复方甘草酸苷对PPD患者抗菌肽LL-37的表达及临床预后的影响
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摘要
目的:观察复方甘草酸苷对着色紫癜性皮肤病(pigmented purpuric dermatosis,PPD)患者抗菌肽LL-37的表达及其对患者临床预后的影响。方法:选取本院2015年4月到2018年4月间收治的54例PPD患者为研究对象,随机抽签将其分为观察组和对照组,每组27例,另外选取30例正常受试者作为正常组。对照组口服甲泼尼龙片、皮损处涂抹氟芬那酸丁酯软膏进行治疗;观察组在此基础上给予口服复方甘草酸苷片治疗;正常组不做任何治疗处理,1个月后进行观察评价。比较观察组和对照组患者的疗效、不良反应发生率及复发率,比较三组血清中LL-37水平与皮损处LL-37水平以及三组血清TNF-α、IL-6、IL-17炎性因子水平。结果:治疗前,观察组和对照组患者血清LL-37水平、皮损处LL-37水平以及血清TNF-α、IL-6、IL-17水平比较无明显差异(P>0.05),治疗后,两组患者血清LL-37水平、皮损处LL-37水平与血清TNF-α、IL-6、IL-17水平均显著降低(P<0.05),且观察组血清LL-37水平、皮损处LL-37水平与血清TNF-α、IL-6、IL-17水平均明显低于对照组(P<0.05)。观察组治疗有效率为70.37%,显著高于对照组51.85%(P<0.05);观察组不良反应发生率为18.52%,略低于对照组33.33%,但差异无统计学意义(P>0.05);观察组复发率为11.11%,略低于对照组18.52%,但差异无统计学意义(P>0.05)。结论:复方甘草酸苷能够降低PPD患者体内抗菌肽LL-37的表达水平,减轻炎性反应,同时不良反应发生率和复发率更低,疗效及安全性更佳,值得临床推广。
AIM:To study the therapeutic effect and the antimicrobial peptide LL-37 level of compound glycyrrhizin in patients with pigmented purpuric dermatosis(PPD). METHODS:A total of 54 patients with PPD admitted to our hospital from April 2015 to April 2018 were enrolled in the study.They were randomly divided into observation group and control group,27 cases in each group,and 30 normal subjects were selected as a normal group.In the control group,oral methylprednisolone tablets and butyl flufenamate ointment were applied to the skin lesions;the observation group was given oral compound glycyrrhizin tablets;the normal group was not treated, and after 1 month,the evaluation was observed.The efficacy,adverse reaction rate and recurrence rate of the observation group and the control group were compared.The LL-37 level in serum of the three groups and the LL-37 level in skin lesions and the TNF-α,IL-6 and IL-17 levels in serum of the three groups were compared.RESULTS:Before treatment,there was no significant difference about the LL-37 level in serum and the LL-37 level in skin lesions and the TNF-α,IL-6 and IL-17 levels in serum between the observation group and the control group(P>0.05).After treatment,the LL-37 level in serum and the LL-37 level in skin lesions and the TNF-α,IL-6 and IL-17 levels in serum were decreased in both groups(P<0.05).The levels of TNF-α,IL-6 and IL-17 in observation group were significantly lower than those of the control group(P<0.05).Before and after treatment,serum LL-37 levels,skin LL-37 levels,and TNF-α,IL-6,and IL-17 levels were significantly higher in the observation group and the control group than those in the normal group(P<0.05).The effective rate of treatment in the observation group was 70.37%,which was significantly higher than that in the control group(51.85%)(P<0.05).The incidence of adverse reactions in the observation group was 18.52%,which was slightly lower than that in the control group(33.33%),but the difference was not statistically significant(P>0.05).The recurrence rate in the observation group was 11.11%,which was slightly lower than that in the control group 18.52%,but the difference was not Statistically significant(P>0.05).CONCLUSION:Compound glycyrrhizin can reduce the expression level of antibacterial peptide LL-37 in patients with pigmentary purpuric skin disease,reduce the inflammatory response,and the incidence of adverse reactions and recurrence rate is lower,the efficacy and safety are better,it is worthy of clinical promotion.
