【目的】 探讨青鹏软膏（由铁棒锤、安息香、人工麝香、棘豆、亚大黄、余甘子等组成）联合司库奇尤单抗注射液治疗 斑块型银屑病血瘀证患者的临床疗效。【方法】 选取2022年10月至2024年3月在安徽医科大学附属滁州市第一人民医院皮肤 科接受治疗的斑块型银屑病血瘀证患者共86例，根据简单化分组方法将患者随机分为观察组和对照组，每组各43例。对照 组给予司库奇尤单抗注射液皮下注射治疗，观察组在对照组的基础上给予青鹏软膏外敷治疗，疗程均为3个月。观察2组患 者治疗前后皮损严重程度评分（包括红斑、浸润、鳞屑评分）、中医证候评分、生活质量评分、血清炎症因子[白细胞介素 17A（IL-17A）、白细胞介素10（IL-10）、血管内皮生长因子（VEGF）]及白细胞p38丝裂原活化蛋白激酶表达水平（包括染色强 度计分和阳性细胞百分比评分）的变化情况，比较2组患者的临床疗效和不良反应总发生率。【结果】（1）治疗3个月后，观察 组的愈显率为 81.40%（35/43），对照组为 58.14%（25/43）；组间比较，观察组的临床疗效明显优于对照组（χ2 = 8.378，P＜ 0.05）。（2）治疗后，2组患者的皮损严重程度评分（包括红斑、浸润、鳞屑评分）、中医证候评分、生活质量评分、血清炎症因 子（包括IL-17A、IL-10、VEGF）及白细胞p38丝裂原活化蛋白激酶表达水平（包括染色强度计分和阳性细胞百分比评分）均较治疗前降低（P＜0.05），且观察组的降低幅度均明显优于对照组（P＜0.05）。（3）观察组的不良反应总发生率为 6.98%（3/43）， 对照组为 13.95%（6/43），组间比较，差异无统计学意义（χ2 = 1.117，P＞0.05），2组患者的不良反应均在治疗后的 1 ~ 2 d内 自然消退。【结论】 青鹏软膏联合司库奇尤单抗注射液治疗斑块型银屑病血瘀证患者临床疗效显著，可有效减轻皮损，通过 抑制白细胞p38丝裂原活化蛋白激酶表达水平发挥抗炎作用。

Objective To investigate the clinical efficacy of Qingpeng Ointment （composed of Aconiti Penduli Radix，，Benzoinum，Artificial Moschus，Oxytropis Falcatae Herba，Rhei Pumili Radix Et Rhizoma，Fructus Phyllanthi，etc.） combined with Secukinumab Injection in treating patients with plaque psoriasis of blood stasis syndrome type. Methods From October 2022 to March 2024 ，a total of 86 patients diagnosed as plaque psoriasis of blood stasis syndrome type from the Department of Dermatology，Chuzhou First People’s Hospital Affiliated to Anhui Medical University were enrolled. The patients were equally randomized into an observation group and a control group using a simplified randomization method，with 43 cases in each group. The control group received subcutaneous injection of Secukinumab Injection， while the observation group received additional topical application of Qingpeng Ointment based on the regimen for the control group. Both groups were treated for 3 months. The following parameters in both groups were assessed before and after treatment：the severity scores of skin lesion （including erythema，infiltration，and scale），traditional Chinese medicine （TCM） syndrome scores，quality of life scores，serum levels of inflammatory factors [interleukin 17A （IL-17A），interleukin 10（IL-10），vascular endothelial growth factor （VEGF）]， and leukocyte p38 mitogen-activated protein kinase （MAPK） expression levels （including staining intensity scores and positive cell percentage scores）. After treatment， the clinical efficacy and total incidence of adverse reactions were compared between the two groups. Results （1） After 3 months of treatment，the markedly-effective rate was 81.40% （35/43） in the observation group versus 58.14%（25/43） in the control group. The intergroup comparison showed significantly superior clinical efficacy in the observation group （χ² = 8.378，P＜0.05）.（2） After treatment，both groups exhibited significant reductions in the severity scores of skin lesion （including erythema，infiltration，and scale），TCM syndrome scores，quality of life scores，serum levels of inflammatory factors （IL-17A，IL-10，and VEGF），and expression levels of p38 MAPK in leukocytes （including staining intensity scores and positive cell percentage scores）（all P＜0.05），and the observation group demonstrated significantly greater reductions in all parameters than the control group （P＜0.05）.（3） The total incidence of adverse reactions was 6.98%（3/43） in the observation group versus 13.95% （6/43） in the control group，showing no statistically significant intergroup difference （χ²=1.117，P＞0.05），and all adverse reactions in both groups resolved spontaneously within 1-2 day（s） after treatment. Conclusion Qingpeng Ointment combined with Secukinumab Injection demonstrates significant clinical efficacy in treating plaque psoriasis with blood stasis syndrome， and is effective on alleviating skin lesions and exerting anti-inflammatory effects through the suppression of leukocyte p38 MAPK expression.

R275.9

国家自然科学基金资助项目（编号：81960825）