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上海中医药大学附属龙华医院皮肤科(上海 200032)
平立,女,硕士,副主任医师,主要从事中医药治疗银屑病的临床与基础研究工作
李晓睿,副主任医师,硕士研究生导师; E-mail:xiaorui_li@126.com
收稿:2026-02-26,
纸质出版:2026-07-10
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平立,顾军,龚悦,等.芍地泻肝颗粒治疗进行期寻常型银屑病伴情志共病的随机、双盲、双模拟临床研究[J].上海中医药杂志,2026,60(7):49-54.
Ping Li,Gu Jun,Gong Yue,et al.Randomized, double‑blind, double‑dummy clinical study of Shaodi Xiegan Granules in treatment of progressive psoriasis vulgaris with emotional comorbidities[J].Shanghai Journal of Traditional Chinese Medicine,2026,60(7):49-54.
平立,顾军,龚悦,等.芍地泻肝颗粒治疗进行期寻常型银屑病伴情志共病的随机、双盲、双模拟临床研究[J].上海中医药杂志,2026,60(7):49-54. DOI: 10.16305/j.1007-1334.2026.z20260226001.
Ping Li,Gu Jun,Gong Yue,et al.Randomized, double‑blind, double‑dummy clinical study of Shaodi Xiegan Granules in treatment of progressive psoriasis vulgaris with emotional comorbidities[J].Shanghai Journal of Traditional Chinese Medicine,2026,60(7):49-54. DOI: 10.16305/j.1007-1334.2026.z20260226001.
目的
2
观察芍地泻肝颗粒治疗进行期寻常型银屑病(PSO)伴情志共病的临床疗效及安全性。
方法
2
将80例进行期寻常型PSO伴情志共病受试者随机分为治疗组和对照组,每组各40例。治疗组口服芍地泻肝颗粒及复方氨肽素片模拟剂,对照组口服复方氨肽素片及芍地泻肝颗粒模拟剂,疗程均为8周。观察两组临床有效率,比较治疗前后PSO面积和严重程度指数(PASI)、瘙痒视觉模拟法(VAS)、匹兹堡睡眠质量指数(PSQI)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评分变化情况以及血清肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-17、5-羟色胺(5‑HT)、脑源性神经营养因子(BDNF)水平的变化。
结果
2
①最终完成试验者72例,治疗组36例、对照组36例。②治疗后,治疗组临床疗效优于对照组(
P
<
0.05)。③治疗后,治疗组PASI、瘙痒VAS、PSQI、HAMA、HAMD评分均下降(
P
<
0.05),且下降幅度优于对照组(
P
<
0.05)。④治疗后,两组TNF-α、IL-6及IL-17水平均降低(
P
<
0.05),且治疗组IL-6水平降低更明显(
P
<
0.05)。⑤治疗后,治疗组5-HT、BDNF水平升高(
P
<
0.05),对照组仅5-HT水平升高(
P
<
0.05);治疗组5-HT、BDNF水平较对照组明显升高(
P
<
0.05)。⑥两组受试者均未出现严重不良事件。
结论
2
芍地泻肝颗粒能够在一定程度上改善进行期寻常型PSO伴情志共病患者的皮损炎症反应,并对焦虑、抑郁情绪及睡眠质量改善产生积极影响,其作用机制可能与降低血清中促炎性细胞因子及升高改善睡眠与情绪的神经递质水平有关。
Objective
2
To evaluate the clinical efficacy and safety of Shaodi Xiegan Granules (SXG) in treating patients with progressive psoriasis vulgaris (PV) and associated emotional comorbidities.
Methods
2
Eighty subjects with progressive PV and emotional comorbidities were randomly assigned to either the treatment group (
n
=40) or the control group (
n
=40). The treatment group received oral SXG and the placebo of Compound Aminopeptide Tablets, while the control group received oral Compound Aminopeptide Tablets and the SXG placebo for 8 weeks. Clinical efficacy was evaluated. Changes in the psoriasis area and severity index (PASI), visual analogue scale (VAS) for pruritus, Pittsburgh sleep quality index (PSQI), Hamilton anxiety rating scale (HAMA), and Hamilton depression rating scale (HAMD) were compared between the two groups. Serum levels of tumor necrosis factor‑α (TNF‑α), interleukin (IL)-6, IL-17, 5‑hydroxytryptamine (5-HT), and brain-derived neurotrophic factor (BDNF) were also measured before and after intervention.
Results
2
①A total of 72 subjects completed the trial, with 36 in each group. ②The clinical efficacy of the treatment group was superior to that of the control group(
P
<
0.05
). ③After treatment, the scores of PASI, itching VAS, PSQI, HAMA, and HAMD in the treatment group decreased(
P
<
0.05), and the decrease was more significant than that in the control group (
P
<
0.05). ④After treatment, the levels of TNF-α, IL-6, and IL-17 decreased in both groups(
P
<
0.05), with a more significant decrease in the treatment group for IL-6 level (
P
<
0.05).⑤After treatment, the levels of 5-HT and BDNF increased in the treatment group(
P
<
0.05), while only the level of 5-HT increased in the control group(
P
<
0.05). The levels of 5-HT and BDNF in the treatment group were significantly higher than those in the control group(
P
<
0.05). ⑥No serious adverse events were reported in either group.
Conclusions
2
SXG effectively alleviates inflammatory skin lesions in patients with progressive PV and emotional comorbidities to a certain extent. Furthermore, the treatment significantly improves anxiety, depression, and sleep quality. The therapeutic mechanism may be associated with the downregulation of pro-inflammatory cytokines and the upregulation of neurotransmitters involved in mood and sleep regulation.
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