CN114832059A - Compound centipede composition for treating psoriasis vulgaris as well as preparation method and application thereof - Google Patents

Compound centipede composition for treating psoriasis vulgaris as well as preparation method and application thereof Download PDF

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CN114832059A
CN114832059A CN202210569976.5A CN202210569976A CN114832059A CN 114832059 A CN114832059 A CN 114832059A CN 202210569976 A CN202210569976 A CN 202210569976A CN 114832059 A CN114832059 A CN 114832059A
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centipede
parts
compound
composition
psoriasis
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安月鹏
杨素清
郑楠
王姗姗
张晴
袁锐
张琼
任宇坤
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Heilongjiang University of Chinese Medicine
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Abstract

The invention belongs to the technical field of traditional Chinese medicines, and particularly discloses a compound centipede composition for treating psoriasis vulgaris, and a preparation method and application thereof. The compound centipede composition is prepared from the following raw materials in parts by weight: 1-5 parts of centipede, 5-30 parts of lithospermum, 15-50 parts of glabrous greenbrier rhizome, 15-35 parts of winged euonymus twig, 5-30 parts of zaocys dhumnade and 5-20 parts of liquorice. The composition provided by the invention fully embodies the pathological theory of the causes of psoriasis virus and stasis and the pathogenesis theory of toxin accumulation and stasis, and achieves the aim of better preventing and treating psoriasis.

Description

Compound centipede composition for treating psoriasis vulgaris as well as preparation method and application thereof
Technical Field
The invention belongs to the technical field of traditional Chinese medicines, and particularly discloses a compound centipede composition for treating psoriasis vulgaris, and a preparation method and application thereof.
Background
The psoriasis is a common clinical disease, the incidence of the psoriasis increases year by year along with the change of modes and structures such as environment, diet, life and the like, the psoriasis can be suffered by all people, has a certain genetic tendency, and has the characteristics of large north, light winter and light summer, long disease course and repeated attack, thereby bringing great psychological and mental pressure to patients.
Psoriasis can be clinically classified into two major types, namely psoriasis vulgaris and psoriasis distinctively, wherein the distinctively can be classified into pustule type, joint type and erythrodermic type, but psoriasis vulgaris is the most common psoriasis. In the aspect of skin damage, the psoriasis vulgaris can initially show a papule with the size of a needle head, gradually expands to a light red or bright red papule or a macule with the size of mung bean or soybean, the papule can be fused into a macule shape, the boundary is clear, a plurality of layers of dry white scales are covered on the surface, a shiny semitransparent film is exposed when the scales are scraped, the film is a film phenomenon, then the film is scraped, a plurality of sieve-shaped bleeding points appear, the spot bleeding phenomenon is a punctiform bleeding phenomenon, the hair can be bundled to bundle-shaped hair when the head is affected, the nail plate is in a thimble shape when the hair is put on the nail, the nail plate is changed to be in a thimble hoop shape, and the nail plate can also be generated at the positions of a mucous membrane and the like; the psoriasis vulgaris can be divided into a progressive stage, a resting stage and a regressive stage in clinical staging, wherein a new rash continuously appears in the progressive stage and a rash appears in acupuncture, friction and trauma, which is called homotypic reaction. Therefore, the characteristic expression aspects of psoriasis vulgaris include a film phenomenon, a punctate bleeding phenomenon, bundled hair, a needle hoop nail change, a homomorphic reaction and the like; the psoriasis vulgaris can be divided into various forms such as drop, coin, patch, map, oyster shell and mixed form in the aspect of skin damage.
Psoriasis vulgaris, in the aspect of western medicine treatment, currently available oral drugs mainly include antibiotics (erythromycin, tetracycline, cephalosporins and the like), retinoids (tretinoin), immunosuppressants (methotrexate, cyclosporine, tacrolimus and the like), immunomodulators (glycyrrhizic acid, thymosin, bacillus calmette guerin and the like), glucocorticoids, biological agents and the like. However, such drugs have the disadvantages that: first, the long-term treatment effect is poor, the skin injury is usually rebounded or relapsed after the medicine is stopped, and particularly, the glucocorticoid can induce psoriasis of pustule type or erythroderma type. Secondly, the safety is poor, and the degree of damage to the liver caused by antibiotics, retinoids and various immunosuppressive agents is large; retinoic acid can affect blood lipid metabolism of patients, cause fetal malformation, and affect serious side effects such as child development and the like; immunosuppressants can affect bone marrow hematopoiesis and female fertility; immunomodulators such as glycyrrhizic acid can cause hypertension and localized edema, and can also influence potassium ion metabolism in serum to cause muscle weakness and even muscle dissolution; the long-term application of the glucocorticoid can convert psoriasis vulgaris into psoriasis pustulosa or erythroderma, but aggravate the disease; the current clinical application of biological agents has not been sufficiently documented to induce cancer, a range of allergic diseases, and the like. Thirdly, the application is limited, for example, the antibiotic also causes dermatitis medicamentosa, and the antibiotic can not be applied to people allergic to corresponding drugs; the vitamin A acid medicine can not be used for special people such as children and pregnancy; immunosuppressants cannot be applied to anemia, women in childbearing age, and other people; immunomodulators such as glycyrrhizic acid cannot be used for patients with severe hypertension, low potassium, myasthenia, etc.; glucocorticoids cannot be used in patients with hypertension, hyperglycemia, ion disorders, low potassium, low calcium, etc.; the biological agent cannot be used for patients with tumors, etc. Fourthly, the cost is high, and the cost of any kind of medicine taken for a long time is higher than that of the traditional Chinese medicine preparation. Therefore, the oral preparation which is effective, long-term, stable, safe, wide in application range and low in cost is selected to treat psoriasis vulgaris.
