目的 探討潤燥止癢膠囊聯(lián)合丙酸氟替卡松治療尋常型銀屑病的臨床療效。方法 將聊城市中醫(yī)醫(yī)院于2021年3月—2024年3月收治的尋常型銀屑病患者122例，依據(jù)隨機數(shù)表法分為對照組（61例）和治療組（61例）。對照組患處涂抹丙酸氟替卡松乳膏，2次/d。治療組在對照組基礎上口服潤燥止癢膠囊，4粒/次，3次/d，兩組患者治療4周。觀察兩組患者臨床療效，比較治療前后兩組患者中醫(yī)證候積分、皮損面積與嚴重程度、免疫功能、炎癥水平、腸道微生態(tài)變化和疾病復發(fā)情況。結果 治療后，治療組總有效率明顯高于對照組（90.16% vs 75.41%，P＜0.05）。治療后，兩組中醫(yī)證候各項積分和銀屑病皮損面積及嚴重程度指數(shù)（PASI）各項指數(shù)評分比治療前明顯下降（P＜0.05），且與對照組比較，治療組評分降低更明顯（P＜0.05）。治療后，兩組CD3⁺、CD4⁺和CD4⁺/CD8⁺水平比治療前明顯升高，而CD8⁺和腫瘤壞死因子-α（TNF-α）、白細胞介素-17（IL-17）、白細胞介素-8（IL-8）水平明顯降低（P＜0.05），且治療后治療組免疫功能和炎癥水平明顯好于對照組（P＜0.05）。治療后，兩組大腸埃希菌、腸球菌菌群數(shù)量比治療前明顯降低，而乳酸桿菌、雙歧桿菌和酵母菌菌群數(shù)量則比治療前升高（P＜0.05），且治療組患者腸道微生態(tài)指標水平明顯好于對照組（P＜0.05）。治療后，治療組復發(fā)率與對照組相比則明顯降低（P＜0.05）。結論 對尋常型銀屑病患者實施潤燥止癢膠囊聯(lián)合丙酸氟替卡松治療，可顯著提升臨床療效，改善中醫(yī)癥狀與機體免疫功能，減輕機體炎癥反應，降低疾病復發(fā)風險。

Objective To investigate the clinical efficacy of Runzao Zhiyang Capsules combined with fluticasone propionate in treatment of psoriasis vulgaris.Methods Patients (122 cases) with psoriasis vulgaris in Liaocheng Hospital of Traditional Chinese Medicine from March 2021 to March 2024 were divided into control (61 cases) and treatment (61 cases) group according to random number table method. Patients in the control group were administered with Fluticasone Propionate Cream, twice daily. Patients in the treatment group were po administered with Runzao Zhiyang Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluations were evaluated, and the TCM syndrome points, skin lesion area and severity, immune function, inflammatory factors, gut microbiota and recurrence in two groups before and after treatment were compared.Results After treatment, the total effective rate in the treatment group was significantly higher than that in the control group (90.16% vs 75.41%, P < 0.05). After treatment, the scores of various TCM syndromes and PASI scores in both groups decreased significantly compared with those before treatment (P < 0.05), and compared with the control group, the score decrease in the treatment group was more obvious (P < 0.05). After treatment, the levels of CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in two groups were significantly higher than before treatment, while the levels of CD8⁺ and TNF-α, IL-17, and IL-8 were significantly lower (P < 0.05). After treatment, the immune function and inflammation levels in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the number of Escherichia coli and Enterococcus flora in two groups was significantly lower than before treatment, while the number of Lactobacillus, Bifidobacterium and yeast flora were increased compared with before treatment (P < 0.05). The level of intestinal microecology indicators in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the recurrence rate in the treatment group was significantly lower than that in the control group (P < 0.05).Conclusion The combination of Runzao Zhiyang Capsules and Fluticasone Propionate Cream can significantly improve clinical efficacy, improve traditional Chinese medicine symptoms and immune function, alleviate inflammatory reactions, reduce the risk of disease recurrence.

R986

國家自然科學基金資助項目（81804104）