桂枝汤加味治疗气血不和型儿童白癜风及对自身免疫的调节

罗光浦; 王天晶; 任盈盈; 朱清华

doi:10.13422/j.cnki.syfjx.2017220188

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桂枝汤加味治疗气血不和型儿童白癜风及对自身免疫的调节

临床 | 更新时间：2024-01-04

- 桂枝汤加味治疗气血不和型儿童白癜风及对自身免疫的调节
- Regulatory Effect of Modified Guizhitang on Immune Function of Patients with Vitiligo with Qi-blood Circulation
- 中国实验方剂学杂志 2017年23卷第22期页码：188-193
- 作者机构：
- 作者简介：
- 基金信息：
  
  广东省科技计划项目公益研究与能力建设资金专项（2014A020221016）。
- DOI：10.13422/j.cnki.syfjx.2017220188
  中图分类号： R275.9
- 纸质出版日期：2017
- 稿件说明：
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罗光浦, 王天晶, 任盈盈, 等. 桂枝汤加味治疗气血不和型儿童白癜风及对自身免疫的调节[J]. 中国实验方剂学杂志, 2017,23(22):188-193.

LUO Guang-pu, WANG Tian-jing, REN Ying-ying, et al. Regulatory Effect of Modified Guizhitang on Immune Function of Patients with Vitiligo with Qi-blood Circulation[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(22): 188-193.
罗光浦, 王天晶, 任盈盈, 等. 桂枝汤加味治疗气血不和型儿童白癜风及对自身免疫的调节[J]. 中国实验方剂学杂志, 2017,23(22):188-193. DOI： 10.13422/j.cnki.syfjx.2017220188.

LUO Guang-pu, WANG Tian-jing, REN Ying-ying, et al. Regulatory Effect of Modified Guizhitang on Immune Function of Patients with Vitiligo with Qi-blood Circulation[J]. Chinese journal of experimental traditional medical formulae, 2017, 23(22): 188-193. DOI： 10.13422/j.cnki.syfjx.2017220188.

摘要

目的：观察桂枝汤加味治疗气血不和型儿童白癜风的临床疗效及对T淋巴细胞亚群、免疫球蛋白和补体的影响。方法：将134例符合要求的患儿，采用SAS 软件生成，随机按数字表法分为观察组与对照组各67例。对照组采用0.03%他克莫司软膏，适量外涂，2次/d。观察组在对照组治疗的基础上服用桂枝汤加味，1剂/d。两组疗程均连续治疗3个月。进行治疗前后白癜风面积评分指数（VASI），黑素指数（MCI），皮肤病生活质量（DIQL）调查量表和气血不和证评分，并评估复色情况；检测治疗前后T淋巴细胞亚群（CD3+，CD4+，CD8+，CD4+/CD8+），补体（C3，C4）和免疫球蛋白（IgG，IgM，IgA）水平。结果：观察组临床疗效总有效率为84.13%，高于对照组的63.49%（χ2 ＝6.938，P<0.01）；治疗后观察组VASI指数低于对照组（P<0.01），DIQL和气血不和证评分均低于对照组（P<0.01），MCI指数高于对照组（P<0.01）；观察组患儿复色率（62.83±11.47）%高于对照组的（53.78±10.29）%（P<0.01）；与健康对照组比较，白癜风患儿外周血免疫球蛋白IgG，IgA水平均明显下降，白癜风患儿外周血T淋巴细胞亚群CD3+，CD4+，CD4+/CD8+水平均有下降，CD8+水平升高（P<0.01）；IgM，C3和C4水平差异均无统计学意义；治疗后观察组患儿治疗后IgG，IgA水平均显著升高（P<0.01），并高于同期对照组（P<0.01），IgM，C3和C4水平变化均无统计学意义；观察组患儿CD3+，CD4+，CD4+/CD8+均较治疗前升高（P<0.01），并高于治疗后对照组水平（P<0.05）；CD8+下降，并低于治疗后对照组水平（P<0.05）。结论：桂枝汤加味治疗气血不和型儿童白癜风，能缩小皮损面积，增加白斑黑素含量，提高复色率，改善了患儿生活质量，有明显的临床疗效，其作用机制可能与调节自身免疫失衡有关，值得临床进一步的研究。

Abstract

Objective: To observe the clinical effect of modified Guizhitang on children with vitiligo (Qi-blood circulation) andits effect onlevels of T lymphocyte subsets

immunoglobulin and alexin. Method: One hundred and thirty-four patients were randomly divided into control group 67 cases and observation group 67 cases by random number table. Patients in control group were given 0.03% tacrolimus ointment

2 times/day. In addition to the therapy of control group

patients in observation group were also given modified Guizhitang

1 dose/day. And 3 months were a course of treatment. Before and after treatment

vitiligo area score index (VASI)

Melanin content index (MCI)

survey scale of quality of life in skin disorder (DIQL)

and score of Qi-blood circulation were graded

and color recovery was recorded. Levels of CD3+

CD4+

CD4+/CD8+ and CD8+ for T lymphocyte subsets

C4 foralexin

IgG

IgM and IgA for immunoglobulin were detected. Result: The total effect rate in observation group was 84.13%

which washigher than 63.49% in control group (χ2=6.938

P<0.01). After treatment

VASI

scores of Qi-blood circulation and DIQL in observation group were lower than those in control group (P<0.01)

and MCI was higher than that in control group (P<0.01). Rate of color recovery was (62.83±11.47)

which was higher than (53.78±10.29) in control group (P<0.01). Compared with healthy control group

among children with vitiligo

levels of IgG and IgA

CD3+

CD4+ and CD4+/CD8+ decreased

level of CD8+ increased (P<0.01).With no statistical significance among levels of IgM

C3 and C4.After treatment

levels of IgG and IgA in observation group increased

which were higher than those in control group (P<0.01). And levels of CD3+

CD4+

CD4+/CD8+ in observation group increased(P<0.01)

which were higher than those in control group (P<0.05). And level of CD8+ decreased

whichwas lower than that in control group (P<0.05). Conclusion: Modified Guizhitang can reduce the area of skin lesion

increase the white melanin content

rate of color recovery rate and ameliorate quality of life of patients

with a significant clinical efficacy. Its mechanism may be correlated with the regulation of autoimmune imbalance

and thus is worthy for further research.

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