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| 1 | 雷公藤多苷的药理毒理作用研究进展显示文摘近年来,雷公藤多苷(TWP)在临床使用越来越广泛,多被用于治疗类风湿关节炎,还作为基本免疫抑制药物治疗各种肾脏疾病,如肾病综合征等,但其临床有多种不良反应事件发生,用药方案存在争议,尤其是使用剂量和使用时间。为了雷公藤多苷的临床合理使用和深入研究,综述其药理毒理研究进展。通过梳理近年来国内外有关雷公藤多苷的药理毒理研究文献,发现雷公藤多苷的药理作用研究多集中在抗炎、抗肿瘤、肾脏保护和免疫抑制方面,主要是通过调节核转录因子-κB(NF-κB)信号通路,雷帕霉素靶蛋白(m TOR)信号通路和细胞凋亡相关信号通路的细胞因子表达水平发挥药理作用;其毒理作用研究多集中在肝毒性、肾毒性和生殖系统毒性方面,毒性作用多与氧化应激反应和炎症因子表达相关。雷公藤多苷的主要活性成分研究集中在雷公藤内酯醇和雷公藤红素。雷公藤多苷药理毒理研究较深入,表明其效、毒存在剂量依赖性和时间依赖性,具有量-效、时-效、量-毒、时-毒关系,未见雷公藤多苷在功效背景下随使用剂量和时间变化的毒性研究,其关联机制仍需进一步深入研究与探讨。 | 何康婧 高增平 尹丽梅 柳芳 | 2020 | 中国实验方剂学杂志2020，26，1： | 51 |
| 2 | 生物制剂治疗银屑病的研究进展显示文摘银屑病是一种慢性炎症性皮肤病,免疫细胞成分和细胞因子均在银屑病的发病中发挥了重要作用.近年来,靶向作用于TNF-α,IL-12/23,IL-17,IL-23的生物制剂,在中重度银屑病的治疗中有着广泛应用.本文对生物制剂治疗银屑病的研究进展进行了综述,主要包括药物种类、安全性、药物失效与药物停用、联合用药、疗效预测与药物转换、新药与基础研究进展等方面,为该领域的发展,如联合治疗、新药研究等方面提供参考.最后,对北京协和医院皮肤科在银屑病的基础研究及临床诊疗等方面的工作进行了综述. | 张翰林 舒畅 晋红中 | 2021 | 中国科学:生命科学2021，51，8： | 10 |
| 3 | 2004—2019年河南省雷公藤制剂不良反应分析显示文摘目的分析2004—2019年河南省雷公藤制剂不良反应/事件(ADR/ADE),分析雷公藤制剂不良反应/事件的发生特点,为雷公藤制剂的临床合理应用提供参考依据。方法收集河南省内2004年1月—2019年5月有关雷公藤制剂不良反应报告203例。回顾性分析此203例患者ADR/ADE的时间、性别、年龄、既往史分布、用药原因及合并用药情况、剂型、累及系统及临床表现、结局。结果 203例发生ADR/ADE的患者中,以2017年比例最高(13.30%),其次为2018年(10.34%);季度分布上1~3月发生率最低,年度/季节分布差异有统计学意义(P<0.05)。男、女构成比分别为56.39%、46.31%,以45~64岁年龄层发生率最高(47.29%),但性别与年龄分布差异无统计学意义。203例患者中,4例既往有过敏史、8例有吸烟史、3例有肾病病史、2例为妊娠期女性、4例饮酒史。片剂剂型比例最高(90.15%)。ADR/ADE发生时间以用药后2~6 h比例最高,其次为用药后6 h^1 d。药物使用时长<1周、1~3周、>3周的构成比分别为71.43%、17.24%、11.33%。类风湿性关节炎、风湿性关节炎的比例(25.12%、24.14%)最高,其中91.13%为单药治疗,8.87%为联合用药。胃肠损害比例(54.68%)最高,其次为皮肤及其附件损害(10.84%),用药部位损害、免疫功能紊乱和感染、内分泌紊乱罕见,构成比分别为0.49%;在临床表现上,以恶心、呕吐出现频次最高。203例患者中181份报告类型为一般,22例为严重;其中结局为痊愈、好转患者构成比分别为58.13%、39.41%,仅1例未好转,构成比为0.49%;未见ADR/ADE所致的死亡事件。结论医务人员应重视雷公藤制剂的不良反应观察,了解雷公藤制剂所致的ADR/ADE的临床规律及特点,严格遵循说明书适应症及剂量操作,最大限度降低雷公藤制剂ADR/ADE相关风险。 | 李雨蔓 陈世伟 夏旭东 彭亚丽 杨雪 王干一 | 2020 | 现代药物与临床2020，35，5： | 9 |
| 4 | 银屑I号对咪喹莫特诱导小鼠银屑病模型核转录因子-κB的调控作用及机制显示文摘目的观察银屑I号对咪喹莫特(imiquimod,IMQ)诱导小鼠银屑病模型核转录因子-κB(nuclear factor,NF-κB)炎症通路的影响及其可能的作用机制。方法建立IMQ诱导小鼠银屑病模型,随机分为模型组、银屑I号组、雷公藤多甙组,每组10只,另选正常小鼠10只作为空白对照组,空白对照组及模型组予等量生理盐水灌胃,银屑I号组、雷公藤多甙组分别给予银屑I号、雷公藤多甙灌胃,连续10天,HE染色观察各组小鼠皮损组织形态学变化;免疫组化法检测皮损组织NF-κB p65蛋白水平,RT-PCR法检测NF-κB mRNA表达情况,订制血液蛋白芯片检测血清白介素6(interleukin 6,IL-6)、白介素10(interleukin 10,IL-10)、白介素17(interleukin 17,IL-17)、干扰素γ(interferon gamma,INF-g)含量。结果与空白对照组比较,模型组小鼠出现明显的红斑、鳞屑及皮肤增厚。与模型组比较,银屑I号组、雷公藤多甙组小鼠红斑、鳞屑及皮肤增厚程度明显减轻;银屑I号组、雷公藤多甙组血清IL-6、IL-10、IL-17、INF-γ水平明显降低(P均<0.01);银屑I号组、雷公藤多甙组皮损组织NF-κB mRNA、NF-κB p65表达也明显降低(P均<0.01)。结论银屑I号能够明显抑制IMQ诱导小鼠模型皮肤增殖,这可能与抑制NF-κB基因表达及减轻炎症反应有关。 | 孙文 陈雨佳 邓婉莹 黄树宏 李勇 刘靖 查旭山 | 2017 | 中国皮肤性病学杂志2017，31，1： | 8 |
