汪海珍，张予晋，杨志波*

    (湖南中医药大学第二附属医院，湖南长沙410005)

    润肤保湿软膏对血虚风燥证银屑病皮肤屏障功能干预作用及机制的研究

    汪海珍，张予晋，杨志波*

    (湖南中医药大学第二附属医院，湖南长沙410005)

    目的探寻润肤保湿软膏对银屑病血虚风燥型皮肤屏障功能的影响及作用机制。方法60例血虚风燥型银屑病患者随机分为两组，治疗组30例使用润肤保湿软膏治疗，对照组30例使用尿素软膏治疗，4周后依据PASI评分法判定疗效；使用Soft5.5皮肤六参数测试仪，对用药前后患者皮损角质层含水量、皮肤中油脂水平及pH值进行测定，通过薄层层析、BIO-RAD Ge1Doc凝胶成像系统、Quantity One软件分析及RT-PCR、Western blot的方法检测分析治疗前、后皮损神经酰胺(Cer)、水通道蛋白(AQP-3)的含量；比较分析两组间及组内的临床疗效及各项指标变化，探寻润肤保湿软膏对血虚风燥型银屑病皮肤屏障功能的干预作用及机制。结果两组治疗后均有一定临床疗效，治疗组明显优于对照组(P<0.05)；两组治疗后皮脂含量、角质层含水量均高于治疗前(P<0.05)，而pH值治疗组明显低于治疗前(P<0.05)，对照组pH值无明显改变(P>0.05)；治疗后两组水通道蛋白(AQP-3)、神经酰胺(Cer)的含量高于治疗前(P<0.05)；治疗组治疗后皮脂含量、pH值、AQP-3、Cer较对照组治疗后改善显著，差异有统计学意义(P<0.05)。结论润肤保湿软膏对血虚风燥型银屑病患者皮肤的屏障功能有显著调节及修复作用，有可能是通过神经酰胺和水通道蛋白对皮肤屏障功能进行修复。

    银屑病；血虚风燥型；润肤保湿软膏；皮肤屏障

    〔Abstract〕Objective To investigate the effect of skin-moistening lotion on skin barrier functions of psoriasis patients with blood deficiency and wind dryness syndrome and its mechanism of action.M ethods Sixty psoriasis patients with blood deficiency and wind dryness syndrome were random ly divided into two groups，thirty cases in treatment group were treated by the skin-moistening lotion and the other thirty patients in control group were treated by the urea frost.The healing effect was evaluated according to the PASI method after 4 weeks.The moisture of horny layer of patients'skin injury ......