摘要:Objective To explore the mechanism of spleen deficiency in the pathogenesis of psoriasis-related inflammation.Methods The model mice with spleen deficiency was established by use of bitter cold and purging medicines combined with nutritional restriction, and then the model of psoriasis-like lesions induced by imiquimod.The mice were randomly divided into control group(Ctrl),spleen deficiency group(PD),imiquimod induced psoriasis-like model group(IMQ)and spleen deficiency combined with psoriasis model group(PD-IMQ).The expression levels of psoriasis-related genes in skin lesions and small intestine were detected by real-time PCR,the contents of psoriasis-related cytokines and chemokines in peripheral blood were detected by liquid phase protein chip, and the diversity of gut microbiota was analyzed by 16 S sequencing.Results Inflammatory infiltration manifestations, like erythema and scales in PD-IMQ group were more serious, IL-17 a, IL-23,IL-6,TGF-β,IL-10 and IL-18 mRNA in skin lesions were significantly higher than those in IMQ group, and the contents of IL-17 A,MIP-1α,MIP-1β,MIP-2,MCP-1,MCP-3,RANTES,IP-10 and Eotaxin in peripheral blood of PD-IMQ group were significantly higher than those of IMQ group, while the content of ST2 was significantly lower.The levels of IL-17 a and ROR γt mRNA in small intestine of PD-IMQ group were significantly higher than those of IMQ group, while the richness and evenness of gut microbiota in PD-IMQ group were significantly lower than those in IMQ group.Compared with IMQ group, the relative abundance of AF12 bacteria was significantly increased, and the relative abundance of TM7,TM7-3,CW040 and F16 was significantly decreased.Conclusion Spleen deficiency may aggravate the response of imiquimod-induced psoriasis-like model to pro-inflammatory factors, which leads to severe lesions by up-regulating the expression of IL-17-related cytokines and chemokines and the abundance of lipid metabolism disorder-related bacteria AF12.
摘要:Objective To investigate the clinical efficacy of blood heat syndrome of psoriasis vulgaris under the same treatment scheme, and explore the related factors affecting the efficacy.Methods The clinical data of 221 patients with blood heat syndrome of psoriasis vulgaris were retrospectively analyzed.PASI25 was used as the cut-off value of clinical efficacy and inefficacy, of which inefficacy was seen in 52 cases and effectiveness in 169 cases.Statistical analysis of patients with general personal data and differences in the results of the first laboratory examination, the indicators with statistical significance were included in the multivariate logistic regression analysis, and the independent related factors affecting the prognosis were obtained.Results 221 patients received TCM treatment, and the core recipe was Liangxue Jiedu Decoction.The total effective rate was 76.9%.NLR,PLR,CRP,hypoproteinemia, abnormal liver function, previous complex treatment and metabolic diseases were independent risk factors for prognosis.Conclusion The comprehensive treatment of TCM with Liangxue Jiedu Decoction as the core recipe has definite clinical effect.The patients′ previous treatment, whether they are complicated with metabolic diseases, NLR,PLR,CRP,liver function and albumin levels are all helpful to evaluate the prognosis.