1.山西省中医院,山西省太原市迎泽区并州西街46号,030012
2.北京中医药大学东方医院
3.北京中医药大学东直门医院
4.江阴天江药业有限公司
5.中山大学孙逸仙纪念医院深汕中心医院
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收稿:2025-04-01,
修回:2025-06-10,
纸质出版:2025-08-17
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任雪雯,邓宇童,冯蕙裳等.化斑解毒方治疗寻常型银屑病血热证的随机双盲对照研究[J].中医杂志,2025,66(16):1679-1686.
REN Xuewen,DENG Yutong,FENG Huishang,et al.A Randomized Controlled,Double-Blind Study on Huaban Jiedu Formulation (化斑解毒方) in the Treatment of Psoriasis Vulgaris with Blood-Heat Syndrome[J].Journal of Traditional Chinese Medicine,2025,66(16):1679-1686.
任雪雯,邓宇童,冯蕙裳等.化斑解毒方治疗寻常型银屑病血热证的随机双盲对照研究[J].中医杂志,2025,66(16):1679-1686. DOI: 10.13288/j.11-2166/r.2025.16.010.
REN Xuewen,DENG Yutong,FENG Huishang,et al.A Randomized Controlled,Double-Blind Study on Huaban Jiedu Formulation (化斑解毒方) in the Treatment of Psoriasis Vulgaris with Blood-Heat Syndrome[J].Journal of Traditional Chinese Medicine,2025,66(16):1679-1686. DOI: 10.13288/j.11-2166/r.2025.16.010.
目的
2
观察化斑解毒方治疗寻常型银屑病血热证的临床疗效及安全性。
方法
2
采用随机、双盲、安慰剂对照研究方法,将60例寻常型银屑病血热证患者随机分为治疗组和对照组各30例。治疗组口服化斑解毒方颗粒联合外用青石止痒软膏,对照组口服安慰剂颗粒联合外用青石止痒软膏,颗粒剂每日1剂,外用软膏均每日2次,疗程为28天。比较两组治疗前和治疗14、28天后银屑病皮损面积及严重程度指数(PASI)评分、瘙痒程度视觉模拟评分法(VAS)评分、中医证候评分、皮肤病生活质量指数(DLQI)评分及银屑病生活压力指数(PLSI)评分;比较两组治疗14、28天后PASI评分改善50%(PASI50)应答率、PASI评分改善75%(PASI75)应答率及临床疗效;比较两组治疗前和治疗28天后血清白细胞介素6(IL-6)、白细胞介素17(IL-17)水平;记录治疗期间两组患者不良反应发生情况。
结果
2
与本组治疗前比较,两组治疗28天后PASI总分、皮损面积积分、红斑积分、鳞屑积分及浸润积分,瘙痒程度VAS评分、中医证候评分、DLQI评分、PLSI评分,血清IL-6、IL-17水平均降低(
P
<0.05)。与对照组同时间比较,治疗组治疗28天后PASI总分及红斑积分、中医证候评分、血清IL-6及IL-17水平均降低,PASI50应答率升高(
P
<0.05)。两组治疗前与治疗28天后差值比较,治疗组在PASI总分、皮损面积积分及红斑积分,中医证候评分、DLQI评分、PLSI评分,血清IL-6、IL-17水平方面高于对照组(
P
<0.05或
P
<0.01)。治疗14、28天后,治疗组总有效率分别为40.00%(12/30)、83.33%(25/30),对照组分别为6.90%(2/29)、41.38%(12/29),治疗组临床疗效均优于对照组(
P
<0.05)。治疗组有3例、对照组有1例患者服药后出现胃部不适感。
结论
2
化斑解毒方可有效改善寻常型银屑病血热证患者的皮损表现及中医证候,减轻瘙痒,提高生活质量,降低炎症因子IL-6及IL-17水平,且安全性较好。
Objective
2
To evaluate the clinical efficacy and safety of
Huaban Jiedu Formulation
(化斑解毒方, HJF) in treating psoriasis vulgaris with blood-heat syndrome.
