| Objective: Psoriasis is an immunity-inflammation reactivitydermatosis at polygene inheritance background, the mechanism of which is not entirely clear, and the psoriasis enplaques is especial pertinacious and difficult to cure. At present, either the Chinese traditional medicine or the Western medicine has its limitation in treating the disease, but with the combination of TCM and western medicine, we can obtain significant effect, which is a new idea worth discussing. According to this idea, we objectively evaluated the clinical efficacy of Dangshe jiedu Decoction and Diyin Tablet of litter dose in treatment of psoriasis enplaques, detected and analyzed the level of IL-2 and TNF-α .which is the main target of pathology from the gene of immunocyte before and after treatment, with the study of the variety of blood lipid .We intended to illustrate the related mechanisms with the combined drugs, expound the scientific connotation of curative effect in one aspect, and provide theoretic gist for this research.Methods: There were 54 patients with psoriasis enplaques, dividedinto 2 groups. 28 patients in one group were given the Dangshe jiedu Decoction and Diyin Tablet of litter dose, while 26 patients in the other were given Dangshe jiedu Decoction. We observed the disease activity with Psoriasis area and severity index (PASI). 6ml of the blood samples were collected from the vein on an empty stomach before and after treatment, 3ml were used to detect blood lipid and the rest to separate the serum and were freezed in -80℃. The level of IL-2 and TNF-α in serum were detected with the method of radicalized immunity.Result: Two cases were clinically cured, fifteen cases showed obviouscurative effect, and the overall efficacy was 60. 7% in the group treated with Dangshe jiedu Decoction and Diyin Tablet of litter dose. One case was clinically cured, twelve cases showed obvious curative effect, and the overall efficacy was 50. 0% in the group treated with Dangshe jiedu Decoction. The overall efficacy in the group treated with Dangshe jiedu Decoction and Diyin Tablet of litter dose, which was better than that in the group of the Dangshe jiedu Decoction. What is more, no obvious side-effect was shown. Experimental study revealed that the Dangshe jiedu Decoction and Diyin Tablet of litter dose could significantly change the level of IL-2 and TNF- a . The Dangshe jiedu Decoction could significantly change the level of TNF-a, but with no significant effect on IL-2. But there was significant change of the level of IL-2 in the 13 effective cases before and after treatment. No obvious effect was shown in either group on decreasing blood lipid.Conclusion:The Dangshe jiedu Decoction and Diyin Tablet of litter dose can effectively ameliorate the symptom of erytherma^ scraps-, soakage and tickling in psoriasis enplaques, and can reduce the PASI grade in partial skin. But HRQOL grade were not obvious changes. The clinical curative rate and efficacy were better than the Dangshe jiedu Decoction alone. What is more, it has no obvious side-effect. The study has demonstrated that the way of Chinese traditional medicine associated with Western medicine can reinforce the superiority effect. It is a treating method worthy of being explored in the research field of anti-psoriasis.The clinical observation and the laboratory study expound in one aspect the possible mechanisms of the medicines which play a role in treatment. As the main target of pathological immunity-inflammation reactivity of psoriasis, IL-2 and TNF-a are the definite target of medical function. It has important theoretic and realistic significance to restrain their excretion or interdict their combination with the acceptor. Combination of TCM with western medicine can regulate the excretive nature of immunocyte, prevent the medium of inflammation, and restrain proliferation and differentiation of keratinocyte , which is a good way to treat psoriasis. This research has provided the foundation of theory for further clinical research on the treatment of the psoriasis enplaques with combination of TCM and western medicine. |
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