| Objective: To observe the clinical efficacy and safety of palmoplantar pustulosis treated with Modified Wushen Decoction,and to explore the mechanism of drug action from a microscopic perspective by detecting the changes of IL-17 in peripheral blood before and after treatment,so as to provide a basis for the prevention and treatment of palmoplantar pustulosis.Methods: Sixty-six patients with palmoplantar pustulosis who visited the Department of Dermatology of Yunnan Provincial Hospital of Traditional Chinese Medicine from November 2021 to December 2022 were randomly divided into 33 cases each in the experimental group and the control group according to the clinical randomized controlled trial method.The experimental group was given Modified Wushen Decoction with water decoction,and the control group was given Avi A capsule orally,and both groups were treated with Zilian-Ointment topically for 8 weeks,with 4 weeks of treatment,requiring weekly follow-up.Quality control was done and the PPPASI scores of patients before treatment,after 4 weeks of treatment and after 8 weeks of treatment,as well as the TCM symptom score,DLQI score and serum IL-17 level before and after treatment were recorded.The data were processed using Excel to create a database and SPSS 27.0software,and the results were analyzed under the guidance of TCM theory.Results: 5 study cases were shed and 61 valid cases were completed(30 cases in the test group and 31 cases in the control group).1.The PPPASI score,DLQI score,IL-17 level,and TCM evidence score of the patients before treatment were not statistically different between the two groups(P>0.05)and were comparable.2.After 4 weeks of treatment,the healing rates of the two groups were 56.67% and29.03%,while the total effective rates were 83.33% and 58.06%,and the healing rates and total effective rates of the test group were better than those of the control group(P<0.05).After 8 weeks of treatment,the healing rate of the two groups was 80.00% and 54.84%,and the test group was better than the control group(P<0.05);the total effective rate of the two groups was 93.33% and 90.32%,and the efficacy of the two groups was comparable(P>0.05).3.After 4 weeks and 8 weeks of treatment,the PPPASI scores of both groups were significantly reduced compared with those before treatment(P<0.01);compared between groups,the PPPASI scores of the test group improved better than those of the control group after 4 weeks of treatment(P < 0.05);after 8 weeks of treatment,there was no statistical difference between the PPPASI scores of the two groups(P>0.05).4.At the end of the treatment course,DLQI score,IL-17 level and TCM evidence score were significantly reduced in both groups compared with those before treatment(P<0.01).There was no statistical difference in DLQI score and IL-17 level between the groups(P>0.05),and the improvement of TCM syndrome score in the test group was better than that in the control group(P<0.05).5.The number of patients with adverse reactions in the test group and the control group were 2 and 10,respectively,and the comparison of adverse reactions between the two groups was lower in the test group than in the control group(P<0.05).6.At the end of the treatment course,the patients with effective treatment in both groups were followed up for 3 months,and there were 2 recurrences in the effective cases in the test group and 10 recurrences in the control group,and the recurrence rate in the test group was lower than that in the control group(P<0.05).Conclusion: The efficacy of Modified Wushen Decoction in the treatment of palmoplantar pustulosis with damp-heat and poisonous evidence is obvious,and it can significantly reduce the lesions and symptoms of patients after 4 weeks of treatment,and it is comparable to the efficacy of Avelox after 8 weeks of treatment,and it can reduce the serum IL-17 level of palmoplantar pustulosis patients.The recurrence rate and the incidence of adverse reactions were lower than those of Avelox,which is worthy of clinical promotion. |
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