| Objective:Observe the clinical effects of cupping therapy plaque type psoriasis,explore the cupping treatment of psoriasis is by reducing the tension of vitiligo patches,weaken the bad physical stimuli leading to excessive activation of the nf-kappa B signaling pathway,so as to reduce inflammation factors,excessive cutin forming cells proliferation,alleviate psoriasis severity of inflammation.Methods:The skin lesions of the patients with psoriasis were counted and the healthy subjects matched with the patients with psoriasis were included,the skin tension,cuticle water content,epidermal oil content and TEWL value were measured in psoriatic lesions,adjacent lesions and corresponding healthy subjects The tension of different parts of the body such as back,abdomen,upper limb extension side,upper limb flexion side,lower limb extension side and lower limb flexion side was measured,target Lesions were treated with cupping therapy,and the cupping group was treated with cupping therapy for 30-45 minutes 3 times a week for 2 weeks,the skin lesion PASI score,skin tension value,cuticle moisture content,sebum content and TEWL value of cupping group and non cupping control group were observed before and after treatment.Animal Experiment:Establish psoriasis-like animal model induced by Imiquimod,through cupping intervention or not,to detect the changes of skin Pasi score,skin tension value,cuticle moisture content,epidermal oil content,TEWL value,p Smad2、p NF-κB、NF-κBp65 and other key proteins were detected by immunohistochemistry Western blot was used to detect the levels of IL-6,IL-17,IL-23 and TNF-α,which are closely related to the Keratin 1,Cytokeratin 10 and NF-κB nuclear transcription factor of Keratinocyte The MRNA levels of IL-6,IL-17,IL-23 and TNF-α,which are closely related to Keratin 1,Cytokeratin 10 and NF-κB nuclear transcription factors,were detected by Real-time PCR.Results:Clinical efficacy observation found that,among the 93 patients,86%(80/93)were upper limb extension,86%(80/93)lower limb extension,77.4%(72/93)head and face,55.9%(52/93)back,50%(47/93)lower limb flexion,40%(38/93)abdomen,37.6%(35/93)upper limb flexion,the most common sites of psoriasis were upper limb extension,lower limb extension,head and face,back,but abdomen,lower limb flexion,upper limb flexion;In 96 healthy subjects,the skin tension of different parts were as follows:frontal tension(6.57±1.03),back tension(6.03±1.2),abdominal tension(4.43±1.15),upper limb flexion side tension(4.84±1.03),upper limb extension side tension(5.58±1.02),lower Limb flexion side tension(5.65±0.97),lower limb flexion side tension(6.57±0.95),forehead,back and lower limb tension were significantly higher than other places,and extension side tension was higher than flexion side.The skin tension of PSORIATIC lesions was(7.80±1.22),that of psoriatic lesions was(6.75±1.54),that of healthy persons was(5.74±1.37)The moisture content of the stratum corneum of psoriatic lesions was%(10.85±1.19),the moisture content of the stratum corneum of psoriatic lesions was%(24.97±4.82),and the moisture content of the healthy persons was%(28.54±8.41)The content of sebum in psoriatic lesions was%(7.71±1.23),that in psoriatic lesions was%(8.33±1.87),that in healthy persons was%(14.23±3.29)The TEWL values of psoriatic lesions(21.64±3.98),psoriatic lesions(8.83±2.54)and healthy persons(5.74±1.37);40 patients with plaque psoriasis were treated with cupping therapy.The clinical effect of target skin lesion in the treatment group was better than that in the non-cupping control group.The specific manifestations were as follows:the Pasi score of the Control Group(6.725±1.714),after treatment,the skin tension of the Control Group(7.44±1.06)and the Treatment Group(6.45±1.01**)decreased significantly.The water content(13.24±0.8684**)of the Treatment Group was higher than that of the Control Group(10.83±0.5088),and the oil content(9.305±0.8105*)of the treatment group was higher than that of the control group(7.703±0.6930)After treatment,the TEWL value of the Treatment Group(16.48±3.130**)was lower than that of the Control Group(21.60±3.895);At the same time,animal experiments also found that in the model