| 5 | 雷公藤与阿维A治疗寻常型银屑病的系统评价显示文摘目的Meta分析雷公藤与阿维A单独或联合治疗寻常型银屑病的疗效和安全性。方法计算机检索Pubmed、Cochrane、中国知网、万方医学网等数据库,收集雷公藤单独或联合阿维A治疗寻常型银屑病的疗效和安全性的随机对照试验。结局指标以银屑病皮损面积和严重性指数评分(PASI)表示,分别比较显效率(PASI评分改善60%~89%)、基本痊愈率(PASI评分改善90%~100%)、药物不良反应差异。对符合纳入标准的临床研究进行资料提取和质量评价,采用Revman5.3软件进行Meta分析。结果共纳入13项研究,1258例患者。雷公藤(n=284)与阿维A单药(n=273)相比,显效率(RR=1.08,95%CI:0.79~1.47,P=0.65)和基本痊愈率(RR=1.22,95%CI:0.67~2.22,P=0.52)差异均无统计学意义。雷公藤联合阿维A(n=368)与阿维A单药(n=365)相比,联合组显效率(RR=1.48,95%CI:1.33~1.64,P<0.01)和基本痊愈率(RR=1.44,95%CI:1.19~1.75,P<0.01)均优于阿维A单药组。联合组与阿维A单药比较,胃肠不适(RR=0.54,95%CI:0.33~0.91,P<0.05)、肝功能异常(RR=0.37,95%CI:0.18~0.78,P<0.05)均减少,皮肤黏膜干燥(RR=0.66,95%CI:0.34~1.27,P=0.21)、血脂升高(RR=0.59,95%CI:0.31~1.11,P=0.10)差异无统计学意义。结论雷公藤可有效治疗寻常型银屑病,雷公藤联合阿维A治疗寻常型银屑病效果优于阿维A单药。 | 程毅 胡彩霞 崔瑜 王文氢 | 2020 | 天津医药2020，48，4： | 5 |
| 6 | 口服中成药治疗银屑病的研究进展显示文摘银屑病是一种慢性、炎症性、系统性疾病,给患者带来了身心负担,并对其生存质量造成巨大影响。目前,西医治疗面临容易复发以及长期使用可能导致不良反应的困境。不少系统评价报道,中药或中药联合西药治疗银屑病非常有前景。由于临床使用方便,中成药已经越来越多的应用于银屑病的治疗。本文通过检索中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普(CQVIP)、万方(Wanfang Database),以及国外Pub Med数据库,综述了目前治疗银屑病的6种常用中成药研究进展及大量关于中成药的报道,包括系统评价、临床随机对照研究、临床观察以及实验室研究等。研究表明,中成药单用、或联合其他药物和疗法治疗银屑病,能够有效改善患者症状,且患者耐受性好。然而,临床试验的设计及实施存在方法学上的不足,在对结果的解读方面需要谨慎。有关中成药疗效及安全性的评价可通过进一步全面的系统评价来实现。 | 卢传坚 喻靖傑 邓浩 邓静文 姚丹霓 闫玉红 | 2018 | 皮肤科学通报2018，35，1： | 5 |
| 7 | Effectiveness and safety of different doses of pioglitazone in psoriasis:a meta-analysis of randomized controlled trials显示文摘Background:Pioglitazone may be beneficial in the treatment of psoriasis.However,based on the effectiveness and safety considerations,it has not been widely used.To fully evaluate the strength of evidence supporting psoriasis treatment with pioglitazone,we conducted a meta-analysis of existing published studies.Methods:PubMed,Ovid,Cochrane Library,Google Scholar,and Web of Science databases were systematically searched before February 2019.Randomized controlled trials(RCTs)of pioglitazone administration compared with placebo,administered to patients with psoriasis for at least 10 weeks,and published in English were included.Quality of the included RCTs was identified by the modified Jadad scale.The quality of evidence for each outcome was evaluated using the GRADEpro Guideline Development Tool online software.Primary outcomes were proportion of patients showing psoriasis area and severity index(PASI)score improvement(<75%)and the mean percent change in PASI score from baseline to the end of treatment.Dichotomous data were analyzed using odds ratios(ORs)corresponding to the 95%confidence interval(CI),whereas continuous variables,expressed as mean and standard deviation,were analyzed using the mean differences(MD)with the 95%CI.Results:Six RCTs were analyzed.Meta-analysis showed that pioglitazone reduced the PASI scores in patients with psoriasis compared with the control group when administered at 30 mg per day(P<0.001,MD=-3.82,95%CI=-5.70,-1.93)and at 15 mg per day(P=0.04,MD=-3.53,95%CI=-6.86,-0.20).The PASI-75 of the pioglitazone group was significantly higher than that of the control group at 30 