芩珠凉血方对银屑病血热证患者血清IL-17、IL-23及皮损中相关转录因子的影响
Influences of Qinzhu Liangxue Decoction on Serum IL-17, IL-23 and Related Transcription Factors of Skin Lesion in Patients with Psoriasis of Blood-heat Syndrome
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摘要: 目的 通过芩珠凉血方对银屑病患者血清IL-17、IL-23及STAT3、RORγt干预作用的研究,为中医治疗银屑病提供依据。方法 临床研究选取60例寻常型银屑病(血热证)患者,随机分为治疗组(30例)及对照组(30例),正常组(10例),治疗组及对照组分别口服芩珠凉血方及阿维A,服药疗程1月。选用银屑病面积严重程度指数(PASI)观察临床疗效,采用酶联免疫法检测对比分析血清IL-17、IL-23的变化,通过免疫组化法检测银屑病皮损组织STAT3、RORγt蛋白表达规律。结果 2组的PASI积分治疗后比治疗前降低,差异具有统计学意义(P<0.01);治疗前2组血清IL-17、IL-23高于正常组(P<0.05),治疗后2组IL-17、IL-23降低(P<0.01)。治疗前2组皮损免疫组化检测STAT3、RORγt高于正常组(P<0.05),治疗后2组STAT3、RORγt降低(P<0.05)。结论 芩珠凉血方可通过改善Th17细胞相关细胞因子,同时调控转录因子STAT3和RORγt,对银屑病治疗发挥作用。Abstract: OBJECTIVE To provide foundation for traditional Chinese medicine in treating psoriasis via studying the intervention effect of Qinzhu Liangxue Decoction on Th17 cells, STAT3 and RORγt of psoriasis patients. METHODS 60 cases of psoriasis vulgaris(of blood-heat syndrome) were selected for clinical research and randomly divided into treatment group(30 cases) and control group(30 cases), with the normal group being 10 cases. Patients in the treatment group and control group was prescribed with oral Qinzhu Liangxue Decoction and acitretin respectively, with the treatment lasting for 1 month. Clinical efficacy was observed based on psoriasis area and severity index(PASI). ELISA was adopted to detect, compare and analyze changes of Th17 cells. Expression rules of STAT3 and RORγt in the lesion tissue of psoriasis were detected by immunohistochemistry technology. RESULTS PASI scores of both groups after treatment were lower than those before treatment, and the difference was statistically significant(P<0.05). Serum Th17 cytokines(IL17, IL23) of the two groups before treatment were higher than the normal group(P<0.05), and both IL17 and IL23 of these two groups went down after treatment(P<0.05). Before treatment, the expression of STAT3 and RORγt via immunohistochemical detection in the lesion area of both groups was higher than that of normal group(P<0.05), while it became lower after treatment(P<0.05). CONCULSION Qinzhu Liangxue Decoction plays an effective role in treating psoriasis by improving Th17 cells and regulating transcription factors STAT3 and RORγt.