In the aspect of treating psoriasis by traditional Chinese medicine, the main oral medicines are mainly treated from the blood system in the theory of establishment, and in addition, the treatment is distinguished from viscera, cold evil, Xuanfu, warm disease and macula, constitution and the like, but certain defects exist, and the specific expression is that: firstly, only aiming at a certain link of psoriasis occurrence, the 'whole' of psoriasis cannot be dynamically recognized from the whole change of the psoriasis; or starting from the specific constitution of some psoriasis patients, the general rule is that the patients are dotted and taken. For example, the psoriasis is treated by Xuanfu, which is mainly aimed at the specific constitution that patients without Pinsu sweat are easy to cause psoriasis, but some patients with psoriasis who generate excessive body sweat exist clinically; the treatment of psoriasis from cold pathogen is mainly aimed at psoriasis patients who are severe in winter and mild in summer and induced by cold, but psoriasis patients have no obvious direct relationship between the occurrence of part of patients and cold, even patients who occur or aggravate in summer; psoriasis is treated by treating epidemic febrile disease and macula, and mainly aims at that a part of psoriasis patients are induced by pharyngitis or tonsillitis due to exogenous infection, so that most of psoriasis patients still have no obvious inducement or can be induced by diet, trauma, emotion and other factors, but not induced by exogenous infection; the principle of differentiating and treating psoriasis from constitutions is related to family inheritance, but many patients still have no family inheritance history, and the current psoriasis patients without family history have higher incidence rate year by year. Secondly, when the traditional Chinese medicine is used for treating psoriasis, the advantages and the characteristics of insect medicines such as detoxification, collateral dredging, wind calming, blood stasis removing and the like are not fully exerted, the heat-clearing and detoxifying herbal medicines are mainly used, and the insect medicines and other types of medicines (branches and leaves, roots, vines, flowers, minerals and the like) are not well combined ingeniously. Thirdly, the mutual relation between the medicine and the disease from the angle of meridian tropism is lacked, the existing oral prescription mostly treats the psoriasis by means of clearing heat and sweating, the prescription which mutually corresponds the medicine and the meridian from the angle of meridian tropism is few and few, and the purpose of disease differentiation and treatment can be achieved by exploring meridian tropism treatment. Therefore, the oral preparation for treating psoriasis vulgaris has wide application prospect by combining the traditional Chinese medicine and the oral preparation for treating psoriasis vulgaris.
Disclosure of Invention
In view of the above technical features, the present invention provides the following technical solutions:
the invention provides a compound centipede composition for treating psoriasis vulgaris, which is prepared from the following raw materials in parts by weight: 1-5 parts of centipede, 5-30 parts of lithospermum, 15-50 parts of glabrous greenbrier rhizome, 15-35 parts of winged euonymus twig, 5-30 parts of zaocys dhumnade and 5-20 parts of liquorice.
Preferably, the compound centipede composition is prepared from the following raw materials in parts by weight: 3 parts of centipede, 30 parts of lithospermum, 30 parts of glabrous greenbrier rhizome, 30 parts of winged euonymus twig, 20 parts of zaocys dhumnade and 10 parts of liquorice.
The invention also provides a preparation method of the compound centipede composition, which comprises the following steps:
weighing centipede, lithospermum, glabrous greenbrier rhizome, winged euonymus twig, zaocys dhumnade and liquorice according to the parts by weight;
mixing the weighed traditional Chinese medicine raw materials, soaking in water, decocting, and sequentially filtering and concentrating the obtained decoction to obtain the compound centipede composition.
Preferably, the water is added for decoction, and the water is added with water which is 8-12 times of the total weight of the mixed medicinal materials for decoction for 2-3 times, and each time lasts for 1.0-2.0 h.
