【摘要】 目的：观察健脾祛湿颗粒联合卡泊三醇软膏治疗银屑病湿热蕴阻证的临床疗效，以及对患者血清白细胞介素-17(IL-17)、白细胞介素-23(IL-23)水平的影响。方法：选取银屑病湿热蕴阻证患者150例，采用随机数字表法将其分为治疗组、对照1组及对照2组，每组各50例。对照1组采用外涂卡泊三醇软膏联合口服复方甘草酸苷片治疗，对照2组采用外涂卡泊三醇软膏治疗，治疗组在对照组2组的基础上加服健脾祛湿颗粒，3组均治疗8周。比较3组治疗前、治疗4周、治疗8周后银屑病皮损面积与严重指数(PASI)评分、皮肤病生活质量指数(DLQI)评分及血清IL-17、IL-23水平，并进行安全性评价，于治疗结束后第4周随访复发情况。结果：总有效率治疗组为96.00%(48/50),高于对照1组的92.00%(46/50)及对照2组的82.00%(41/50),差异均有统计学意义(P<0.05)。治疗4周后及8周后，3组PASI、DLQI评分及血清IL-17、IL-23水平均较治疗前下降，且治疗后同时间节点治疗组均优于对照1、2组(P<0.05)。治疗过程中，3组均未出现明显不良反应。复发率治疗组低于对照1、2组(P<0.05)。结论：健脾祛湿颗粒联合卡泊三醇软膏治疗银屑病湿热蕴阻证疗效显著，能改善患者临床症状，降低患者PASI、DLQI评分以及血清IL-17、IL-23水平，且无明显不良反应，复发率亦较低，值得临床推广应用。更多还原

【Abstract】 Objective: To investigate the clinical effect of Jianpi Qushi granules combined with calcipotriol ointment in the treatment of psoriasis with damp-heat accumulation and stagnation and its effect on the serum levels of interleukin-17(IL-17) and interleukin-23(IL-23). Methods: A total of 150 patients with psoriasis with damp-heat accumulation and stagnation were selected and divided into treatment group, control group 1,and control group 2,with 50 patients in each group.The patients in the control group 1 were given oral administration of compound glycyrrhizin tablets in addition to external application of calcipotriol ointment, and these in the control group 2 were given external application of calcipotriol ointment, those in the treatment group were given Jianpi Qush granules in addition to the treatment in the control group 2;all three groups were treated for 8 weeks.The three groups were compared in terms of Psoriasis Area and Severity Index(PASI) score, dermatology life quality index(DLQI) score, and the serum levels of IL-17 and IL-23 before treatment and after 4 and 8 weeks of treatment; safety evaluation was performed, and the patients were followed up at week 4 after treatment to observe the onset of recurrence. Results: The treatment group had a significantly higher overall response rate than the control group 1 and the control group 2 [96.00%(48/50) vs 92.00%(46/50)/82.00%(41/50),P<0.05]. After 4 and 8 weeks of treatment, all three groups had significant reductions in PASI score, DLQI score, and the serum levels of IL-17 and IL-23,and the treatment group had significantly better indices than the control group 1 and the control group 2 at each time point after treatment(P<0.05). No obvious adverse reactions were observed in any group during treatment, and the treatment group had a significantly lower recurrence rate than the control group 1 and the control group 2(P<0.05). Conclusion: Jianpi Qushi granules combined with calcipotriol ointment has a marked clinical effect in the treatment of psoriasis with damp-heat accumulation and stagnation and can improve clinical symptoms and reduce PASI score, DLQI score, and the serum levels of IL-17 and IL-23,with few adverse reactions and a relatively low recurrence rate, and therefore, it holds promise for clinical application.更多还原