objective: To study the clinical effect, psychological effect and mechanism of natural therapy of traditional Chinese medicine(TCM) in the treatment of psoriasis vulgaris in quiescent stage. Methods: A total of 80 cases of patients with psoriasis vulgaris in quiescent stage were randomly divided into the observation group(50 cases) and the control group(30 cases). The observation group was treated with natural therapy of TCM, while the control group was treated with Acitretin. The psoriasis area and severity index(PASI), the stratum spinosum thickness and the superficial dermal capillary vessel count under confocal laser scanning microscopy(CLSM), the levels of tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6) and squamous cell carcinoma antigen(SCCA) in peripheral blood, the total mean value of symptom checklist 90(SCL-90) were all measured. All data were gotten just before treatment, after 8 weeks treatment and after 4 weeks follow-up. Results: After 8 weeks treatment, the values of PASI, stratum spinosum thickness, superficial dermal capillary vessel count, TNF-α, IL-6, SCCA and SCL-90 in the two groups were all significantly lower than those before treatment(P<0.05); the values of TNF-α and SCL-90 in observation group were all significantly lower than those in the control group(P<0.05). After 4 weeks of follow-up, the values of PASI, stratum spinosum thickness, TNF-α, IL-6, SCL-90 and recurrence rate in observation group were all significantly lower than those in control group(P<0.05). Conclusion: For psoriasis vulgaris in quiescent stage, natural therapy of TCM can achieve basically the same therapeutic effect as Acitretin. Natural therapy of TCM has advantages over Acitretin on reducing recurrence rate and psychotherapy. The mechanism of the advantages may be related to reducing the expression of TNF-α and IL-6, and improving the patients’ emotion.更多还原