The invention also provides application of the compound centipede composition in preparing a medicine for treating psoriasis vulgaris.
Preferably, the compound centipede composition is used for preparing a medicine for treating psoriasis vulgaris with syndrome of toxin accumulation and blood stasis.
The invention also provides a medicine for treating psoriasis vulgaris, which comprises the compound centipede composition.
Preferably, the composition also comprises auxiliary materials or carriers commonly used in pharmacy.
Preferably, the pharmaceutical preparation is a tablet, a capsule, a granule, an oral liquid, an ointment or a cream.
The compound centipede composition provided by the invention consists of centipedes, lithospermum, glabrous greenbrier rhizome, winged euonymus twig, zaocys dhumnade and liquorice, and the compatibility is based on the classic theory of poison and stasis in traditional Chinese medicine, and specifically comprises the following components: centipede is used as monarch drug, one can exert the effect of insect drugs on combating poison with poison to detoxify and dissipate stagnation, and can extinguish wind and enter collaterals to relieve convulsion, and the centipede plays the effects of dispelling wind and poison and dredging collaterals and stasis aiming at the initial 'poison' of psoriasis and the 'stasis' of returning to the home, and is in accordance with the theories of 'generation of virus by disease' and 'stasis by long-term disease' of the formula; the lithospermum, the glabrous greenbrier rhizome and the winged euonymus twig are ministerial medicines, and the lithospermum not only aims at the heat change and the heat toxin in the development process of the psoriasis, but also can clear the blood stasis of the blood on the one hand; glabrous greenbrier rhizome, rhizoma Smilacis Glabrae, one of which can eliminate dampness and toxin and can activate collaterals and remove arthralgia and blood stasis aiming at dampness change in disease development; ramulus Euonymi, aiming at the blood stasis in the final stage of disease development, exerts the effect of removing blood stasis and toxic substances, and can also aim at the stagnation of blood in the channels and collaterals of blood vessels to remove blood stasis; the three medicines can respectively clear away heat and toxic materials, remove dampness and toxic materials, remove blood stasis and exhibit remarkable detoxifying effect, can activate blood stasis, remove arthralgia and stasis, and remove stagnation and stasis, and react to achieve the equivalent functions of removing blood stasis and dredging collaterals, thereby fully exhibiting the pathogenesis of 'toxin accumulation and blood stasis' of psoriasis; the zaocys dhumnades is an adjuvant drug, is an insect product together with the centipedes, can detoxify, calm wind, detoxify, assist the centipedes in dispelling wind, dredge collaterals, relieve convulsion, and enhance the curative effects of detoxification and blood stasis removal by matching with the effect of monarch and minister blood stasis removal channels; the liquorice is an assistant and guide drug, one drug can relieve various toxins, and the liquorice is combined with monarch, minister, assistant and guide drugs to separate and relieve different toxins; in addition, the other herbs can harmonize the recipe, moderate the property of herbs, harmonize collaterals and resolve stasis, and smooth blood collaterals. The medicines are combined, and the functions of dispelling wind-evil, clearing away heat and toxic materials, removing dampness and toxic materials, removing blood stasis and removing toxic materials are combined in the aspect of 'poison'; in the aspect of stasis, the Chinese herbal medicine decoction integrates the effects of dredging collaterals and dissolving stasis, promoting blood circulation and dissolving stasis, removing arthralgia and removing stasis and blood collaterals, and plays the roles of detoxifying and dissolving stasis of the centipede toxin-vanquishing decoction and treating psoriasis vulgaris together.
Compared with the prior art, the invention has the beneficial effects that:
1. the compound centipede composition provided by the invention breaks through the limitation and limitation of the traditional 'blood system' differentiation, and the establishment is based on the 'poison' and 'stasis' theories in the traditional Chinese medicine, and simultaneously organically combines the 'poison' and the 'stasis' together, considers that the 'poison' is a key factor and an initial factor of psoriasis occurrence according to the 'virus generation' of psoriasis, considers that the 'stasis' is a necessary result and a return of the development of psoriasis according to the 'long-term illness must be stasis', so that the 'poison' and the 'stasis' are taken as the first end and the second end, the 'poison' and the 'stasis' are linked in the aspect of etiology, and the treatment principle aiming at the 'toxin stagnation' pathogenesis of the psoriasis is drawn up as a 'detoxification and stasis removing method'. The compatibility of the formula fully embodies the pathogenesis theory of the pathogenesis of the virus and stasis of the psoriasis and the pathogenesis theory of the stasis accumulation of the virus, aims at the dynamic development rule of the whole course of the psoriasis disease, removes the initial virus of the disease by dispelling wind, clearing heat and toxic materials, removing damp and toxic materials, removing stasis and removing all toxic materials, removes the stasis developed by the disease by dredging collaterals and stasis, activating blood stasis, removing arthralgia and stasis, removing stagnation and stasis and regulating blood collaterals, thereby achieving the aim of preventing and treating the psoriasis.
