| T helper17cell (Th17) is a newly discovered effect T cells, under the induction ofIL-23, Th17cells can reproduce, activate and secretion of IL-17, IL-21, IL-22andTNF alpha and various cytokines. Currently, more and more research indicated thatTh17cells and related factors involved in the pathogenesis of psoriasis. Th17cells andrelated factors in the pathogenesis of psoriasis provides a new direction and strategy toresearch and treatment of psoriasis.This paper combined the clinical research and the basic experiment, to blood heatsyndrome patients with psoriasis vulgaris as the research object, explored the correlationof blood heat syndrome with psoriasis vulgaris and TH17related factor, for the study oftreatment of blood heat with psoriasis vulgaris for target cells; usedLiang-Xue-Huo-Xue-Tang treating blood heat syndrome patients with psoriasis vulgaris,compared before and after treatment of TH17related factors change, it provideslaboratory evidence of Liang-Xue-Huo-Xue-Tang treating blood heat syndrome patientswith psoriasis vulgaris.Experiment1The CorrelationAnalysis of Blood HeatSyndrome With Psoriasis Vulgaris and TH17Related FactorObjective: to explore the correlation of the blood heat syndrome with psoriasisvulgaris and TH17related factor, anf search out the target cells of drug treating bloodheat with psoriasis vulgaris. Methods: recorded the patient's general condition, clinical manifestation (PASIscore and TCM symptom scores and H.E. pathology), peripheral blood serum TH17related cytokines, skin tissue TH17related protein expression.Analysis the correlationof blood heat syndrome patients in the expression level of TH17related factors andclinical manifestations (PASI score and TCM symptom score and the thickness ofepidermis), and compare different of TH17related protein expression in differentregions.Results: Recorded22cases of blood heat syndrome patients with psoriasis vulgaris,calculated scales, erythema, infiltration, the lesion area situation, and the PASI score(4.24~19.35), the average PASI score:12.21±5.25. Recorded Traditional Chinesemedicine (TMC) main clinical symptom score (12-23), average TMC clinical symptomscore:17±4.62. Recorded tissue pathology, H.E. average epidermis thickness:153.2±30.4?m. detected the serum cytokines IL-17a (232.38±47.38pg/ml), IL-1beta (23.71±9.73pg/ml), the INF-gamma (43.29±6.28pg/ml), IL-4(17.52±5.62pg/ml).Correlation of the serum IL-17a and PASI score, the serum IL-17a and theTMC main symptom scores were positive (r=0.89, p <0.001?r=0.77, p <0.001), theserum IL-17a and the thickness of epidermis is negative (r=0.18, p=0.42). the serumIL-1beta and PASI score, the serum IL-1beta and the TCM main symptom scores arenegative (r=0.23, p=0.31?r=-0.02, p=0.93), the serum IL-1beta and the thickness ofepidermis were positive (r=0.67, p <0.001).The expression of STAT3protein in the lesion is significantly higher than skintissue from5cm of the edge of the lesion (t=2.66, p=0.019), but no difference wasfound between the lesion and the normal tissue edged of the lesion (t=0.99, p=0.34).The expression of P-STAT3protein in the lesion is significantly higher than skin tissue from5cm of the edge of the lesion and the normal tissue edge of the lesion (t=2.47, p=0.027?t=3.07, p=0.008). The expression of ROR-gamma protein in the lesion is nosignificantly different than skin tissue from5cm of the edge of the lesion and thenormal tissue edge of the lesion(t=0.64, p=0.53; t=0.43, p=0.67).Conclusion:1.Correlation of the serum IL-17a and PASI score, the serum IL-17a and the TMC main symptom scores were positive. the serum IL-17a and thethickness of epidermis is negative. the serum IL-1beta and PASI score, the serum IL-1beta and the TCM main symptom scores are negative, the serum IL-1beta and thethickness of epidermis were positive.2. The expression of STAT3protein in the lesion is significantly higher than skintissue from5cm of the edge of the lesion, but no difference was found between thelesion and the normal tissue edged of the lesion. The expression of P-STAT3protein inthe lesion is significantly higher than skin tissue from5cm of the edge of the lesion andthe normal tissue edge of the lesion. The expression of ROR-gamma protein in thelesion is no significantly different than skin tissue from5cm of the edge of the lesionand the normal tissue edge of the lesionExperiment2Intervention Effect of Liang-Huo-Huo-Xue-Tangto Blood Heat Syndrome Patients With Psoriasis Vulgaris by InhibitingTH17Related FactorObjective: used Liang-Xue-Huo-Xue-Tang treating blood heat syndrome patientswith psoriasis vulgaris, compared before and after treatment of TH17related factorschange, it provides laboratory evidence of Liang-Xue-Huo-Xue-Tang treating bloodheat syndrome patients with psoriasis vulgaris. Methods: Chosen blood heat syndrome patients with psoriasis vulgaris as theresearch object, double-blind, randomized, divided into research group (31cases, usedLiang-Xue-Huo-Xue-Tang oral) and control group (20cases, the placebo oral), recordedof patients before and after treatment PASI score, TMC main symptom scores,side-effect, peripheral blood serum of TH17related cytokines, peripheral blood TH17related factor mRNA, comparing the difference between before and after treatment inthe research group and the differences between the research group and the controlgroup.Results: after six weeks treatment in research group (31cases), the erythema colorshallow gradually, scales sparse gradually, skin smooth gradually, infiltration graduallyreduce, lesions had obvious improvement (t=4.26, p <0.001), compared with thecontrol group (20cases), PASI score lower significantly(t=2.18, p=0.036). after sixweeks treatment in research group, erythema color shallow gradually, skin burning anditching gradually reduce, upset irritability gradually ease, the TMC major clinicalsymptoms significantly improved (t=5.94, p <0.001); Compared with the controlgroup (20cases),6weeks after treatment, the TCM main clinical symptoms score lowersignificantly (t=3.85, p <0.001).Recorded a total of51cases of side-effect, all patients did not appear abnormalvital signs before and after the treatment, and it's no obvious difference of side-effectbetween before and after the treatment.Detected the expression of IL17a, IL-1beta, INF-gamma, IL-4in week0,6weekend of the research group and control group respectively, found that the researchgroup of IL-17a before and after treatment significantly reduced (t=2.72, p=0.016),and the rest cytokines have no obvious difference before and after the treatment. Compared before and after treatment, peripheral blood IL-17a mRNASTAT3mRNA, and RORC mRNAexpression decreased significantly (t=7.36, p <0.001?t=12.5, p <0.001?t=18.53, p <0.001); The control group before and after treatment, IL-17a mRNASTAT3mRNA, and RORC mRNAexpression did not decreasedsignificantly(t=2.44, p=0.26?t=2.33, p=0.88?t=4.53, p=0.11).Conclusion: Liang-Xue-Huo-Xue-Tang can effectively reduce the blood heatsyndromes in patients with psoriasis PASI score, the TMC main symptom scores,peripheral blood IL17a, IL17a mRNA, STAT3mRNA, RORC mRNAexpression, andhas no obvious side-effect. |
PDF Full Text Request