Effect Of Qingre Huoxue Jiedu Prescription On Psoriasis NGF And CREB Signal Transduction Network

Psoriasis is a common chronic recurrent skin disease,is the genetic background,and is closely related to environmental factors,involving skin diseases associated with immune immunity,cell proliferation and apoptosis,inflammation,microvascular abnormalities and other aspects.The morbidity is high.although not directly endanger the life,but has the serious direct influence to the patient's physical health and the mental health.At present the treatment from the blood is the main diagnostic method for the treatment of psoriasis.Professor wa li Liu psoriasis pathogenesis can be summarized as"One Treatment.Three syndrome types,more combined syndromes",Psoriasis patients have the characteristics of stubborn disease and long-term healing.The treatment of psoriasis with Chinese medicine is flexible,various methods,low recurrence rate and small side effects.However,the mechanism of its treatment needs further study.With the increasing incidence of psoriasis,people began to pay attention to patients with psoriasis group life,found closely related to the development of neuroendocrine immune network and psoriasis,its exact mechanism remains to be further explored in the us.In previous study,we found that the proliferation of serum Qingre Huoxue Jiedu prescription can inhibit a variety of psoriasis associated cells in vitro,and can affect the expression of keratinocytes in the levels of cAMP,CaM.NF-kB gene,and the above factors are psoriasis related signal transduction pathways:an important part of the cAMP signaling pathway,Ca2+-CaMK signaling pathway.NF-kB.First part Literature Review1.Summarization of Chinese medicine in the treatment of psoriasis,the ancient records of modern Chinese medicine treatment,including psoriasis pathogenesis,oral and external treatment of traditional Chinese medicine and acupuncture treatment etc..2.Discuss the neuroendocrine immune network and the nerve growth factor,cAMP response element binding protein.P38 mitogen activated protein kinase related to psoriasis pathogenesis and their correlation.Second part Professor Liu wali Academic Thought and Experience for the Treatment of PsoriasisSystematically summarize the academic origins of Professor Zhang,academic ideas on the treatment of skin diseases and the clinical experience of treatment of psoriasis.Third part Clinical StudyClinical study of Qingre Huoxue Jiedu prescription in treating psoriasis vulgaris blood stasis syndromeObjective:To observe the clinical efficacy of Qingre Huoxue Jiedu Decoction in treating psoriasis vulgaris and its correlation with PASI and VAS.Methods:60 patients with psoriasis vulgaris blood stasis syndrome were randomly divided into two groups.The medicine was added and subtraction for the prescription of clearing heat and activating blood and detoxifying drugs((Smilax glabra 30g,honeysuckle 10g,Folium Isatidis 10g,shikonin 10g,Hedyotis diffusa 15g,Rehmannia glutinosa 10g,cortex moutan 10g,Salvia miltiorrhiza 15g,angelica 10g,licorice 6g),one dose a day and two times in the morning and evening.The study group and the control group were treated with compound Huanglian ointment,two times a day for 8 weeks.The index of the area and severity of psoriasis(PASI)was used for the evaluation of the curative effect,and the itching degree was recorded by VAS(visual analogue scale),and the dialectic of Chinese medicine was scored.Results:after 8 weeks of treatment,The study group 1 cases were cured,12 cases were markedly effective,11 cases were effective,6 cases were ineffective,and the total effective rate was 80%.The control group received 8 weeks of treatment,0 cases were cured,6 cases were markedly effective,11 cases were effective,13 cases were ineffective,and the total effective rate was 56.6%.The difference between the two groups was statistically significant(P<0.05).PASI score:the score of PASI in the study group was 11.23+2.45 before treatment and 4.33+1.07 in the 8 week treatment.The difference was statistically significant before and 8 weeks before treatment(P<0.05).The PASI score of the control group was 12.33+2.78 before treatment,and 6.38+1.47 for 8 weeks.There was a significant difference between before treatment and 8 weeks of treatment(P<0.05).The difference