Observation Of The Clinical Efficacy Of Qinggan Liangxue Jiedu Decoction And Its Intervention On Mouse Psoriasis-like Models

1.Clinical Observation:An effective observation of Qinggan Liangxue Jiedu Decoction in the treatment of blood-heat psoriasisObjective:To observe the effect of Qinggan Liangxue Jiedu Decoction on efficacy,anxiety and TCM syndrome in patients with blood-heat psoriasis.Methods:30 patients with blood-heat psoriasis were enrolled.Qinggan Liangxue Jiedu Granules were given,1 dose/day,2 times a day for 4 weeks.Psoriasis area and disease severity index score(PASI score),itch score,Hamilton anxiety scale score and TCM syndrome score were used as evaluation criteria.RESULTS:Of the 30 patients,3 were recovery(PASI 90),3 were marked(PASI 75),17 were effective(PASI 50),and 7were ineffective(PASI scores were less than PASI 50).The total effective rate was76.67%.Compared with before treatment,the PASI score,itch score Hamilton anxiety scale score and TCM syndrome scores after treatment were statistically different(P<0.05).Before treatment,there was 1 patient without anxiety(3.33%),10 patients(33.33%)may have anxiety,12 patients(40.00%)with mild anxiety,5 patients(16.67%)with moderate anxiety,and 2 patients(6.67%)with severe anxiety.After treatment,there were 17 patients without anxiety(56.67%),11 patients with anxiety(36.67%),1 patient with mild anxiety(3.33%),and 1 patient with moderate anxiety(3.33%),but there was no severe anxious patients.After treatment,there was a positive correlation between the PASI score and the Hamilton anxiety scale score,as well as the decline between PASI score and the Hamilton anxiety scale score.Conclusion:Qinggan Liangxue Jiedu Decoction has some therapeutic effect on psoriasis blood-heat syndrome,which include improve patients’ anxiety and TCM syndromes.However,due to the small sample size of this study,the conclusions above still need further large-sample researches to verify in the future.2.Animal Experiment One:The effects of Qinggan Liangxue Jiedu and Liangxue Huoxue decoction on behavior and the expression of neuropeptide Y in psoriatic mice induced by imiquimodObjective:To observe the effects of Qinggan Liangxue Jiedu(QGLXJD)decoction and Liangxue Huoxue(LXHX)decoction on behavior and the expression of neuropeptide Y in psoriatic mice induced by imiquimod.Method:30 male BALB/c mice were randomly divided into blank control group,model group,QGLXJD group(QG),LXHX group(LX)and MTX group.The skin psoriasis model was induced by applying 5%imiquimod cream(IMQ)on the back.The Psoriasis skin lesion area and severity index(PASI)were used for daily scoring,and the behavioral differences of mice in each group were evaluated by using the open-field and elevated plus maze(EPM)respectively.The thickness of the epidermis was measured under the light microscope after HE staining.The expression of CD3+ T cells and PCNA were detected by immunohistochemistry.Meanwhile,we used real-time PCR to detect the expression levels of IL-23,IL-1β,and IL-12 mRNA,Western blot to NPY protein in skin lesions.Results:Compared with group C,the epidermal thickness,PCNA,CD3+T cells,IL-1β,IL-12,and IL-23 mRNA expression in group M were all increased(P<0.05).Compared with the M group,the epidermis was thinner,and the expression levels of PCNA,CD3+T cells,IL-1β,IL-12,and IL-23 mRNA were all decreased(P<0.05).Compared with group C,the anxiety level of psoriatic mice was higher,which was most obvious in group M.The anxiety level was low in the QG group compared with the M group,while the anxiety level was higher in the LX group compared with the QG group.NPY was highest in group M,and decreased in group LX,QG and C.Correlation analysis showed that there was a negative correlation between PASI score of lesions and the number,the time as well as the distance of mice in the open field.But there was no correlation between PASI score with the time and distance of entering the four corners of the open field,however,there was a positive correlation between PASI score and the time of entering the four lines.The PASI score was positively correlated with the time and times of entering the closed arm,and negatively correlated with the time and times of entering the open arm.Conclusion:The overall efficacy of QGLXJD decoction is superior to LXHX decoction,and it may be based on regulating the expression of NPY to improve the anxious behavior of mice,so as to achieve the comprehensive treatment effect on the mouse psoriasis-like model.3.Animal Experiment Two:Effects of Qinggan Liangxue Jiedu Decoction on Mice Psoriasis-Like Lesions Induced by ImiquimodObjective:To observe the effects of Qinggan Liangxue Jiedu(QGLXJD)decoction on mice psoriasis-like lesions induced by imiquimod.Methods:Seventy-two BALB/c mice were randomly divided into 6 groups:control group,model group,QGLXJD groups and MTX group.Imiquimod cream(IMQ)was daily used to induce the psoriasis-like lesion model.Meanwhile,each group but control group,was intragas-tric administration once a day in six days.model group was given by purified water.QGLXJD groups were given by QGLXJD decoction,MTX group was given by Methotrexate.The lesions are evaluated according to the psoriasis area and severity index(PASI)daily.On the 7th day,the histology and epidermal thicknesses were observed under high microscope.Meanwhile,the expression of CD11c+ dendritic cells,Neurokinin-1 receptor(NK-1R),Calcitonin Gene Related Peptide(CGRP)are counted.The expression of substance P(SP)and NPY protein was detected by Western blot.Results:The skin lesions of the model group were thick,infiltrate,and erythema.Compared with the model group,the skin lesions of the other groups were relatively light.Compared with the control group,the epidermal value of the model group was significantly increased,and the CD11c positive cells were significantly increased(P<0.01).Compared with the model group,the expression number of CD11c positive cells decreased significantly in other groups.Compared with the control group,CGRP,NK-1R expression in model group were raised(P<0.01),while the treatment groups were significantly lowered(P<0.05),being compared with model group.Compared with the control group,the expression of SP in the skin lesions of psoriatic groups showed an increasing trend.Compared with group C,NPY expression was significantly increased in group M,and there was a statistical difference between the two groups(P<0.05).Compared with group M,the expression levels of NPY protein in MTX,Q-M and Q-L groups were all lower,and the differences were statistically significant.Correlation analysis showed that the expressions of CD11c+DCs,CGRP,NK-1R and NPY were positively correlated with PASI score.Conclusion:QGLXJD decoction can improve the mice psoriasis-like skin through down-regulating the expression of NK-1R,NPY and CGRP,reduce the abnormal epidermal cell proliferation,inflammation cells infiltration and the expression of CD11c+ dendritic cells.