mg per day(P<0.001,OR=8.30,95%CI=3.99,17.27)and at 15 mg per day(P=0.03,OR=2.96,95%CI=1.08,8.06).No statistically significant differences in total adverse events were observed between the groups.There were no significant differences in common adverse reactions such as weight gain and elevated liver enzymes between the two pioglitazone groups.Conclusions:Use of pioglitazone in the current treatment of psoriasis is beneficial.The therapeutic effect of the daily 30 mg dose may be greater than that of the 15 mg dose per day with no significant change in the frequency of adverse reactions. | Jing-Zhan Zhang Yuan Ding Fang Xiang Shi-Rong Yu De-Zhi Zhang Meng-Meng Guan Xiao-Jing Kang | 2020 | Chinese Medical Journal2020，，4： | 3 |
| 8 | 自血疗法联合雷公藤多苷片治疗银屑病血热证临床观察显示文摘目的探讨自血疗法联合雷公藤多苷(tripterygium wilfordii polyglycosidium,TWP)治疗银屑病血热证的疗效。方法观察银屑病1组(寻常型银屑病血热证患者30例,TWP治疗8周)和2组(寻常型银屑病血热证患者30例,自血疗法联合TWP治疗8周)治疗前后的银屑病面积和严重程度指数(Psoriasis Area and Severity Index,PASI)评分变化,并比较2组的愈显效率。结果治疗前,2组PASI评分无统计学差异(P> 0. 05);治疗后,2组的PASI评分均较各组治疗前显著降低(P均<0. 05),且2组的PASI评分明显低于1组(P <0. 01);银屑病1组和2组的愈显率分别为56. 67%和83. 33%,组间差异有显著性(P <0. 05)。结论自血疗法联合TWP治疗寻常型银屑病血热证疗效显著,安全经济。 | 贺琪 石全 皮先明 郑毅 李家文 | 2019 | 光明中医2019，0，17： | 3 |
| 9 | Effect of Traditional Chinese Medicine plus narrow-band medium-wave ultraviolet B radiation on moderate-to-severe psoriasis vulgaris in a case series显示文摘OBJECTIVE: To investigate the efficacy and safety of Traditional Chinese Medicine (TCM) therapy combined with ultraviolet B light therapy in the treatment of moderate-to-severe psoriasis. METHODS: Patients with moderate-to-severe psoriasis (skin lesion area > 10% of the body surface area) for 2 consecutive years were treated with TCM (oral and external use of herbal medicines, acupuncture, and herbal bathing) and narrow-band medium-wave ultraviolet B light treatment for 12 weeks. The treatment effect was evaluated based on the Psoriasis Area Severity Index (PASI), the achievement of a 50% reduction in the PASI (PASI50), the achievement of a 75% reduction in the PASI (PASI75), pruritus score, Dermatology Life Quality Index, and safety. RESULTS: A total of 95 outpatients were enrolled, and 92 subjects (96.8%) completed the 12-week treatment course. At baseline, the average proportion of the body surface area covered by skin lesions was 12.4%, and the average PASI was 17.7. All patients had previously been treated with conventional medicine (89.1% of patients received ultraviolet light treatment, 50.0% received glucocorticoids, and 21.7% received acitretin). After the 12-week treatment course, 22 patients (23.9%) achieved PASI75, and 43 (46.7%) achieved PASI50. The post-treatment pruritus score and Dermatology Life Quality Index of all treated patients were significantly lower than the respective baseline