of imiquimod-induced psoriasis-like mice,cupping intervention treatment of imiquimod-induced psoriasis-like mice led to a decrease in skin tension value,an increase in water content in stratum corneum,an increase in oil content in Epidermis,and a decrease in TEWL,the psoriasis phenotype skin damage improves,the inflammation reduces obviously;Detect the level of IL-6,IL-17,IL-23,TNF-αprotein closely related to NF-κB nuclear transcription factor by Western blot method for marker K1 and cell differentiation marker K10.The result:K1 blank group VS manufacturing module VS cupping group(0.41±0.06 VS 0.89±0.07 VS0.56±0.06);K10 blank group VS manufacturing module VS cupping group(0.34±0.03VS 0.84±0.03 VS 0.66±0.08);IL-17 Blank group VS manufacturing module VS cupping group(0.52±0.12 VS 0.99±0.09 VS 0.64±0.08);IL-23 blank group VS manufacturing module VS cupping group(0.44±0.06 VS 0.93±0.06 VS 0.75±0.08);TNF-αblank group VS build module VS cupping group(0.34±0.01 VS 0.99±0.11 VS 0.64±0.08);IL-6 blank group VS build module VS cupping group(0.36±0.07 VS 1.02±0.06 VS 0.69±0.09),Compared with the blank control group,the expression of IL-23,IL-17,IL-6,TNF-αin the model group and the cupping group were up-regulated(P<0.05)the protein expression of K1 and K10 was up-regulated;compared with the model group In the cupping group,the secretion of inflammatory factors IL-23,IL-17,IL-6,and TNF-αwas significantly reduced,and the protein expression was significantly reduced,while the protein expression of keratinocyte differentiation markers K1 and K10 was down-regulated;The m RNA level was detected by RT-PCR method,and the results showed:K1 blank group VS manufacturing module VS cupping group(4.17±2.93 VS 7.23±3.87 VS 4.90±3.39);K10 blank group VS manufacturing module VS cupping group(2.60±1.00VS 5.22±2.05 VS 2.06±1.06);IL-17 Blank group VS manufacturing module VS cupping group(5.71±1.92VS 14.9±4.35 VS 7.8±1.99);IL-23blank group VS manufacturing module VS cupping group(3.19±2.47 VS 29.00±14.62 VS 8.67±3.27);TNF-αblank group VS manufacturing module VS cupping group(2.01±1.30 VS 12.16±2.44 VS 6.78±2.60);IL-6 blank group VS manufacturing module VS cupping group(9.87±15.08 VS 45.94±31.16 VS11.34±9.03).Compared with the blank control group,the expressions of the above factors were up-regulated in the model and cupping groups(P<0.001).Compared with the model,the expression of K1 and K10 was significantly down-regulated in the cupping group,the secretion of inflammatory factors IL-23,IL-17,IL-6,and TNF-αwas reduced,and the expression of m RNA was all down-regulated(P<.001);The expression of key proteins p Smad2,p NF-κB,and NF-κBp65 were detected by immunohistochemistry.The blank control group had no positive expression of p Smad2,p NF-κB,NF-κBp65 in the epidermis.Both p Smad2 and p NF-κB were positively expressed in the epidermal layer of the cupping group and the cupping group.The expression of p Smad2 in the cupping group was significantly lower than that of the cupping group(16/cm~2 VS 3cm~2,P<0.001).The positive expression of p NF-κB in the cupping group Significantly lower than the model(87%VS 19%,P<0.001).The positive expression of NF-κBp65 in the cupping group and the cupping group was positive.The positive expression rate of NF-κBp65 in the cupping group was significantly lower than that of the cupping group(83%VS 35%,P<0.001).Conclusion:1.The distribution of psoriasis skin lesions has a certain pattern.It is more likely to occur on the scalp,the extensor side of the limbs and other places with greater tension,while the flexion side is less frequent,suggesting that mechanical tension factors play an important role in the course of psoriasis.2.Cupping is an effective method for the treatment of plaque psoriasis.It can significantly reduce the PASI score and skin tension value of the skin lesion,increase the water content of the skin lesion,and improve the skin barrier function.3.Cupping therapy effectively improves the inflammation of psoriasis,which is related to reducing the excessive activation of NF-κB signaling pathway,which is the potential mechanism of cupping treatment of psoriasis. |
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