Methods
2
A randomized, double-blind, plac
ebo-controlled study was conducted with 60 patients diagnosed with psoriasis vulgaris of blood-heat syndrome. Patients were randomly assigned to either a treatment group or a control group, with 30 cases in each. The treatment group received HJF granules orally, one dose a day, combined with topical
Qingshi Zhiyang Ointment
(青石止痒软膏), while the control group received placebo granules, one dose a day, combined with the same topical ointment. Both groups were topically treated twice daily of 28 days treatment cours. Psoriasis area and severity index (PASI), visual analogue scale for pruritus (VAS), traditional Chinese medicine (TCM) syndrome scores, dermatology life quality index (DLQI), and psoriasis life stress inventory (PLSI) were assessed before treatment and on day 14 and day 28. Response rates for PASI 50 (≥50% reduction) and PASI 75 (≥75% reduction), as well as overall clinical efficacy, were compared between groups. Serum levels of interleukin-6 (IL-6) and interleukin-17 (IL-17) were measured before and after 28 days of treatment. Adverse reactions during treatment were recorded.
Results
2
After 28 days of treatment, both groups showed significant reductions in PASI total score, lesion area score, erythema, scaling, and infiltration scores, pruritus VAS score, TCM syndrome score, DLQI, PLSI, and serum IL-6 and IL-17 levels (
P
<0.05). Compared to the control group, the treatment group had significantly greater improvements in PASI total score and erythema score, TCM syndrome score, serum IL-6 and IL-17 levels, and PASI 50 response rate after 28 days (
P
<0.05). Between-group comparisons of score differences before and after 28-day treatment revealed that the treatment group showed significantly better improvements in PASI total, lesion area score, erythema score, TCM syndrome score, DLQI, PLSI, and inflammatory markers (
P
<0.05 or
P
<0.01). The total effective rate on day 14 and day 28 was 40.00% (12/
30) and 83.33% (25/30) in the treatment group, versus 6.90% (2/29) and 41.38% (12/29) in the control group, respectively. The clinical efficacy in the treatment group was significantly superior to that in the control group (
P
<0.05). Mild gastric discomfort occurred in 3 patients in the treatment group and 1 in the control group.
Conclusion
2
HJF can effectively improve skin lesions and TCM symptoms relieve pruritus, enhance quality of life, and reduce inflammatory markers IL-6 and IL-17, in patients with blood-heat syndrome of psoriasis vulgaris, with a good safety profile.
中华医学会皮肤性病学分会银屑病专业委员会 . 中国银屑病诊疗指南(2023版) [J]. 中华皮肤科杂志 , 2023 , 56 ( 7 ): 573 - 625 .
李元文 . 中医皮肤病学 [M]. 北京 : 科学出版社 , 2023 : 156 - 160 .
李雪 , 杭小涵 , 邓宇童 , 等 . 银屑病中医治疗“枢机”之窥见 [J]. 北京中医药 , 2021 , 40 ( 8 ): 826 - 829 .
于心荟 , 李元文 , 任雪雯 , 等 . 化斑解毒方对咪喹莫特诱导银屑病样皮炎小鼠模型抗炎机制探究 [J]. 环球中医药 , 2023 , 16 ( 7 ): 1317 - 1322 .
赵辨 . 中国临床皮肤病学(下) [M]. 2版 . 南京 : 江苏科学技术出版社 , 2017 : 1104 - 1113 .
李慎秋 , 陈兴平 , 周礼义 , 等 . 皮肤病性病诊疗指南 [M]. 3版 . 北京 : 科学出版社 , 2013 : 219 - 224 .
中华医学会皮肤性病学分会银屑病专业委员会 . 中国银屑病诊疗指南(2018完整版) [J]. 中华皮肤科杂志 , 2019 , 52 ( 10 ): 667 - 710 .
杨志波 . 中医皮肤性病学 [M]. 上海 : 上海科学技术出版社 , 2020 : 134 - 135 .
陈丽君 . 凉血解毒法治疗白疕血热证的回顾性分析及其作用机制研究 [D]. 北京 : 北京中医药大学 , 2021 .
