摘要目的 采用“血分论治”方法治疗寻常型银屑病患者,观察其外周血Th17、Treg细胞变化,探讨“血分论治”银屑病的作用机制.方法 选择32例寻常型银屑病患者(血热证组17例,血瘀证组15例),分别给予清热凉血方、益气活血方治疗,于治疗前后流式细胞分析法检测外周血Th17细胞和CD4+ CD25+ Treg细胞亚群的变化.同时选择15例健康人为对照组.结果 治疗前两组患者Th17/Treg[ (4.21 ±0.52)％、(3.32±0.43)％]显著高于对照组[(1.79 ±0.18)％,P＜0.01]；中药治疗后均明显下降[(2.41±0.22)％、(2.02±0.12)％,P ＜0.05].患者Th17/Treg表达水平与PASI评分呈正相关(r=0.471,P＜0.05).结论 “血分论治”寻常型银屑病可通过调节Th17 /Treg水平发挥治疗作用.

abstractsObjective To investigate the action mechanism of blood-stage treatment that affects psoriasis vulgaris using observation of the Th17/Treg expression.Methods A total of 32 patients ( blood heat group,n =17 ; blood stasis group,n =15) and 15 healthy people ( control group,n =15 ) were observed.The frequencies of Th17 and Treg in peripheral blood were detected by flow cytometric analysis in patients before and after treated by heat-clearing and blood-cooling decoction,qi-enriching and blood-activating decoction.Results The ratio of Th17/Treg in peripheral blood [ blood heat group (4.21 ± 0.52 )％ ;blood stasis group( 3.32 ± 0.43 )％ ] was significantly increased in patients compared with controls [ ( 1.79 ±0.18)％ ] ( P ＜0.01 ).After herbal treatment,the ratio of Th17/Treg expression in the blood heat group [ ( 2.41 ± 0.22 ) ％ ] and in blood stasis group [ ( 2.02 ± 0.12 ) ％ ] was significantly decreased ( P ＜ 0.05 ),respectively.Conclusions Blood-stage treatment works well on Th17/Treg expression in patients with psoriasis vulgaris.