between the study group and the control group was statistically significant at 8 weeks(P<0.05).The degree of VAS pruritus:the score of VAS in the study group was 7.70+1.17 before treatment and 0.53+0.06 in the 8 week treatment.The difference was statistically significant before and 8 weeks before treatment(P<0.05).The control group was 7.20 + 1.19 before treatment,and 3.13+0.45 for 8 weeks.The difference was statistically significant before treatment and 8 weeks after treatment(P<0.05).The improvement of TCM dialectical score in the study group was statistically different(P<0.05)before and after 8 weeks of treatment.There was a statistical difference between the control group before and after 8 weeks of treatment(P<0.05).There was a significant difference between the two groups before and 8 weeks after treatment(P<O.05).No adverse reactions were found in the study group of Qingrejiedu Huoxue recipe.Conclusion:the prescription of clearing heat and activating blood and detoxification of Chinese medicine is effective in the treatment of psoriasis vulgaris blood stasis syndrome.It can obviously reduce the value of PASI and VAS and improve the dialectical score of various Chinese medicine,and it is safe to use the medicine.Fouth part Experimental StudyEffect of Qingre Huoxue Jiedu prescription on serum NGF and CREB related signal transduction networks in psoriasis patients with blood stasis syndromeObjective:To investigate the important role of NGF and CREB signal transduction network related factors in the pathogenesis of psoriasis,and to explore the main targets of intervention of Chinese herbal medicine " Qingre Huoxue Jiedu Therapy ".Methods:Peripheral blood mononuclear cells were extracted from the peripheral blood of 6ml patients before and after treatment and normal control group,and peripheral mononuclear lymphocytes were extracted from the patients before and after treatment.This experiment adopts the method of real-time fluorescence quantitative PCR and Western Blot detection,detection before and after detoxification Qingre Huoxue Jiedu therapy,expression of NGF in peripheral blood of patients with psoriasis,blood stasis and related receptor CREB signal transduction network related protein.Results:The results of real time quantitative PCR overall display,NGF in serum of patients with blood stasis syndrome of psoriasis vulgaris,NGF mRNA TrkA high affinity receptor mRNA and low affinity receptor P75 mRNA and CREB PKA mRNA,mRNA,P38 protein pathway promotes the expression of apoptosis gene Bax before mRNA treatment increased,compared with the control group,the differences were statistically significant(P<0.05);after 8 weeks of treatment,Qingre Huoxue Jiedu recipe can effectively reduce the expression of NGF in serum of patients with high affinity receptor TrkA mRNA,CREB mRNA and P38 mRNA protein pathway,before and after the treatment compared the differences were statistically significant(P<0.05);NGF low affinity receptor P75mRNA and PKA mRNA before treatment and treatment after compared the expression decreased,the difference was not statistically significant(P>0.05).The expression level of apoptosis suppressor gene bcl-xL and mRNA was lower than that of the normal control group before treatment,and the expression level increased significantly after 8 weeks treatment,the difference was statistically significant(P<0.05).Western Blot showed that the expression of blood stasis syndrome of psoriasis vulgaris patients with NGF,TrkA,P75,p-CREB,PKA,P38,Akt and bax in peripheral blood were significantly higher than the normal control group,the expression of bcl-xL was significantly lower than the normal group,the expression of CREB and close to the normal control group;after 8 weeks after treatment Chinese medicine,Qingre Huoxue Jiedu Decoction can reduce the expression of NGF in peripheral blood of patients with P75,p-CREB,TrkA,PKA,P38,bax,Akt,NGF and Akt decreased,which was statistically significant,and increased the expression of bcl-xL before and after treatment,compared with statistical significance.The expression of CREB also increased after treatment.Conclusion:After 8 weeks of treatment with Qingre Huoxue Jiedu Decoction,the expression of various factors(except CREB and bel-xL)decreased,and the expressions of CREB and bcl-xL showed an upward trend.