目的 探讨润燥止痒胶囊联合丙酸氟替卡松治疗寻常型银屑病的临床疗效。方法 将聊城市中医医院于2021年3月—2024年3月收治的寻常型银屑病患者122例，依据随机数表法分为对照组（61例）和治疗组（61例）。对照组患处涂抹丙酸氟替卡松乳膏，2次/d。治疗组在对照组基础上口服润燥止痒胶囊，4粒/次，3次/d，两组患者治疗4周。观察两组患者临床疗效，比较治疗前后两组患者中医证候积分、皮损面积与严重程度、免疫功能、炎症水平、肠道微生态变化和疾病复发情况。结果 治疗后，治疗组总有效率明显高于对照组（90.16% vs 75.41%，P＜0.05）。治疗后，两组中医证候各项积分和银屑病皮损面积及严重程度指数（PASI）各项指数评分比治疗前明显下降（P＜0.05），且与对照组比较，治疗组评分降低更明显（P＜0.05）。治疗后，两组CD3⁺、CD4⁺和CD4⁺/CD8⁺水平比治疗前明显升高，而CD8⁺和肿瘤坏死因子-α（TNF-α）、白细胞介素-17（IL-17）、白细胞介素-8（IL-8）水平明显降低（P＜0.05），且治疗后治疗组免疫功能和炎症水平明显好于对照组（P＜0.05）。治疗后，两组大肠埃希菌、肠球菌菌群数量比治疗前明显降低，而乳酸杆菌、双歧杆菌和酵母菌菌群数量则比治疗前升高（P＜0.05），且治疗组患者肠道微生态指标水平明显好于对照组（P＜0.05）。治疗后，治疗组复发率与对照组相比则明显降低（P＜0.05）。结论 对寻常型银屑病患者实施润燥止痒胶囊联合丙酸氟替卡松治疗，可显著提升临床疗效，改善中医症状与机体免疫功能，减轻机体炎症反应，降低疾病复发风险。

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

国家自然科学基金资助项目（81804104）