| This dissertation is composed of two parts:literature review and clinical research.The part of literature review:The first literature review:This paper reviews the recent research papers on clinical research results of plaque psoriasis.The first part it summarizes the etiology and pathogenesis of plaque psoriasis from the four aspects,phlegm dampness,blood stasis,blood dryness and blocking of wei Yang.And it also provides in terms of resolving phlegm,removing blood stasis,moistening dryness,and xuanyang.The second literature review:This paper reviews recent psoriasis research results on treatment from blood differentiation in recent years and illustrates the relationship between T cells and psoriasis.This paper also summarizes immune characteristics of blood heat,blood stasis and blood dry syndrome respectively from the Th1/Th2,of Th17/Treg,Th22 aspects.This paper indicates purpose and meaning of the immune characteristics research on blood stasis.The part of clinical research:OBJECTIVE:To observe the levels of Th1/Th2,Th17/Treg and Th22 related cytokines IFN-1,IL-4,IL-17A,IL-10 and IL-22 in patients with plaque psoriasis(blood stasis syndrome),compare with the healthy control group and summarize immune function characteristics of blood stasis syndrome in psoriasis.To observe the effect of exianhuaban decoction on skin lesions and serum levels of Th1/Th2,Th17/Treg and Th22 related cytokines IFN-1,IL-4,IL-17A,IL-10 and IL-22 in patients with plaque psoriasis(blood stasis syndrome),compare with the healthy control group and explore the curative effect of exianhuaban decoction and it’s effect on Thl/Th2,Th17/Treg imbalance and Th22 expression in patients with plaque psoriasis(blood stasis syndrome).METHODS:Select 30 cases of patients with plaque psoriasis(blood stasis syndrome)and give each patient exianhuaban decoction for 4 weeks,assess and record the patients’ PASI score and VAS index before and after the treatment,observe curative effect,and detect serum Th1/Th2,Th17/Treg and Th22 related cytokines IFN-1,IL-4,IL-17A,IL-10 and IL-22 in the peripheral blood before and after treatment by ELISA.At the same time,30 cases of the healthy control group were selected to detect the serum levels of Th1/Th2,Th17/Treg,and Th22 related cytokines IFN-1,IL-4,IL-17A,IL-10 and IL-22 in the peripheral blood,and calculate the IFN-1/IL-4,IL-17A/IL-10 ratios before and after treatment in the two groups,to estimate the migration degree of Th1/Th2,Th17/Treg and the expression level of Th22.Results:Serum levels of IFN-1 and IL-17A in patients with plaque psoriasis(blood stasis syndrome)were significantly higher than those in the healthy control group,with statistically significant differences(all P<0.05).The levels of IL-4,IL-10 and IL-22 were not significantly different from the healthy control group(all P>0.05).Th1/Th2 and Th17/Treg were significantly higher than the healthy control group,with statistically significant differences(all P<0.05).PASI score and VAS index were significantly decreased after the treatment with exianhuaban decoction(P<0.05).Serum levels of IFN-1、IL-17A and IL-22 in patients with plaque psoriasis(blood stasis syndrome)decreased significantly compared with those before treatment(all P<0.05),and IL-4 increased significantly compared with those before treatment(all P<0.05).Th1/Th2 and Th17/Treg decreased significantly compared with that before treatment,with statistically significant differences(P<0.05).After treatment,serum levels of IFN-1,IL-4,IL-17A,IL-10 and IL-22,as well as Th1/Th2 and Th17/Treg were not significantly different from the healthy control group(all P>0.05).Conclusion:Th1/Th2 and Th17/Treg immune imbalance exists in the blood stasis syndrome of psoriasis,and the blood stasis syndrome of psoriasis is mainly characterized by up-regulated expression of Th1/Th17 related cytokines.Exianhuaban decoction can improve skin lesions of plaque psoriasis(blood stasis syndrome)and relieve itching,with good clinical efficacy.It can regulate Th1/Th2,Th17/Treg balance and down-regulate Th22 expression in patients with plaque psoriasis(blood stasis syndrome). |
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