【摘要】 目的 观察针刺联合解毒活血通络汤治疗血瘀型银屑病的临床疗效。方法 将银屑病(血瘀证)患者104例,采用随机数字表法随机分为中药组(52例)和联合组(52例)。中药组给予解毒活血通络汤治疗,联合组给予针刺联合解毒活血通络汤治疗。观察两组治疗前后免疫功能指标(CD3~+、CD4~+、CD8~+、CD4~+/CD8~+)、血流动力学指标[低切血液黏度(LBV)、血沉(ESR)、高切血液黏度(HBV)、血浆黏度(PV)]、炎性因子[白细胞介素-6 (IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞介素-23(IL-23)]水平、甲皱襞微循环(流态积分、形态积分、管周积分及总积分)变化,并比较两组的临床疗效。结果 两组治疗后CD3~+、CD4~+、CD4~+/CD8~+水平均较治疗前升高(P<0.05),且联合组高于中药组(P<0.05);两组治疗后CD8~+、LBV、ESR、HBV、PV、IL-6、TNF-α、IL-23水平较治疗前降低(P<0.05),且联合组低于中药组(P<0.05);两组治疗后流态积分、形态积分、管周积分及总积分较治疗前降低(P<0.05),且联合组低于中药组(P<0.05)。联合组总有效率为92.3%,高于中药组的75.0%(P<0.05)。结论针刺联合解毒活血通络汤用于血瘀型银屑病患者,能够改善血流动力学水平及甲皱襞微循环,降低炎症反应,提高免疫功能及临床疗效。更多还原

【Abstract】 Objective To observe the clinical efficacy of acupuncture plus Jiedu Huoxue Tongluo decoction for psoriasis due to blood stasis. Method One hundred and four patients with psoriasis(blood stasis syndrome) were allocated, using a random number table, to a Chinese herbal medicine group(52 cases) and a combination group(52cases). The Chinese herbal medicine group took Jiedu Huoxue Tongluo decoction and the combination group received acupuncture plus Jiedu Huoxue Tongluo decoction. Immune function indicators(CD3~+, CD4~+, CD8~+ and CD4~+/CD8~+),hemodynamic indicators [low-shear blood viscosity(LBV), erythrocyte sedimentation rate(ESR), high-shear blood viscosity(HBV) and plasma viscosity(PV)], inflammatory factors [interleukin-6(IL-6), tumor necrosis factor-α(TNF-α) and interleukin-23(IL-23)] levels and nail fold microcirculation(fluid state score, morphology score,perivascular score and total score) were observed in the two groups before and after treatment. The clinical efficacy was compared between the two groups. Result After treatment, CD3~+, CD4~+ and CD4~+/CD8~+ levels increased in the two groups compared with before(P<0.05) and were higher in the combination group than in the Chinese herbal medicine group(P<0.05); CD8~+, LBV, ESR, HBV, PV, IL-6, TNF-α and IL-23 levels decreased in the two groups compared with before(P<0.05) and were lower in the combination group than in the Chinese herbal medicine group(P<0.05); the fluid state score, morphology score, perivascular score and total score decreased compared with before(P<0.05) and were lower in the combination group than in the Chinese herbal medicine group(P<0.05). The total efficacy rate was 92.3% in the combination group, which was higher than 75.0% in the Chinese herbal medicine group(P<0.05). Conclusion Acupuncture plus Jiedu Huoxue Tongluo decoction can improve hemodynamics and nail fold microcirculation, reduce inflammatory reaction and ameliorate immune function in treating patients with psoriasis due to blood stasis.更多还原