克银合剂治疗血热证中重度寻常型银屑病的临床观察及其与IL-23/Th17细胞轴的关系

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[关键词］银屑病;克银合剂;凉血除湿法;IL-23/Th17细胞轴;临床疗效 ［中图分类号］R758.63［文献标志码]A [文章编号] 1671-7783（2025）06-0534-05 DOI： 10.13312/j.issn.1671-7783.y240223

[Abstract]Objective：To observe the clinical eficacy and safety of Keyin mixture in treating moderate-to-severe plaque psoriasis with blood-heat syndrome and preliminarily explore its intervention effects on the IL-23/Th17 cell axis.Methods：A total of 30 patients with moderate-to-severe plaque psoriasis and blood-heat syndrome who attended the Dermatology Department of Jiangyin Hospital of Traditional Chinese Medicine from January 2O23 to March 2O24 were enrolled as the study group，and 30 healthy volunteers were selected as the control group.The study group received oral Keyin mixture （3O mL per dose，three times daily） for 12 weeks.Psoriasis area and severity index （PASI） scores，body surface area （BSA） scores，and dermatology life quality index（DLQI） scores were compared before and after treatment in the study group.Serum levels of IL-17，IL-22，IL-23，IL-6，and TNF- α⋅α∝ were measured in both groups before treatment and in the study group after treatment. Adverse reactions were recorded throughout the study. Results： After 12 weeks of treatment，the study group showed significant reductions in PASI， BSA， and DLQI scores compared to baseline （all P<0.01 ），with PASI 50 and PASI 75 response rates of 63.3% and 16.7% ，respectively. Before treatment， serum levels of IL-17，IL-22，IL-6，IL-23，and TNF- α⋅α∝ in the study group were significantly higher than those in the control group （all P<0.01 ）. After 12 weeks of treatment， the serum levels of these cytokines in the study group were significantly decreased compared to pretreatment values （all P<0.01 ）. No obvious adverse reactions were observed during treatment，and there were no significant abnormalities in blood routine， urine routine，liver function，or kidney function before and after treatment. Conclusion： Keyin mixture exhibits significant effcacy and good safety in the treatment of moderate-to-severe plaque psoriasis with blood-heat syndrome. Its therapeutic mechanism may involve suppressing the expression of IL-23/Th17 axis-related factors（IL-23，IL-22，IL-17，IL-6，TNF- α ）.

[Key Words]psoriasis； Keyin mixture; blood-cooling and dampness-eliminating therapy； IL-23/Th17 cell axis ;clinical efficacy

银屑病是一种由T淋巴细胞介导的免疫相关性慢性炎症性皮肤病，主要表现为红斑、丘疹、鳞屑等，寻常型为临床常见类型，且我国患病率逐年上升。（剩余6941字）