2. The compound centipede composition provided by the invention combines the types of the animal insect drugs (centipede and zaocys dhumnade), the root-stem drugs (lithospermum, glabrous greenbrier rhizome and liquorice), the branch-leaf drugs (winged euonymus twig) and other drugs from different sources, so that the overall compatibility of the prescription is proper and practical, and the curative effect of the prescription for treating psoriasis is enhanced.
3. The medicines belonging to the five meridians of the heart (lithospermum and liquorice), the liver (centipede, lithospermum, glabrous greenbrier rhizome, winged euonymus twig and black-tail snake), the spleen (winged euonymus twig, black-tail snake and liquorice), the stomach (glabrous greenbrier rhizome and liquorice) and the lung (black-tail snake and liquorice) are matched with each other, and the five meridians of the heart, the liver, the spleen, the stomach and the lung in the meridians and collaterals are matched in the matching way, so that the medicines can circulate the whole body, detoxify and eliminate stasis, and better play a therapeutic role.
Detailed Description
The following detailed description of specific embodiments of the invention is provided, but it should be understood that the scope of the invention is not limited to the specific embodiments. All other embodiments, which can be obtained by a person skilled in the art without any inventive step based on the embodiments of the present invention, are within the scope of the present invention. The experimental methods described in the examples of the present invention are all conventional methods unless otherwise specified.
Example 1
A compound centipede composition for treating psoriasis vulgaris is composed of the following raw materials: centipede 3g, alkanna tinctoria 30g, glabrous greenbrier rhizome 30g, winged euonymus twig 30g, black-tail snake 20g and licorice root 10 g.
Example 2
A compound centipede composition for treating psoriasis vulgaris is composed of the following raw materials: 1g of centipede, 5g of lithospermum, 15g of glabrous greenbrier rhizome, 15g of winged euonymus twig, 5g of zaocys dhumnade and 5g of liquorice.
Example 3
A compound centipede composition for treating psoriasis vulgaris is composed of the following raw materials: centipede 5g, alkanna tinctoria 30g, glabrous greenbrier rhizome 50g, winged euonymus twig 35g, black-tail snake 30g and licorice root 20 g.
Example 4
A compound centipede composition for treating psoriasis vulgaris is composed of the following raw materials: centipede 3g, alkanna tinctoria 20g, glabrous greenbrier rhizome 25g, winged euonymus twig 30g, black-tail snake 25g and licorice root 10 g.
Example 5
A compound centipede composition for treating psoriasis vulgaris is composed of the following raw materials: 2g of centipede, 15g of lithospermum, 40g of glabrous greenbrier rhizome, 20g of winged euonymus twig, 15g of zaocys dhumnade and 12g of liquorice.
The compound centipede compositions provided by the above examples 1-5 are all prepared according to the following method:
weighing Scolopendra, radix Arnebiae, rhizoma Smilacis Glabrae, ramulus Euonymi, Zaocys, and Glycyrrhrizae radix;
mixing the weighed traditional Chinese medicine raw materials, adding water, soaking for 30min, decocting for 2 times, each time for 2.0h, combining the two decoctions, sequentially filtering and concentrating the obtained decoction to obtain the compound centipede composition.
Example 6
The compound centipede composition for treating psoriasis vulgaris is different from the compound centipede composition in the embodiment 1 in the preparation method, and specifically comprises the following steps:
weighing Scolopendra, radix Arnebiae, rhizoma Smilacis Glabrae, ramulus Euonymi, Zaocys, and Glycyrrhrizae radix;
mixing the weighed traditional Chinese medicine raw materials, soaking in water for 20min, decocting for 3 times, each time for 1.0h, combining the two decoctions, and sequentially filtering and concentrating the obtained decoction to obtain the compound centipede composition.
Since the effects of the compound centipede compositions prepared in examples 1-6 are substantially the same, the effects will be described below by taking the compound centipede composition prepared in example 1 as an example.
1. General data
350 patients with psoriasis vulgaris are selected, the patients are divided into 174 cases of a treatment group and 176 cases of a control group by adopting a random digital table method, the patients are divided into blood heat syndrome, blood dryness syndrome and blood stasis syndrome by clinical Chinese medicine syndrome differentiation after being grouped, 9 patients (3 cases of the treatment group and 6 cases of the control group) are dropped in the research process, so that the number of actually finished cases is 171 cases of the treatment group and 170 cases of the control group, and the general conditions of syndrome distribution, age, sex, the course of the disease and the like of psoriasis patients in each group are shown in table 1.