AIM:To study the therapeutic effect and the antimicrobial peptide LL-37 level of compound glycyrrhizin in patients with pigmented purpuric dermatosis(PPD). METHODS:A total of 54 patients with PPD admitted to our hospital from April 2015 to April 2018 were enrolled in the study.They were randomly divided into observation group and control group,27 cases in each group,and 30 normal subjects were selected as a normal group.In the control group,oral methylprednisolone tablets and butyl flufenamate ointment were applied to the skin lesions;the observation group was given oral compound glycyrrhizin tablets;the normal group was not treated, and after 1 month,the evaluation was observed.The efficacy,adverse reaction rate and recurrence rate of the observation group and the control group were compared.The LL-37 level in serum of the three groups and the LL-37 level in skin lesions and the TNF-α,IL-6 and IL-17 levels in serum of the three groups were compared.RESULTS:Before treatment,there was no significant difference about the LL-37 level in serum and the LL-37 level in skin lesions and the TNF-α,IL-6 and IL-17 levels in serum between the observation group and the control group(P>0.05).After treatment,the LL-37 level in serum and the LL-37 level in skin lesions and the TNF-α,IL-6 and IL-17 levels in serum were decreased in both groups(P<0.05).The levels of TNF-α,IL-6 and IL-17 in observation group were significantly lower than those of the control group(P<0.05).Before and after treatment,serum LL-37 levels,skin LL-37 levels,and TNF-α,IL-6,and IL-17 levels were significantly higher in the observation group and the control group than those in the normal group(P<0.05).The effective rate of treatment in the observation group was 70.37%,which was significantly higher than that in the control group(51.85%)(P<0.05).The incidence of adverse reactions in the observation group was 18.52%,which was slightly lower than that in the control group(33.33%),but the difference was not statistically significant(P>0.05).The recurrence rate in the observation group was 11.11%,which was slightly lower than that in the control group 18.52%,but the difference was not Statistically significant(P>0.05).CONCLUSION:Compound glycyrrhizin can reduce the expression level of antibacterial peptide LL-37 in patients with pigmentary purpuric skin disease,reduce the inflammatory response,and the incidence of adverse reactions and recurrence rate is lower,the efficacy and safety are better,it is worthy of clinical promotion.
引文
[1] 郭静,赵玉贤,李征.不同治疗手段对进展期肝癌患者生活质量的影响[J].齐鲁护理杂志,2016,22(14):57-58.
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[11] 陈晋,翟晓翔.荆芥炭方联合雷公藤多甙片治疗进行性PPD37例[J].福建中医药,2013,44(5):29-30.
[12] Jin X,Li Q,Wei L,et al.Efficacy and safety of compound glycyrrhizin combined with calcium dibutyryladenosine cyclophosphate in treating psoriasis vulgaris[J].China Pharmaceuticals,2016,14(11):152-153.
[13] 谢湘江,赵京霞,底婷婷,等.抗菌肽LL-37在银屑病发病机制中的作用[J].中国皮肤性病学杂志,2016,22(7):748-750.
[14] Sardana K,Sarkar R,Sehgal VN.Pigmented purpuric dermatoses:an overview[J].Int J Dermatol,2010,43(7):482-488.
[15] 杨浩,罗鹏程,付靖瑜,等.抗菌肽LL-37序列分析与结构研究[J].中华医院感染学杂志,2016,26(22):5076-5079.
[16] 肖倩,黄柳霞,曾建明,等.铜绿假单胞菌痰培养阳性患者抗菌肽LL-37、CRP水平变化及临床意义[J].国际检验医学杂志,2018,32(2):146-148.
[17] 伍慧丽,谭永康,马列清,等.复方甘草酸苷联合舒肝宁注射液治疗病毒性肝炎疗效观察[J].中国中医药信息杂志,2009,16(6):72-73.
[18] 冀慧霞.复方甘草酸苷在重症皮肤病治疗中的应用体会[J].中国中医药信息杂志,2007,14(1):69-71.
[19] Ya-Ping LI,Zhang JL.Effect and safety of compound glycyrrhizin on chronic severe hepatitis B[J].新乡医学院学报,2016,15(5):23-25.
[20] 陈瑞萍,李媛丽,杨庆琪,等.浅析色素性紫癜性皮病从血分论治[J].中华中医药杂志,2018,54(4):132-135.
