| objective To observe the clinical efficacy of Tibetan medicine twenty-five taste tea gel on juvenile atopic dermatitis and its influence on atopic dermatitis animal models,and preliminarily discuss its therapeutic mechanism for atopic dermatitis,so as to lay a foundation for further experimental research,clinical application and market promotion of Tibetan medicine Er-shiwuwei Ercha Gel.Method 1 clinical observation In this study,64 patients with atopic dermatitis who were treated in the Department of Dermatology of Gansu University of traditional Chinese medicine in February January 2017 were selected and randomly divided into 2 groups.The treatment group was treated with Tibetan medicine Er-shiwuwei Ercha Gel for external use,while the control group was given butyric acid Hydrocortisone Cream for external use,and 2W was given to the control group.The lesion area and severity index score(EASI score),itching degree score and adverse reactions were evaluated before,1 and 2 weeks after treatment.The patients were followed up for 4 weeks after the treatment,and the recurrence rate was counted.2 Experimental study Forty BALB/c mice were randomly divided into two groups:blank group(6 mice)and model group(34 mice).The mice in each group were depilated at 2cm*2cm.The model group used 0.5% DNFB to induce atopic dermatitis in the depilated area of the back.The blank group was fed normally.Four mice in the model group were randomly selected after 4 weeks to observe the pathological changes of the skin lesions,suggesting that the model group would be established successfully.They were randomly divided into 5 groups,namely,model control group,positive drug control group(butyric acid Hydrocortisone Cream group),Tibetan medicine Er-shiwuwei Ercha Gel high,medium and low dose group.After intervention,the changes of skin lesions,pathological changes,and levels of IL-6 and IL-22 in peripheral blood were observed after the intervention of the corresponding drugs.The Tibetan medicine Er-shiwuwei Ercha Gel for atopic dermatitis was discussed.Therapeutic mechanism.Result 1 Clinical observation1.1 Comparison of pruritus score between two groups Compared with before treatment and 1 week after treatment,the itching symptoms of each group were significantly alleviated after 2 weeks(P<0.05),but there was no significant difference between the two groups(P>0.05).1.2 Comparison of EASI score and skin lesion score between the two groups After 1 week of treatment,the lesion area of each group was reduced,but there was no significant difference compared with that before treatment(P>0.05).After 2 weeks of treatment,the lesion area was significantly reduced(P<0.05).Compared with before treatment,after 1 week and 2 weeks of treatment,the lesions of erythema,papule/edema(sclera),scales(skin exfoliation),lichenization and other skin lesions in the same group were obvious in both groups.The scores of EASI decreased significantly(P<0.05).Before and after treatment,there was no significant difference in skin lesion scores and EASI scores between the two groups(P>0.05).1.3 Comparison of total effective rate between two groups After 2 weeks of treatment,the clinical efficacy of the two groups was compared.The total effective rate of the treatment group was 81.3%,and that of the control group was 75%.There was no significant difference between the two groups(P>0.05).1.4 Contrast of adverse reactions There were no adverse reactions such as pigmentation,skin atrophy,erythema and increased velvet hair in the treatment group,while there were 2 cases of erythema in the control group,1 case of pigmentation and 1 case of increased velvet hair in the control group.1.5 Relapse Rate Comparison After 2 weeks of treatment,the patients in the two groups were followed up for 4 weeks.No patients were lost during the follow-up period.The recurrence rate was 21.9% in the control group and 6.25% in the treatment group.The difference was significant(P < 0.05).2 Animal experiments2.1 Skin lesions in mice In the course of stimulation,the model mice showed varying degrees of skin flushing,exudation,scaling,scab formation and skin thickening on the back,which accorded with AD lesions.After treatment of 2W,compared with the model control group,the skin lesions of rats in each group were alleviated to varying degrees.Among them,Tibetan medicine Er-shiwuwei Ercha Gel medium,high dose group and positive drug control group were more relieved.2.2 Histopathological findings Compared with the blank group,the histopathology of the model group showed that the epidermal cells and intracellular edema,the stratum corneum and spinous layer became thicker,accompanied by lymphocyte infiltration,indicating the successful establishment of AD mice model.Compared with the model control group,there was slight thickening of stratum corneum and stratum corneum in the low dose group of Tibetan medicine Er-shiwuwei Ercha Gel,while the Tibetan medicine Er-shiwuwei Ercha Gel medium,high dose group and positive drug control group basically returned to normal,showing a small amount of lymphocyte infiltration.2.3 Determination of IL-6 and IL-22 Compared with the blank group,the serum levels of IL-6 and IL-22 in the model control group were significantly higher(P<0.01);compared with the model control group,the levels of IL-6 and IL-22 in the peripheral serum of mice in each medication group were significantly lower(P<0.05).Compared with the positive drug control group,the content of IL-6 and IL-22 in Tibetan medicine Er-shiwuwei Ercha Gel medium and high dose group was quite similar(P>0.05),and there was no significant difference between Tibetan medicine Er-shiwuwei Ercha Gel medium and high dose group(P>0.05).conclusion 1 Tibetan medicine Er-shiwuwei Ercha Gel and butyric acid Hydrocortisone Cream have different degrees of improvement on atopic dermatitis itching,erythema,papule/edema(swelling),scaling(exfoliation),lichenation and other skin lesions,and the overall effect of the two is equivalent.Compared with butyric acid Hydrocortisone Cream,Tibetan medicine Er-shiwuwei Ercha Gel had fewer adverse reactions and lower recurrence rate.2 Tibetan medicine Er-shiwuwei Ercha Gel can reduce the level of IL-6 and IL-22 in peripheral blood of mice,so as to reduce inflammation and improve skin lesions in mice. |
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