七宝美髯丹治疗肝肾不足型斑秃临床研究

Clinical study of alopecia areata Qibao Meiran dan treatment of liver and kidney deficiency

关键词:  七宝美髯丹  复方甘草酸苷  肝肾不足型  斑秃  临床疗效  细胞因子

Key words:  Qibao Meiran dan  compound glycyrrhizin  liver and kidney deficiency type  alopecia areata  clinical curative effect  cytokines

摘要:

[目的]分析七宝美髯丹治疗肝肾不足型斑秃的临床疗效、相关细胞因子的表达及对生活质量的影响。[方法]本研究对象选取2016年1月-2017年10月皮肤科门诊62例肝肾不足型斑秃患者，根据随机原则分成对照组和观察组各31例。对照组患者给予复方甘草酸苷片口服+生姜外搽，观察组患者给予七宝美髯丹口服+生姜外搽。连续治疗2个月，对比两组治疗效果及外周血Th17细胞、Treg细胞占CD4+T淋巴细胞比例、血清白介素-6（IL-6）、白介素-23（IL-23）等相关细胞因子水平、生活质量的差异。[结果]治疗后对照组痊愈2例、显效6例、有效13例、无效10例，总有效率为67.74%；复发8例，复发率为25.81%。观察组痊愈5例、显效10例、有效15例、无效1例，总有效率为96.77%，无复发，组间比较有统计学差异（P<0.05）。治疗前两组患者外周血Th17细胞、Treg细胞占CD4+T淋巴细胞比例、血清白介素-17（IL-17）、IL-6、IL-23及转化生长因子-β（TGF-β）水平无统计学差异（P>0.05）；治疗后观察组外周血Th17细胞占CD4+T淋巴细胞比例（0.60±0.29）%低于对照组的（0.78±0.33）%；Treg细胞占CD4+T淋巴细胞比例（2.89±0.63）%高于对照组的（2.37±0.71）%，组间有显著的统计学差异（P<0.05）。治疗后观察组血清IL-6、IL-23水平分别为（7.08±1.63） pg/mL、（62.56±7.35） pg/mL，低于对照组的（7.95±1.75） pg/mL、（69.57±9.05） pg/mL，组间有显著的统计学差异（P<0.05）。治疗后观察组患者生理功能、情感功能、心理状况和社会功能等生活质量评分分别为（83.54±7.35）分、（92.04±8.38）分、（89.56±8.12）分，均高于对照组的（78.25±8.14）分、（85.21±10.76）分、（80.85±9.48）分，组间有显著的统计学差异（P<0.05）。治疗期间两组患者均未见明显的不良反应。[结论]采用七宝美髯丹治疗肝肾不足型斑秃的临床疗效具有较大的优势，可调节外周血Th17细胞、Treg细胞比例，调节血清IL-6、IL-23等相关细胞因子水平，使患者获得更好的生活质量。

Abstract:

[Objective] To analyze the expression of clinical efficacy, Qibao Meiran dan treatment of liver and kidney deficiency type of alopecia areata associated cytokine and the effect on quality of life.[Methods] Chosen 62 cases of liver and kidney deficiency alopecia areata patients from Jan. 2016 to Oct.2017, randomly divided into the control group and the observation group, 31 cases each. The control group were treated with oral Compound Glycyrrhizin Tablets + ginger wiped, observation group were treated with oral Qibao Meiran dan + ginger wiped. After 2 months of continuous treatment, the therapeutic effects of the two groups were compared. The percentage of Th17 cells, Treg cells in CD4⁺T lymphocytes, the levels of cytokines related to serum IL-6 and IL-23, and the quality of life in patients with peripheral blood were compared.[Results] After treatment, the control group was cured in 2 cases, markedly effective in 6 cases, effective in 13 cases, ineffective in 10 cases, the total effective rate was 67.74%, recurrence in 8 cases, the recurrence rate was 25.81%. The observation group was cured in 5 cases, markedly effective in 10 cases, effective in 15 cases, ineffective in 1 cases, the total effective rate was 96.77%, there was no recurrence, there was a significant difference between the two groups (P<0.05). Two groups of patients before treatment of peripheral blood Th17 cells, Treg cells accounted for the percentage of CD4⁺T cells, there was no significant difference in serum IL-17, IL-6, IL-23 and TGF-α levels (P>0.05); the observation group after treatment of Th17 cells in peripheral blood CD4⁺T lymphocyte ratio lower than the control group; Treg cells accounted for CD4 percentage of +T cells was higher than that of the control group and there is a statistically significant difference between groups (P<0.05). After treatment, the serum IL-6 and IL-23 levels of the observation group were lower than that of the control group, and there was a statistically significant difference between the two groups (P<0.05). After treatment, the scores of physical function, emotional function, psychological status and social function in the observation group were higher than those in the control group, and there was a statistically significant difference between the two groups (P<0.05). There were no obvious adverse reactions in the two groups during the treatment.[Conclusion] The clinical efficacy of Qibao Meiran dan in the treatment of liver and kidney deficiency type of alopecia areata has great advantages, can regulate the peripheral blood Th17 cells, Treg cell ratio, IL-6, IL-23 and other related regulation of serum cytokine levels, make patients get better quality of life.