TABLE 1 comparison of psoriasis patients
Figure BDA0003659653610000081
Note: the age, sex and course of the disease of the two groups of patients with the same syndrome type are tested by independent samples t or chi 2 The test shows that the statistics show no difference and are comparable.
2. Diagnostic criteria
(1) Diagnostic standard for western medicine disease
The following criteria are made according to the relevant discussion about the clinical manifestations of psoriasis vulgaris in Chinese clinical dermatology: (1) skin damage performance: red papules, maculopapules, plaques, covered with dry silvery-white scales; (2) skin lesion morphology: drip type, coin type, floor pattern, mixed type; (3) skin lesion site: can occur in all parts of the body, can occur in the head with visible fasciculate hair, can occur in the nails with visible apical acicular nail changes; (4) special signs: thin film phenomenon, spotting phenomenon; (5) and (3) clinical staging: the progression phase, resting phase, regression phase.
(2) Syndrome diagnosis standard of traditional Chinese medicine
The following criteria are established according to the relevant discussions of syndrome types of psoriasis vulgaris in TCM therapists in dermatology departments with psoriasis (2017), wherein: (1) blood heat syndrome: the color is bright red, the scale is obvious, new rash appears continuously, the development is rapid, and the pruritus is severe; restlessness, dry stool, dark urine; red tongue with thin and yellow coating and wiry, slippery or rapid pulse; (2) syndrome of blood dryness: the color is light red, the scales are dry, and the chapping is obvious; dry mouth and tongue; pale tongue with little or thin and white coating and thready or thready and rapid pulse; (3) blood stasis syndrome: the color is dark red, the scales are thick, and the scales are repeatedly attacked; with the symptoms of scaly skin, dark complexion, dark menses or blood clots; dark purple tongue with petechia, ecchymosis, thin coating, deep and thready pulse.
3. Inclusion criteria
(1) The diagnostic standard of the western medicine disease of psoriasis vulgaris is met; (2) respectively meets the traditional Chinese medicine syndrome diagnosis standards of blood heat syndrome, blood dryness syndrome and blood stasis syndrome of psoriasis vulgaris; (3) the age range is 18-65 years old; (4) the patient compliance is good, and the related grouping, medication, clinical data acquisition and the like of the research can be completed as required; (5) signing the informed consent.
4. Exclusion criteria
(1) Patients with psoriasis of pustule type, joint type, and erythrodermic type; (2) patients with severe medical conditions, psychiatric conditions, allergic conditions; (3) patients with other skin diseases that affect the determination of the psoriatic lesion index are pooled; (4) pregnant or lactating women; (5) patients who have received other various internal and external drug treatments in nearly 1 month; (6) patients who are participating in other clinical drug trials.
5. Method of treatment
(1) Treatment group
Treatment groups the compound centipede composition provided in example 1 was orally administered. Each dose of the medicine is soaked and decocted twice by the conventional method, 300mL of juice is obtained in total, the juice is evenly mixed and evenly divided into two parts, 150mL of the juice is warm taken 30min after breakfast and supper, 1 dose is taken every day, and the juice is continuously taken for 4 weeks.
(2) Control group
The control group orally administered compound glycyrrhizin tablet (MEINTONG). The main components are as follows: glycyrrhizin, glycine and methionine. The manufacturer: kaishan tablet company, Japan (Split charging of Wei Material (China) pharmaceutical Co., Ltd.). Specification: 25mg 10s 10 plates. Approval document No.: the national standard of medicine J20130077. Batch number: 20191107. the taking method comprises the following steps: 50 mg/time, 3 times/day, and is administered with warm water after meal for 4 weeks.
6. Index observation and evaluation
(1) Evaluation of skin Damage index PASI
The skin damage indexes of two groups of patients before treatment and 4 weeks after treatment are observed and scored according to an internationally recognized psoriasis skin damage area and severity index (PASI) scoring method, and the skin damage index score of each psoriasis patient is integrally evaluated through quantitative values of erythema, infiltration, scale and skin damage area of the skin damage.
(2) Evaluation of clinical efficacy
The skin damage index PASI value is used as a measurement index, and the related discussion about the treatment effect judgment of the psoriasis vulgaris in the diagnosis and treatment guideline of common diseases in the dermatology of traditional Chinese medicine is referred to: (1) the clinical cure is as follows: the change rate of the skin damage index is more than or equal to 90 percent; (2) the effect is shown: the skin damage index change rate is more than or equal to 60 percent and less than 90 percent; (3) the method has the following advantages: the change rate of the skin damage index is more than or equal to 20 percent and less than 60 percent; (4) and (4) invalidation: the skin damage index change rate is less than 20% or is a negative value. The change rate of the skin damage index is (pre-treatment skin damage index PASI score-post-treatment PASI skin damage index score)/pre-treatment skin damage index PASI score multiplied by 100%. The significant efficiency is (clinical cure number + significant number)/the total number of patients in the group x 100%.
