依巴斯汀联合马齿苋治疗特应性皮炎的临床观察

Clinical Observation of Ebastine Combined with Portulacae Herba in the Treatment of Atopic Dermatitis

关键词:  依巴斯汀  马齿苋  微小RNA  特应性皮炎  免疫  炎症

Key words:  ebastine  Portulacae Herba  micro RNA  atopic dermatitis  immune  inflammatory

摘要:

目的 探讨依巴斯汀联合马齿苋治疗特应性皮炎（atopic dermatitis，AD）的临床疗效及对miR-186-5p、miR-409-3p水平、免疫状态的影响。方法 2014年10月至2017年10月在新疆医科大学附属中医医院就诊的112例AD患者被随机分为对照组和观察组，每组56例。对照组口服依巴斯汀，观察组在对照组基础上进行马齿苋塌渍治疗。比较治疗前、治疗2周、4周的症状评分和临床有效率，比较治疗前后外周血Th17/Treg、IL17水平以及皮损边缘皮肤标本的miR-186-5p、miR-409-3p表达。结果 治疗前，2组各指标均无显著差异，治疗2，4周后，观察组症状评分显著低于对照组（P<0.05）；治疗2，4周时观察组的总有效率分别为66.07%，80.36%，显著高于对照组35.72%，57.14%（P<0.05）。治疗后2组Th17%、Th17/Treg、IL-17均显著下降，且观察组显著低于对照组（P<0.05）；2组miR-186-5p、miR-409-3p表达均显著下降，且观察组显著低于对照组（P<0.05）。结论 依巴斯汀联合马齿苋能有效改善AD临床症状，提高疗效，下调皮肤中miR-186-5p、miR-409-3p的表达，降低血清Th17/Treg表达，改善炎症状态。

Abstract:

OBJECTIVE To analyze the clinical effect of ebastine combined with Portulacae Herba in the treatment of atopic dermatitis(AD) and its effect on miR-186-5p and miR-409-3p expression. METHODS One hundred and twelve cases of AD patients from Oct.2014 to Oct.2017 in Affiliated Hospital of Traditional Chinese Medicine, Xinjiang Medical University were randomly divided into control group and observation group, 56 cases in each group. The control group was given ebastine orally, while the observation group was treated with Portulacae Herba external application additionally based on the control group. The symptom scores and clinical efficacy were compared before treatment, 2 and 4 weeks after treatment. The levels of Th17/Treg, IL17 in peripheral blood and the expressions of miR-186-5p and miR-409-3p in skin specimens at lesion margins were compared before and after treatment. RESULTS Before treatment, all indexes of two groups showed no significant difference. After 2 and 4 weeks of treatment, the symptom score of the observation group was significantly lower than that of the control group(P<0.05). The total effective rates of the observation group were 66.07% and 80.36% respectively at 2 and 4 weeks of treatment, which were significantly higher than those of the control group(35.72% and 57.14%, P<0.05). After treatment, Th17%, Th17/Treg and IL-17 in the two groups were decreased significantly, and that in the observation group was significantly lower than that in the control group(P<0.05), and the expression of miR-186-5p and miR-409-3p of two groups were decreased significantly, and that in the observation group was significantly lower than that in the control group(P<0.05). CONCLUSION Ebastine combined with Portulacae Herba can effectively improve the clinical symptoms of AD, improve the curative effect, down-regulate the expression of miR-186-5p and miR-409-3p in skin, reduce the expression of Th17/Treg in serum, and improve the inflammatory state.