| ObjectivePsoriasis is a common dermatology,difficult to cure,etiology and pathogenesis is still unclear,plenty of evidence now indicates that the occurrence of psoriasis is the result of many factors.Many scholars believe that psoriasis belong to immune mediated diseases,The imbalance between Th1/Th2 is its main mechanism.Thl cells secreted IL-2,IFN-γ,Th2 cells secreted IL 4,IL-6,IL-10,which may explain the abnormal expression of inflammatory cytokines partly in peripheral blood of patients with psoriasis.But the characteristic skin lesions of psoriasis vulgaris mainly performance on the basis of inflammatory lupus characterized by a large number of silver scales.From a pathological perspective,Mainly for cutin thick,parakeratosis,and small abscess composed of neutrophils will be found under or in the cuticle(Munro abscess).So it is not comprehensive or convinced if explain the lesions of psoriasis only from the perspective of imbalance relationship between Thl/Th2.We found that there are a lot of evidences suggest that neutrophils(polymorphonuclear neutrophils,PMNs)play an important role in the process of the pathogenesis of psoriasis both at home and abroad.It has devoured and antiseptic effect,can secrete a variety of inflammatory factors involved in immune regulation.Neutrophil elastase(neutrophil elastase,NE)is the most important secretions of the neutrophils activated which can stimulate the cutin cell proliferation through the EGFR signaling pathways.It can explains the phenomenon that cutin thick with psoriasis vulgaris,parakeratosis and the areas with PMNs infiltration increasing proliferation.Trappin-2 protein is NE endogenous inhibitor which inhibits activity of NE through the degradation of NE.So many scholars put forward the pathogenic theory that the imbalance between NE/Trappin-2 maybe the main cause of psoriasis.They Believe that the balance between NE and trappin-2 plays an important role on the occurrence of psoriasis,KC abnormal proliferation and inflammatory lesion.No.1 Yinxie Formula has been used for a long time and has achieved obvious curative effect in the treatment of psoriasis in our apartment.Proved by clinical and experiment,it can relieve the pain,improve the clinical symptoms of patients with psoriasis obviously,and has an influence on the expression of cytokines related to psoriasis.In order to conform that No.1 Yinxie Formula has clear curative effect on psoriasis through regulating the balance between NE and Trappin-2、Th1 and Th2 more intuitively,we set tripterygium wilfordii group,Chinese medicine group and Chinese medicine+in tripterygium wilfordii group,then compare the expression level of NE,trappin-2,IL-4,IFN-γ in peripheral blood serum of patients with psoriasis vulgaris in three groups,and explore how the disorder relationship between NE and trappin-2,Th1 and Th2 play a role in the process of on the pathogenesis of psoriasis at the same time.To elucidate the inner material basis of No.1 Yinxie Formula,from the blood" in treatment of psoriasis vulgaris and make the etiology,pathogenesis of psoriasis clearify,and provides a new direction of treatment of psoriasis with Chinese and western medicine.MethodsCollection of 135 cases of patients with psoriasis vulgaris,and divided into three groups randomly.Tripterygium wilfordii group treated withtripterygium wilfordii piece,TCM group treated with No.1 Yinxie Formula,TCM+tripterygium wilfordii group treated with tripterygium wilfordii piece and No.1 Yinxie Formula.Three groups of patients taking dug for 4 weeks andexternal use purple dragon cream,twice a day at the same time.Each patient will be evaluated the curative effect reference to psoriasis skin lesion area and severity index(PASI)and drew peripheral blood before and after treatment.Then using ELISA to detect the expression level of NE,trappin-2,IL-4,IFN-γ in peripheral blood serum of patients with psoriasis vulgaris.ResultsThe effective rate of Tripterygium wilfordii group was 62.5%,Chinese medicine group was 68.75%,the traditional Chinese medicine+tripterygium wilfordii group was 81.25%,By χ2 test,they had differences signi.Ccantly(P<0.05).The differences among these three groups of PASI score、concentration of NE,Trapp in-2 and IL-4 before and after the treatment were also had statistical significance(P<0.05).ConclusionNo.1 Yinxie Formula jiont tripterygium wilfordii can achieve good curative effect when be used to the patients with psoriasis vulgaris,Its mechanism may be t.hrough regulating the balance between NE and Trappin-2,Thl and Th2,then to inhibit the immune inflammatory response to reach the effect for the treatment of psoriasis.The expression level of IL-4 decreased in tripterygium wilfordii group,and it rise in TCM+tripterygium wilfordii group in a modest range,but the difference of the expression level before and after the treatment with statistical significance inTCM+psoriasis group only(P<0.05). |
