目的 应用祛湿止痒洗剂治疗大鼠湿疹模型，考察祛湿止痒洗剂对大鼠湿疹样皮损的药理作用，并从免疫炎症和皮损处菌群角度探究其治疗湿疹的机制。方法 56只雌性SD大鼠，随机分为对照组、模型组、祛湿止痒洗剂（5.5、11、22 g/L）组、地塞米松组、炉甘石洗剂组。通过记录皮损评分、耳肿胀、瘙痒次数评价疗效。苏木精–伊红染色法（HE）染色观察皮肤组织形态学变化。酶联免疫法检测皮血清中白细胞介素（IL）-2、IL-17、IL-23及免疫球蛋白E（IgE）表达水平。血液分析检查嗜酸性粒细胞、白细胞、中性粒细胞水平。免疫组化法检测背部皮损组织中IL-17、IL-23阳性表达，采用16S rRNA技术测定皮损处微生物变化。结果 与模型组相比，祛湿止痒洗剂组治疗后湿疹大鼠的皮肤损伤、瘙痒、耳肿胀情况明显减轻（P＜0.05、0.01），祛湿止痒洗剂（5.5、22 g/L）组脾脏指数显著降低（P＜0.01）。湿疹大鼠背部皮损皮肤痂皮愈合加快，炎症细胞浸润减轻。血清中IL-2、IL-17、IL-23、IgE水平明显降低（P＜0.05、0.01）。祛湿止痒洗剂各剂量组血液中嗜酸性粒细胞明显降低，背部皮损组织中IL-17、IL-23表达明显降低（P＜0.01）。大鼠背部皮损处皮肤表面葡萄球菌属、棒状杆菌属菌群绝对丰度值有明显的降低，而乳杆菌属有明显的升高。结论 祛湿止痒洗剂可治疗大鼠湿疹所致的瘙痒和皮肤损伤，其作用机制可能与调节免疫、炎症反应及影响皮损处的菌群相关。

Objective To investigate the pharmacological effects of Qushi Zhiyang Lotion on eczema-like skin lesions in rats by using Qushi Zhiyang Lotion to treat eczema model in rats, and to explore its mechanism of treating eczema from the perspective of immune inflammation and skin lesion flora. Methods 56 Female SD rats were randomly divided into control group, model group, Qushi Zhiyang Lotion (5.5, 11, 22 g/L) group, dexamethasone group, and calamine lotion group. The efficacy was evaluated by skin lesion score, ear swelling and itching times. HE was used to observe the morphological changes of skin tissue. The expression levels of IL-2, IL-17, IL-23, and IgE in serum were detected by enzyme-linked immunosorbent assay. Blood analysis examined eosinophils, white blood cells, and neutrophil levels. The expression levels of IL-17 and IL-23 in dorsal skin lesions were detected by immunohistochemistry, and the microbial changes in skin lesions were determined by 16 S-rRNA technique. Results Compared with model group, the skin damage, itching and ear swelling of the eczema rats in the Qushi Zhiyang Lotion group were significantly reduced (P< 0.05, 0.01), and the spleen index in the Qushi Zhiyang Lotion (5.5, 22 g/L) group was decreased (P< 0.01). The healing of skin scabs on the back of eczema rats was accelerated, and the infiltration of inflammatory cells was reduced. The levels of IL-2, IL-17, IL-23, and IgE in serum were significantly decreased (P< 0.05, 0.01). Eosinophils in the blood decreased significantly, the expression of IL-17 and IL-23 in dorsal skin lesions was significantly decreased (P< 0.01). The absolute abundance of Staphylococcus and Corynebacterium on the skin surface of the skin lesions on the back of the rats was significantly reduced, while Lactobacillus was significantly increased. Conclusion Qushi Zhiyang Lotion can treat pruritus and skin damage caused by eczema in rats, and its mechanism may be related to the regulation of immunity, inflammatory response and the influence of flora at skin lesions.

R287.6

广西重点研发计划项目（桂科AB25069028）；广西中医药大学“桂派中医药传承创新团队”项目（2022A005）