| Objective:Through the clinical study of patients with psoriasis vulgaris, to clarify the changes of lesional skin barrier dysfunction and the repair effect of dangguiyinzi on lesional skin barrier dysfunction of patients with psoriasis vulgaris from different angles; Through the study of animal models of psoriasis vulgaris, to clarify the mechanism of dangguiyinzi on lesional skin barrier dysfunction of patients with psoriasis vulgaris, and provide a theoretical basis for dangguiyinzi adjust skin barrier function of psoriasis.Method:1The subjects were100cases of clinic patients with psoriasis vulgaris, randomly selected25patients, and candidates25healthy volunteers cases as control, and detecting the index of the skin lesions of patients with normal skin and psoriasis vulgaris skin barrier function: sebum content, skin moisture and transepidermal water loss (TEWL), and analyse the differences between psoriasis and healthy skin.2Analyse the amount of sebum, the skin moisture content and TEWL of100cases of psoriasis vulgaris patients before treatment from age, season, duration and other different angles. Explain the changes in skin lesions of psoriasis skin barrier function.3.100patients were randomly divided into control group and treatment group,50cases in each group, all patients of two groups were given the same basic treatment: Tretinoin Cream coated (take once every night),0.005%Calcipotriol Ointment coated (twice-daily), the treatment group added dangguiyinzi, four weeks as a treatment, and all patients were treated with two courses, after the treatment detecting the sebum content, skin lesions of skin moisture content and (TEWL), and analysing the changes in psoriasis skin barrier function after accepted dangguiyinzi. Pay a return visit to the patients, to evaluate the relationship between the recurrence rate and dangguiyinzi intervention.4Through the intervention of dangguiyinzi in animal models of psoriasis, ELISA was used to detect the molding lesions ceramide (Cer) content, RT-PCR and West Blot method for detection of molding lesions of aquaporin3(AQP-3), filaggrin (Filaggrin), cysteine aspartic acid protease14(Caspase-14) content and protein gene expression, analysis of the changes of protein in skin of psoriasis vulgaris in the barrier and the skin barrier function is closely related to the mechanism analysis, Chinese Angelica Decoction regulating skin barrier function.Result1There is obvious difference index barrier function of skin lesion of psoriatic patients and healthy control group (P<0.01):compared with healthy group, decreased, oil content in patients with lesions of psoriasis TEWL rise, skin moisture content decreased, the skin lesions of patients with psoriasis, a skin barrier function decreased.2.100cases of psoriasis patients were divided into65cases of advanced,35patients with stable stage, compared with healthy skin, although both fell, skin fat content increased TEWL, skin moisture content decreased, but the degree of change in advanced lesions than the stable period is more significant (P<0.05), that the skin barrier function in psoriatic lesions the advanced vulgaris damage more serious.3.100patients were divided into four age stages:18-30years,31-40years,41-50years,51-60years old, compared with the skin lesions and normal human skin, there are indicators of changes in skin oils decreased, TEWL increased, the skin moisture content decreased, with the increase of age, index changes more significantly,18-30years and51-60years old before (P<0.01). As the barrier function injury decreased the growth of the age the skin grease, moisture will also aggravate psoriasis.4.100patients were divided into spring, summer, autumn, winter four group, have obvious seasonal difference lesions index variation degree of each index, change of season spring summer autumn winter season was smaller, the degree of change in the larger. In spring and summer, autumn and winter respectively, compared with that of patients with psoriasis, a skin barrier function and season spring summer autumn and winter, the illness is lighter, heavier, and seasonal humid environment has a relationship.5.100patients were randomly divided into treatment group and control group of Western medicine, drug intervention, the callback skin oils, moisture content of TEWL, skin lesions, traditional Chinese medicine group is better than western medicine group, the Chinese Angelica Decoction has a good repair on psoriasis skin barrier function. Two groups of patients with different time comparison shows that the recurrence of psoriasis, half year and one year after the visit of the relapse rate in the treatment group than in the control group. The expression and protein content of skin lesions of psoriasis vulgaris in animal model of6AQP-3, Filaggrin, Caspase-14gene decreased significantly, the content of Cer decreased obviously, Chinese Angelica Decoction intervention the index callback, effects due to the western medicine group (P<0.01).Conclusion1compared with healthy skin, skin barrier function in patients with psoriasis vulgaris were significantly decreased, specifically in the sebum content decreases, decrease the water content, transepidermal water loss increases, the skin barrier dysfunction may be the main factor leading to lesions of dry, scaling. Clinical studies from different angles analysis conclusion, skin barrier function of patients with psoriasis vulgaris changes with seasons, age, course of the different degree of injury, the skin barrier function of different. The wetting degree the influence of seasonal changes in climate related; with the increase of age, skin barrier function injury in patients with more severe; causes lesions of barrier function damage is more obvious progress may be directly proportional to the degree of damaged skin.2Chinese Angelica Decoction on patients with psoriasis vulgaris skin barrier function of the regulatory role, can improve the skin lesions, skin sebum content water content, reduce transepidermal water loss, Chinese Angelica Decoction has certain effect in preventing the recurrence of psoriasis vulgaris.The Cer content decreased lesional psoriasis vulgaris animal model, AQP-3expression and protein content, Filaggrin, Caspase-14gene decreased significantly, Chinese Angelica Decoction intervention callback. Experiments prove that the regulatory effect of Chinese Angelica Decoction on the skin of patients with psoriasis vulgaris barrier function probably by increasing the amount of sebum, moisturizing factor gene expression and adjust the content of the skin barrier function related to skin barrier function returned to normal. |
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