(3) Evaluation of recurrence Rate
Clinical follow-up 3 months after treatment was performed on the patients who healed clinically, and if the patients had new psoriatic rash, the disease was considered to be recurrent. The recurrence rate is the number of recurrence cases/the number of recovery cases in the group x 100%.
(4) Evaluation of safety
The objective safety indexes of liver function (alanine aminotransferase ALT and aspartate aminotransferase AST) and kidney function (urea nitrogen BUN and blood creatinine Cr) before and after treatment of two groups of patients are qualitatively evaluated, and subjective safety indexes of headache, dizziness, chest distress, insomnia, nausea, diarrhea and the like which may appear in the patients are evaluated at the same time.
(5) Detection and evaluation of psoriasis key factors IL-17 and IL-23
Aiming at detecting Th17 type cytokine interleukin-17 (interleukin-17, IL-17) and interleukin-23 (interleukin-23, IL-23) which are clinically considered to be closely related to the occurrence and development of psoriasis vulgaris at present, the specific detection method is as follows: by adopting enzyme-linked immunosorbent assay (ELISA), 3mL of fasting venous blood of a patient is taken from morning and morning before and after treatment, the fasting venous blood is placed in a non-anticoagulation tube, supernatant is taken after centrifugation and is placed in a refrigerator at the temperature of minus 80 ℃ for storage, absorbance is measured at the wavelength of 450nm of an enzyme labeling instrument during detection, a standard curve is drawn to calculate the concentration of a sample, and the content of factors is detected according to the specifications of an IL-17 kit (Shanghai enzyme-linked bioscience, Inc., mL035984) and an IL-23 kit (Shanghai enzyme-linked bioscience, Inc., mL 038452).
7. Results
7.1 comparison of skin Damage index PASI in two groups of patients
After 4 weeks of treatment, the skin lesion index of each syndrome type in the treatment group is obviously reduced (P is less than 0.01) compared with that before treatment, and the PASI of the patients with blood heat syndrome, blood dryness syndrome and blood stasis syndrome after treatment is lower than that in the control group (P is less than 0.01), which is shown in Table 2.
Table 2 psoriasis patients skin damage index (PASI) comparison table (points,
Figure BDA0003659653610000111
)
Figure BDA0003659653610000112
note: compared with the treatment before the same group of treatment, a p<0.05, b p is less than 0.01; compared with the control group after the treatment of the same syndrome type, c p<0.01。
7.2. clinical curative effect comparison results of two groups of patients
After 4 weeks of treatment, the clinical efficacy of each syndrome type of the treatment group is better than that of the control group (P is less than 0.01), and the treatment group shows better treatment effect in different blood syndromes, which is shown in Table 3.
Table 3 comparative clinical efficacy of psoriasis patients table (example,%)
Figure BDA0003659653610000113
Figure BDA0003659653610000121
Note: compared with the group with the same syndrome type, a p<0.05。
7.3. results of the recurrence rate comparisons between two groups of patients
After the treatment, the patients who are cured in clinic are followed up for 3 months, and the result shows that the relapse rate of the patients in the treatment group is obviously lower than that of the patients in the control group, and the result is shown in table 4.
Table 4 comparative table of recurrence rate of psoriasis patients (example,%)
Figure BDA0003659653610000122
7.4. Safety evaluation results
The objective safety indexes of liver function and kidney function before and after treatment of two groups of patients are basically expressed as normal values, and only 1 patient in the control group has transient BUN increase after treatment, is related to high-protein diet of the patient after desquamation due to psoriasis, and is advised to recover to be normal after diet adjustment (see table 5). The nausea symptoms of only 1 patient in the treatment group are mainly caused by gastrointestinal discomfort caused by the fact that the traditional Chinese medicine decoction is not orally taken, the nausea symptoms are relieved by adjusting the taking method of the traditional Chinese medicine and gradually adaptively taking the traditional Chinese medicine, the headache and the dizziness which appear after the control group takes the compound glycyrrhizin tablet are side effects of the medicine, the subjective symptoms are slight, and the progress of the whole clinical study is not influenced (see table 6).
TABLE 5 Objective safety index qualitative comparison table (example) for psoriasis patients
Figure BDA0003659653610000123
Figure BDA0003659653610000131
Note: positive/positive indicates that the pre-treatment and post-treatment indices are normal; the normal/abnormal indicates that the index is normal before treatment and abnormal after treatment; abnormal/positive indicates that the index is abnormal before treatment and normal after treatment; the different/different indicates that the index before and after treatment is abnormal.
