The Therapeutic Effect Of Cleaning Heat And Removing Blood Stasis Method Treating Psoriasis And Its Influence On Cytokine Network

Psoriasis,which is commonly called "niupixuan" and called "baibi" in traditional Chinese medicine,is the common chronic recurrent inflammatory dermatoses,and its skin lesions appearance is red maculopapule covered multilayer argentate scale.Its prevalence of male is higher than female,its prevalence in city is higher than in country,and its prevalence in north is higher than in south.The prevalence in nature population is about 0.1-3%, which has obvious seasonality.The prevalence in the white race is highest and lowest in melanian and modera in xanthoderm.It is believed in our Chinese medicine that the occurrence of psoriasis is related with blood heat,blood deficiency and blood stasis which caused by invasion of exogenous evil, internal injury caused by excess of seven emotions,estrangement of spleen and stomach and so on.Meanwhile it is believed in western medicine that the main reasons or inducement of its occurrence and development are genetic factor, infection,dysmetabolism,endocrine secretion factor,immunity factor,spirit factor and so on.On the basis of before experience summary,considered the characteristics of lingnan climate,from the angle of stagnation of blood stasis and heat, exploring the "from heat" treatment of psoriasis in many ways,it is believed that psoriasis is caused by intrinsic blood heat which turns into toxic because of long time stagnation,and its leads to the toxic evil of blood heat outward to skin and muscle and causes the disease.Heat toxic invading inward which leads to depletion of body fluid and stagnation of Qi and blood is the pathological change of different stage of psoriasis developing and changing, though it is different,the pathological characteristics has heat and blood stasis,and stagnation of blood stasis and heat breaks through the wholes process.Because of that,we followed the guidance of the principle of treating stagnation of blood stasis and heat of Taiyang syndrome of blood stasis of《Treatise on Cold-induced Febride Diseases》,worked out the Chinese herbal compound which has the action of clearing heat and removing blood stasis,and explored the curative effect and mechanism of action of treating psoriasis by the clinical and experimental study.This article is divided into two parts.One is literature review and the other is research report.Literature review includes two parts.The first one,Traditional Chinese clinic and research development on the psoriasis,includes its successive changes,the opinions of neoteric doctors on its pathogenesis and medical and surgical treatment.The second one is modern clinic and research development on the psoriasis.It gains special concerns of the academic circles' owing to its unknown etiological factors and pathogenesis.Besides,it is scarce of effective therapeutic tools.Considerable research has been performed on epidemiology,etiological factors,pathogenesis,and therapy in recent years.The research report includes two parts.One is about clinical research, and the other is about experimental one.Clinical verification on blood-heat syndrome of psoriasis treated by Chinese herbal compound with the action of clearing heat and removing blood stasis was performed and clinical effect was explored.And the clinical research was completed by departmrnt of dermatology of the first affiliated hospital of Guangzhou university of traditional Chinese medicine.In clinical verification on blood-heat syndrome of psoriasis applyed with Chinese herbal compound with the action of clearing heat and removing blood stasis,78 cases with blood-heat syndrome were selected and 40 cases applied with Chinese herbal as treatment group and 38 cases applied with Tripterygium Wilfordii tablet for controlled group.The two groups had comparability because there were no significant deviations in the sex,age,course of disease,shape of skin destruction,PASI score before treatment,syndromes score between them.Results showed that there was significant difference of PASI score before and after the treatment in both groups(P＜0.01).There was no significant difference of PASI score after the treatment in both group(P＞0.05).And there was no significant difference of general efficacy between the two groups(P＞0.05),which indicated that the both are effective.Chinese herbal compound with the action of clearing heat and removing blood stasis could improve clinical symptoms of Chinese medicine such as itch of skin,upset, thirsty,constipation,yellow urine,tongue picture,pulse demonstration and so on.And the results showed that there was better efficacy using Chinese herbal compound with the action of clearing heat and removing blood stasis treating ordinary blood heat syndrome of psoriasis,especially in clinical symptoms of Chinese medicine such as upset,thirsty,urine and stool and so on.Experimental research includes three parts:Experimental researchⅠ:The model of proliferative vaginal epithelial cells of mice in estrogen cycle was used to study the prohibition efficacy of Chinese herbal compound with the action of clearing heat and removing blood stasis.Kunming female mice was randomly divided into six group:small,medium and large doses groups of Chinese herbal(groupl,2,3),tripterygium glycosides group(group4),tripterygium glycosides plus Chinese medicine group (group5) and negative control group(group6).In the experimental research, there was statistical difference between negative control group and tripterygium glycosides group(P＜0.05),between negative control group and small doses group of traditional Chinese medicine,large doses group of traditional Chinese medicine,and tripterygium glycosides plus Chinese medicine group.It was found that there was statistical difference between medium doses group of traditional Chinese medicine and tripterygium glycosides group(P＜0.05),and there was no differencein tripterygium glycosides group compared with small doses group of traditional Chinese medicine,large doses group of traditional Chinese medicine,and tripterygium glycosides plus Chinese medicine group(P＞0.05).Experimental researchⅡ:The model of the scale epidermis cells of mice tail was used to study the promoting differentiation efficacy of Chinese herbal compound with the action of clearing heat and removing blood stasis.C57 mice Groups were divided as above.In the experimental research,there was statistical difference between negative control group and large doses group of traditional Chinese medicine(P＜0.05),but it dose not promote the formation of the scale epidermis cells of the tail.there was no difference between tripterygium glycosides group and negative control group(P＞0.05).the promoting function of formation of the scale epidermis cells of the tail was not obvious in five groups with drugs.Experimental researchⅢ:CBA technique was used to observe the influence on cytokine network of the psoriasis animal model applied with Chinese herbal compound.The 12 samples of blood serum were taken from two groups above(six Kunming mice,six C57mice,male and female was equal).The level of IL-1R, IL-2,IL-5,IL-6,IL-10,TNF-a in peripheral blood of six groups had no difference,but the level of IFN-γ,GM-CSF,IL-17,IL-4 had statistical difference,and its level of some doses groups of traditional Chinese medicine were elevated in different degree.The research shows that Chinese herbal compound with the action of clearing heat and removing blood stasis treating the blood-heat syndrome of psoriasis in clinic is effective and safe,and the therapy is simple accurate. The experiment shows that the compound can evidently resist against the vaginal epithelium mitosis,and inhibit epidermal cell proliferation;secondly the doses of IFN-γ,GM-CSF,IL-17,IL-4 in clearing heat and removing blood stasis treatment groups of mice serum increase at various levels.Suggesting that the principles of the therapy may be not the simple increase and decrease of the simple cell factor,but the result of multiple cytokines interaction.Anyway the mechanism need further study,and the dosage form needs be improving.