皮敏消胶囊结合雷公藤多苷片治疗湿热互结型湿疹疗效观察及对血清LTB4与SP水平的影响

张大雷　李 韵

[关键词]湿疹;雷公藤多苷片;皮敏消胶囊;白三烯B4;P物质

[中图分类号]R758.23    [文献标志码]A    [文章编号]1008-6455（2021）12-0120-05

Clinical Ttudy on Piminxiao Capsules Combined with Tripterygium Wilfordii in Treatment of Eczema and the Expression Level of LTB4、SP

ZHANG Da-lei，LI Yun

（Department of Dermatology，Anyang District Hospital，Anyang 455000，Henan，China）

Abstract： Objective  To investigate the clinical efficacy of Piminxiao Capsules combined with Tripterygium wilfordii in treatment of eczema and the expression level of LTB4、SP. Methods  94 Patients with eczema from January 2019 to October 2019 were enrolled in this study.the patients were divided into control and treatment groups（n=47）. The patients in the control group were administered with Tripterygium wilfordii， the patients in the treatment group were administered with Piminxiao Capsules on the basis of control group.After treatment， the efficacies were evaluated， and symptoms integral， DLQI scores and LTB4， SP in two groups were compared. Results  the clinical efficacies in the control and treatment groups were76.60% and 95.74%， respectively， and there was difference between two groups （P<0.05）， symptoms integral， DLQI scores and LTB4，SP in two groups were significantly decreased， and the differences were statistically significant in the same group （P<0.05），and the observational indexes in the treatment group were significantly better than those in the control group， with significant difference between two groups（P<0.05）， the incidence of adverse reactions in the control and treatment groups were no difference between two groups（P>0.05）， The recurernce rate within 6 months in treatment groups were significantly lower than that in the control group（P<0.05）. Conclusion  Piminxiao Capsules combined with Tripterygium wilfordii has clinical curative effect in treatment of eczema， and can reduce the levels of LTB4， SP， relieve the clinical symptoms of patients， which has a certain clinical application value.

Key words： eczema; tripterygium wilfordii; Piminxiao Capsules; LTB4; SP

濕疹是皮肤科常见的临床疾病之一，根据古代中医记载其发病部位在肌肤之表，表现为瘙痒、皮肤增厚和不同程度的苔藓样病变，治疗难且时间长[1]。西医治疗目前主要以激素、抗生素等对症治疗[2]，以上药物虽然治疗时见效快，在短时间内可以达到理想的治疗效果，但是副作用大，如激素会引起骨质疏松、低钾低镁等，长时间使用易产生依赖性或对肾上腺功能产生影响，尤其对老年人和婴儿使用时需慎重。因此，临床目前较多使用雷公藤治疗湿疹，其可以替代糖皮质激素发挥疗效[3]，但随着临床使用，发现雷公藤有严重的肝肾损伤危害和血液系统障碍[4-5]，整体效果不佳。皮敏消胶囊是由除湿、清火、凉血等中药组成的复方制剂。研究发现用于荨麻疹等皮肤疾病有良好效果。因此，本研究探索雷公藤联合皮敏消胶囊治疗湿疹的临床疗效及相关评价。

湿疹的发病机制尚不清楚，有学者认为可能与免疫调节相关[6]。白三烯（Leukotriene，LT）是人体内重要的炎症趋化因子，主要包括LTB4、LTC4、LTD4、LTE4。其中LTB4是强有效的炎症因子，研究发现它与多种皮肤疾病的发生发展有关[7]。P物质（SP）是一种神经肽类，主要在中枢神经系统中表达，可以激活免疫系统，促进T细胞活化，从而调节免疫应答反应[8]。本文从中医现代理论出发，探索以上两种药物，通过调节LTB4、SP表达对湿疹的治疗作用。

1  资料和方法