史周华 , 张雪飞 . 中医药统计学 [M]. 北京 : 科学出版社 , 2009 : 153 .
GERDES S , KORBER A , BIERMANN M , et al . Absolute and relative psoriasis area and severity index (PASI) treatment goals and their association with health-related quality of life [J]. J Dermatolog Treat , 2020 , 31 ( 5 ): 470 - 475 .
ANSTEY AV , KRAGBALLE K , 朱国兴 . 钙泊三醇/二丙酸倍他米松软膏获得PASI50和PASI75的回顾性分析 [J]. 世界核心医学期刊文摘(皮肤病学分册) , 2006 , 2 ( 12 ): 19 - 20 .
PEDERSEN CB , MCHORNEY CA , LARSEN LS , et al . Reliability and validity of the Psoriasis Itch Visual Analog Scale in psoriasis vulgaris [J]. J Dermatolog Treat , 2017 , 28 ( 3 ): 213 - 220 .
SZABO A , BRODSZKY V , RENCZ F . A comparative study on the measurement properties of Dermatology Life Quality Index (DLQI),DLQI-relevant and skindex-16 [J]. Br J Dermatol , 2022 , 186 ( 3 ): 485 - 495 .
GUPTA MA , GUPTA AK . The Psoriasis Life Stress Inventory: a preliminary index of psoriasis-related stress [J]. Acta Derm Venereol , 1995 , 75 ( 3 ): 240 - 243 .
郑筱萸 . 中药新药临床研究指导原则(试行) [M]. 北京 : 中国医药科技出版社 , 2002 : 299 - 302 .
高东宸 , 张丽雅 . 药物不良反应监察指南 [M]. 北京 : 中国医药科技出版社 , 1996 : 10 - 12 .
官科汶 , 谢秀丽 , 卢传坚 . 寻常型银屑病中医证候演变规律的文献数据分析 [J]. 中医杂志 , 2025 , 66 ( 8 ): 834 - 840 .
张晓彤 , 高云逸 , 宋坪 . 寻常型银屑病中医辨证特点概况及思考 [J]. 中医杂志 , 2019 , 60 ( 20 ): 1732 - 1736 .
中华中医药学会皮肤科分会 , 北京中医药学会皮肤病专业委员会 , 北京中西医结合学会皮肤性病专业委员会 . 寻常型银屑病(白疕)中医药循证临床实践指南(2013版) [J]. 中医杂志 , 2014 , 55 ( 1 ): 76 - 82 .
丁黎薇 , 王春环 , 袁兆毓 , 等 . 凉血解毒汤联合中药熏洗辅助治疗血热型银屑病的效果研究 [J]. 中国药物滥用防治杂志 , 2024 , 30 ( 6 ): 1122 - 1125 .
唐娟 , 费良阅 . 凉血解毒汤联合窄谱中波紫外线治疗寻常型银屑病血热证的疗效观察 [J]. 中国中西医结合皮肤性病学杂志 , 2023 , 22 ( 2 ): 157 - 160 .
张益生 , 张天博 , 陈若曦 , 等 . 青石止痒软膏治疗进行期寻常型银屑病血热内蕴证观察 [J]. 中医药临床杂志 , 2019 , 31 ( 11 ): 2170 - 2173 .
李雅瞳 , 李元文 , 邓宇童 , 等 . 基于Caspase-1/GSDMD蛋白通路探究青石止痒软膏对银屑病小鼠模型的干预机制 [J]. 中医杂志 , 2025 , 66 ( 2 ): 170 - 177 .
魏荣 , 吴斌 , 吕静 . 白细胞介素-6抑制剂对银屑病模型大鼠背部皮肤组织的影响及作用 机制 [J]. 中国老年学杂志 , 2020 , 40 ( 4 ): 856 - 860 .
FURUE M , FURUE K , TSUJI G , et al . Interleukin-17A and keratinocytes in psoriasis [J]. Int J Mol Sci , 2020 , 21 ( 4 ): 1275 .
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