TABLE 6 comparison table of subjective safety index for psoriasis patients (example)
Figure BDA0003659653610000132
Note: absence/absence means no symptoms before and after treatment; absence/presence indicates absence before and presence after treatment; presence/absence indicates presence of symptoms before treatment and absence after treatment; presence/presence indicates both before and after treatment.
7.5. Results of IL-17 and IL-23 detection in sera of two groups of patients
After 4 weeks of treatment, the IL-17 and IL-23 in the serum of each syndrome type of the treatment group are obviously reduced (P is less than 0.01) compared with the serum before treatment, and the IL-17 and IL-23 contents of the patients with blood heat syndrome, blood dryness syndrome and blood stasis syndrome after treatment are obviously lower than those of the control group (P is less than 0.01), which is shown in Table 7.
Table 7 comparative table of serum IL-17, IL-23 levels for psoriasis patients (ng/L,
Figure BDA0003659653610000133
)
Figure BDA0003659653610000134
Figure BDA0003659653610000141
note: compared with the treatment before the same group of treatment, a p<0.05, b p is less than 0.01; compared with the control group after the treatment of the same syndrome type, c p<0.01。
in conclusion, the traditional Chinese medicine composition provided by the invention can effectively reduce the PASI score of psoriasis vulgaris patients with traditional Chinese medicine syndromes, and reduce the content of IL-17 and IL-23 in the serum of psoriasis patients with syndromes, and has the advantages of obvious clinical curative effect, low recurrence rate and higher safety.
Typical cases
Case 1
For men, 10 years old, the main symptoms are tonsillitis caused by exogenous infection, then the systemic spread of spot-shaped erythema, pimple, silvery white scale covering, obvious subjective itching, new eruption every day, thin-film phenomenon (+), punctate bleeding phenomenon (+), tonsil II degree enlargement, and the course of the disease is more than 1 week. And (3) diagnosis: psoriasis vulgaris (advanced stage). Treatment: the centipede toxin-vanquishing decoction is orally taken 2 times a day, 150ml each time, and is warm taken half an hour after breakfast and supper, and most of psoriasis skin rash is eliminated after 2 weeks of treatment.
Case 2
For women, the age of 45 years old, the primary symptom is the past psoriasis history, the skin damage gradually worsens after eating seafood, flaky erythema can be seen on the whole body, part of rash is fused into flaky patches, a thick layer of silvery white scale is covered, the subjective itching is obvious, no new eruption exists basically, the thin film phenomenon (+), the punctate bleeding phenomenon (+), the course of disease is more than 20 years, and the aggravation lasts for 3 months. And (3) diagnosis: psoriasis vulgaris (quiescent phase). Treatment: the centipede toxin-vanquishing decoction is orally taken 2 times a day, 150ml each time, and is taken warm half an hour after breakfast and supper, after 4 weeks of treatment, rash and scales of psoriasis are completely removed, most of erythema disappears, and the color tends to normal skin color.
Case 3
For men, 33 years old, the main symptoms are psoriasis history for 2 years, skin damage is mild, severe and recurrent, severe in winter and mild in summer, the skin is not easy to sweat, localized plaque-shaped dark red spots can be seen on the back, double elbows and buttocks, thick layers of silvery white scales are covered on the skin, a large amount of desquamation can be seen on the head, the head is in a bundle shape, no new eruption exists, the phenomenon of thin film (+) and the phenomenon of punctate bleeding (+) are seen. And (3) diagnosis: psoriasis vulgaris (quiescent phase). Treatment: the centipede toxin-vanquishing decoction is orally taken 2 times a day, 150ml each time, and is warm taken half an hour after breakfast and supper for 4 weeks, skin rash on scalp basically disappears, fasciculate hair disappears, plaque-like skin rash on the whole body is obviously thinned, and scales basically disappear.
Case 4
For men of 56 years old, the main symptoms are that the psoriasis has a history of more than 10 years, skin lesions of the whole body are mostly seen and scattered on erythema and papules, silvery white scales are covered on the skin lesions, dark erythema can be seen on the glans of the patients, a small amount of fine scales are covered on the glans, the subjective pruritus is obvious, the symptoms are particularly severe at night, and the nails are changed like thimble hoops. And (3) diagnosis: psoriasis vulgaris. Treatment: the centipede toxin-vanquishing decoction is orally taken 2 times a day, 150ml each time, is taken warm half an hour after breakfast and supper, skin rash is completely eliminated after 6 weeks of treatment, slight pigmentation is remained on the local part, and meanwhile, half a follow-up year shows that the thimble hoop nail is obviously improved, the skin rash of a patient does not relapse, and the long-term curative effect is stable.