[21] 陆建光.激素治疗PPD的临床疗效探讨[J].继续医学教育,2016,30(4):164-165.
[22] 戴文欢.中药治疗血热型PPD34例临床研究[J].亚太传统医药,2017,13(6):138-139.
[23] 孟俊全.两种疗法治疗PPD的临床对比分析[J].中国社区医师(医学专业),2013,15(4):24-25.
[2] 丁海荣,王丙信,任清华,等.复方甘草酸苷联合柳氮磺吡啶治疗溃疡性结肠炎的临床研究[J].现代药物与临床,2016,31(3):367-370.
[3] Engin B,Ozdemir M,Kaplan M,et al.Patch test results in patients with progressive pigmented purpuric dermatosis[J].JEADV,2009,23(2):209.
[4] 李娜.温阳和营、凉血化瘀法配合复方甘草酸苷治疗寻常型银屑病疗效及对血清TNF-α影响[J].现代中西医结合杂志,2016,25(12):1268-1270.
[5] Lee SH,Kwon JE,Lee KG,et al.Granulomatous variant of chronic pigmented purpuric dermatosis associated with hyperlipidaemia.[J].JEADV,2010,24(10):1243-1245.
[6] 姚小卫.复方甘草酸苷辅助治疗艾滋病合并皮肤病的临床疗效分析[J].保健医学研究与实践,2017,14(5):67-69.
[7] 赵辨.中国临床皮肤病学[M].江苏科学技术出版社,2015,31(3):144-148.
[8] 中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:99-100.
[9] Ozkaya DB,Emiroglu N,Su O,et al.Dermatoscopic findings of pigmented purpuric dermatosis[J].ABD,2016,91(5):584.
[10] 王永强.三七通舒胶囊联合糖皮质激素治疗PPD临床分析[J].中国现代药物应用,2014,24(11):154-156.
[11] 陈晋,翟晓翔.荆芥炭方联合雷公藤多甙片治疗进行性PPD37例[J].福建中医药,2013,44(5):29-30.
[12] Jin X,Li Q,Wei L,et al.Efficacy and safety of compound glycyrrhizin combined with calcium dibutyryladenosine cyclophosphate in treating psoriasis vulgaris[J].China Pharmaceuticals,2016,14(11):152-153.
[13] 谢湘江,赵京霞,底婷婷,等.抗菌肽LL-37在银屑病发病机制中的作用[J].中国皮肤性病学杂志,2016,22(7):748-750.
[14] Sardana K,Sarkar R,Sehgal VN.Pigmented purpuric dermatoses:an overview[J].Int J Dermatol,2010,43(7):482-488.
[15] 杨浩,罗鹏程,付靖瑜,等.抗菌肽LL-37序列分析与结构研究[J].中华医院感染学杂志,2016,26(22):5076-5079.
[16] 肖倩,黄柳霞,曾建明,等.铜绿假单胞菌痰培养阳性患者抗菌肽LL-37、CRP水平变化及临床意义[J].国际检验医学杂志,2018,32(2):146-148.
[17] 伍慧丽,谭永康,马列清,等.复方甘草酸苷联合舒肝宁注射液治疗病毒性肝炎疗效观察[J].中国中医药信息杂志,2009,16(6):72-73.
[18] 冀慧霞.复方甘草酸苷在重症皮肤病治疗中的应用体会[J].中国中医药信息杂志,2007,14(1):69-71.
[19] Ya-Ping LI,Zhang JL.Effect and safety of compound glycyrrhizin on chronic severe hepatitis B[J].新乡医学院学报,2016,15(5):23-25.
[20] 陈瑞萍,李媛丽,杨庆琪,等.浅析色素性紫癜性皮病从血分论治[J].中华中医药杂志,2018,54(4):132-135.
[21] 陆建光.激素治疗PPD的临床疗效探讨[J].继续医学教育,2016,30(4):164-165.
[22] 戴文欢.中药治疗血热型PPD34例临床研究[J].亚太传统医药,2017,13(6):138-139.
[23] 孟俊全.两种疗法治疗PPD的临床对比分析[J].中国社区医师(医学专业),2013,15(4):24-25.
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