The Curative Effect Observation And Mechanism Approach Of Auricular Therapy Combining With The Curative Effect To Psoriasis Vulgaris By Topical Western Medicine

ObjectiveTo explore the effect of the auricular therapy combined with topical Western medicine in treating psoriasis valguris.Methods90cases of out-patient of psorisis vulgaris from the dermatology department of the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine and Guangzhou Red Cross Hospital, were randomly divided into46cases of therapy group (Auricular therapy combined with topical Western medicine), and44patients control group (topical Western medicine).1momths later, observed the clinical efficacy and safety indicators of the two groups (such as blood routine, urine routine, liver and kidney function, and electrocardiogram test), measuring scales of Psoriasis Area and Severity Index (PASI), Relapse Rate, Visual analogue scale (VAS), Dermatology Life Quality Index (DLQI), Time to Relapse, Effective Time and so on, and then carry out comparative study of efficacy. At the same time, we test Cytokine (TNF-a、IL-8、IL-10、IL-12、IL-17、IL-23) before and after the research by ELISA.Databases were established with Epidata3.0. Data were processed by statistical analysis with SPSS17.0. First, continuous variables were tested of normality. The t-test was applied on measurement data which obey normal distribution between groups and between pre-and post treatment indices. Nonparametric rank sum test was applied on data which disobey normal distribution. Enumeration data were applied χ2test and ranked data were applied rank sum test. Repetitive measurement data were processed by repetitive measurement and analysis of variance. Two-tailed P values<0.05were considered to be statistically significant.ResultsTwo case of the control group couldn’t finish the research due to losing contaction.1. Clinical resultThe baseline characteristics of patients in two groups were the same.1.1Main curative effect index---Psoriasis Area and Severity Index (PASI)The comprehensive PASI reducing rate of the treatment group was (88.6%,39/44) significantly higher than the control group (77.3%,34/44)(P<0.05). There were no cases deterioration in the treatment group. With the repetitive measurement and analysis of variance, after treatment, the scores of PASI decreased in both groups, but the decrement in the treatment group was more significant (P<0.005).1.2Main curative effect index---The Relapse RateThe Relapse Rate of the treatment group (60.0%,24/40) was much lower than the control group (94.9%,37/39).1.3Secondary curative effect indexThe Effective Time of the treatment group (2weeks) was shorter than the control group (3weeks).The Time to Relapse of the treatment group (5weeks) was longer than the control group(1week).The scores of VAS indicators of the treatment group decreased respectively than the control group after4weeks treatment (F<0.005).With stratified analysis, on the lever of course of disease≤5years, heat in blood type, the scores of DLQI of the treatment group decreased respectively than the control group(P<0.005). But there was no significant difference in the DLQI between the two groups on other lever.No abnormalities were found in routine hematology, urinalysis, liver and kidney function, blood calcium, chlorinum, kalium, natrium as well as in electrocardiogram. There was no adverse reaction observed in either group.2. Experimental resultThe baseline characteristics of patients in two groups were the same. 2.1Groups comparison2.1.1Before the treatment, IL-8, IL-17A, IL-23in the treatment group and control group was lower than the healthy group (P<0.05). After4weeks treatment, TNF-a, IL-8, IL-17A, IL-23in the treatment group and control group was lower than the healthy group (P<0.05).2.1.2After4weeks treatment, TNF-a in the treatment group was lower than the control group (P<0.05)2.1.3There was no significant difference on TNF-a, IL-8, IL-10, IL-12(P70), IL-17A, IL-23in the comprehensive PASI reducing rate between the treatment group and control group(P>0.05).2.1.4The change of IL-12(P70) on blood dry syndrome in the treatment group was better than control group (P<0.05)2.1.5The change of IL-23on the stable phase in the treatment group was better than control group (P<0.05)2.2Comparison before and after treatmentThere was no significant difference on TNF-a, IL-8, IL-10, IL-12(P70), IL-17A, IL-23between the treatment group and control group before and after the treatment(P>0.05).2.3Correlation analysisThere was a linear positive correlation between TNF-a and IL-8, IL-10; IL-8and IL-10; IL-10and IL-12(P70), IL-17A, IL-23; IL-17A and IL-23(P<0.05). There was no any linear positive correlation between TNF-a, IL-8, IL-10, IL-12(P70), IL-17A, IL-23(P>0.05).Conclusions1. The auricular therapy combined with topical Western medicine shows definite curative effect in treating psoriasis valguris,2. The auricular therapy combined with topical Western medicine was better and safer than topical Western medicine only, which can lower the Relapse Rate, shorter the Time to Relapse, and longer The Time to Relapse.3. The auricular therapy combined with topical Western medicine is effective, safe, simple, economical and could be applied easily. This research has the approval of the Ethic review from the Ethics Committee of Guangdong Provincial Hospital of Traditional Chinese Medicine, China.4. TNF-a, IL-8, IL-17A, IL-23showed important effectiveness on pathogenesy of psorisis.5. The auricular therapy combined with topical Western medicine could lower the inflammatory reaction of psorisis.6. TNF-a, IL-8, IL-10, IL-12(P70), IL-17A, IL-23were linear positive correlated.