Case 5
The main symptoms of a female age of 41 years are that fresh erythema and silvery white scales appear on the damaged part of the skin before 1 week after the trauma, then a small amount of similar rash, red color and subjective pruritus gradually appear on the whole body, and psoriasis rash appears on the spot acupuncture part every day after the hospitalization of the patient, and homomorphic reaction (+). And (3) diagnosis: psoriasis vulgaris (advanced stage). Treatment: the centipede toxin-vanquishing decoction is orally taken 2 times a day, 150ml each time, and is warm taken half an hour after breakfast and supper for 2 weeks, skin rash is completely eliminated, no pruritus is caused, and homomorphic reaction is caused (-).
Case 6
In the case of men of age 42, the main symptoms are that a large number of erythema and pimples are visible around the body, the psoriasis is obvious accompanied by scales, the subjective itching is obvious, particularly at night, the mother has family history of the psoriasis, the psoriasis appears after about age 30, the rash repeatedly attacks in more than 10 years, and no obvious cold or climate inducement exists. And (3) diagnosis: psoriasis vulgaris. Treatment: the centipede toxin-vanquishing decoction is orally taken 2 times a day, 150ml each time, and is taken warmly half an hour after breakfast and supper, psoriasis rash is completely eliminated after 4 weeks of treatment, and the disease does not relapse after 1 year of follow-up visit.
Case 7
For men, the age of 40 years old, the main symptoms are psoriasis for 2 months at the beginning, the whole body is scattered in spot-shaped bright red spots, remarkable silvery white scales are covered, the subjective pruritus is severe, and diseases are induced after tonsil inflammation. And (3) diagnosis: psoriasis vulgaris. Treatment: the centipede toxin-vanquishing decoction is orally taken 2 times a day, 150ml each time, is warm taken half an hour after breakfast and supper, skin rash is basically and completely eliminated after 4 weeks of treatment, and the content of IL-17 in serum after treatment is 28.5ng/L and is only slightly higher than the normal average level.
While preferred embodiments of the present invention have been described, additional variations and modifications in those embodiments may occur to those skilled in the art once they learn of the basic inventive concepts. Therefore, it is intended that the appended claims be interpreted as including preferred embodiments and all such alterations and modifications as fall within the scope of the invention.
It will be apparent to those skilled in the art that various changes and modifications may be made in the present invention without departing from the spirit and scope of the invention. Thus, if such modifications and variations of the present invention fall within the scope of the claims of the present invention and their equivalents, the present invention is also intended to include such modifications and variations.

Claims (9)

1. A compound centipede composition for treating psoriasis vulgaris is characterized by being prepared from the following raw materials in parts by weight: 1-5 parts of centipede, 5-30 parts of lithospermum, 15-50 parts of glabrous greenbrier rhizome, 15-35 parts of winged euonymus twig, 5-30 parts of zaocys dhumnade and 5-20 parts of liquorice.
2. The compound centipede composition for treating psoriasis vulgaris according to claim 1, characterized in that the compound centipede composition is prepared from the following raw materials in parts by weight: 3 parts of centipede, 30 parts of lithospermum, 30 parts of glabrous greenbrier rhizome, 30 parts of winged euonymus twig, 20 parts of zaocys dhumnade and 10 parts of liquorice.
3. A method for preparing the compound centipede composition of claim 1 or 2, which is characterized by comprising the following steps:
weighing centipede, lithospermum, glabrous greenbrier rhizome, winged euonymus twig, zaocys dhumnade and liquorice in parts by weight;
mixing the weighed traditional Chinese medicine raw materials, soaking in water, decocting, and sequentially filtering and concentrating the obtained decoction to obtain the compound centipede composition.
4. The preparation method of the compound centipede composition according to claim 3, wherein the water decoction is to add water which is 8-12 times of the total weight of the mixed medicinal materials for decoction for 2-3 times, each time for 1.0-2.0 h.
5. Use of a compound centipede composition according to claim 1 or 2 for the manufacture of a medicament for the treatment of psoriasis vulgaris.
6. The use as claimed in claim 5, wherein the compound centipede composition is used for preparing a medicament for treating psoriasis vulgaris with the syndrome of toxin accumulation and stasis.
7. A pharmaceutical formulation for the treatment of psoriasis vulgaris comprising the compound centipede composition of claim 1 or 2.
8. The pharmaceutical preparation of claim 7, further comprising pharmaceutically acceptable adjuvants or carriers.
9. The pharmaceutical formulation of claim 8, wherein the pharmaceutical formulation is a tablet, capsule, granule, oral liquid, paste or cream.
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CN112516250A (en) * 2020-12-22 2021-03-19 黑龙江中医药大学附属第一医院(黑龙江中医药大学第一临床医学院) Traditional Chinese medicine composition for treating psoriasis vulgaris and preparation method thereof

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