values (P < 0.0001). No adverse effects were detected by the monitoring of blood, urine, stools, liver and kidney function, and echocardiography.CONCLUSION: Comprehensive therapy comprising TCM therapy combined with ultraviolet B light therapy achieved good outcomes for patients with moderate-to-severe psoriasis. | Li Tiantian Zhou Dongmei Xu Xuying Qu Jianhua Jiang Chunyan Lan Haibing Lou Weihai Chen Weiwen Jin Li Liu Rongqi Liu Zhiyong Zhang Cang Duan Lanhua Bohua Li Xu Jingna Zhou Tao Jiang Xi Cao Wei Zhang Guangzhong Liu Jianping Sun Liyun Wang Ping | 2019 | Journal of Traditional Chinese Medicine2019，39，5： | 2 |
| 10 | 基于转运体的中药毒性研究进展显示文摘中药是指在中医理论指导下可用于疾病治疗和预防的一种天然中草药。许多中药疗效显著但存在一定的毒性,中药的毒性一直制约着其使用。现代研究也从物质基础深入到肝脏代谢酶角度,近年来研究发现许多中药的活性成分或其提取物产生毒副后果与转运体功能异常有关。从而导致中药在体内吸收、分布、排泄过程发生变化,同时也可能引起体内内源性物质紊乱。因此,基于转运体角度,阐明中药对转运体活性表达及分子机制,对临床安全合理用药及新药研制开发具有指导性意义。本文就近来年相关研究进行综述。 | 张羽 鞠爱霞 李秋红 | 2019 | 化学工程师2019，33，3： | 2 |
| 11 | Enhanced uptake and anti-maturation effect of celastrol-loaded mannosylated liposomes on dendritic cells for psoriasis treatment显示文摘Psoriasis is an autoimmune skin disease in which dendritic cells(DCs) trigger the progression of psoriasis by complex interactions with keratinocytes and other immune cells. In the present study,we aimed to load celastrol, an anti-inflammatory ingredient isolated from Chinese herbs, on mannosylated liposomes to enhance DC uptake as well as to induce DC tolerance in an imiquimod-induced psoriasis-like mouse model. Mannose was grafted onto liposomes to target mannose receptors on DCs. The results demonstrated that compared with unmodified liposomes, DCs preferred to take up more fluorescence-labeled mannosylated liposomes. After loading celastrol into mannose-modified liposomes,they effectively inhibited the expression of maturation markers, including CD80, CD86 and MHC-II, on DCs both in vitro and in vivo. Additionally, after intradermal injection with a microneedle, celastrolloaded mannose-modified liposomes(CEL-MAN-LPs) achieved a superior therapeutic effect compared with free drug and celastrol-loaded unmodified liposomes in the psoriasis mouse model in terms of the psoriasis area and severity index, histology evaluation, spleen weight, and expression of inflammatory cytokines. In conclusion, our results clearly revealed that CEL-MAN-LPs was an effective formulation for psoriasis treatment and suggested that this treatment has the potential to be applied to other inflammatory diseases triggered by activated DCs. | Long Xi Zibei Lin Fen Qiu Shaokui Chen Ping Li Xin Chen Zhenping Wang Ying Zheng | 2022 | Acta Pharmaceutica Sinica B2022，12，1： | 2 |
| 12 | 银屑病“新血证论”辨治银屑病理论溯源及实践显示文摘银屑病(psoriasis)的临床诊疗一直以来是一个重要的医学问题。近年来,中医学“血分论治”银屑病达成共识。紧扣“血热阳浮”“血瘀”两大病理因素,学者总结前人经验提出银屑病“新血证论”诊疗思想。在治疗上重视决银方、桃丹方及雷公藤的应用,丰富和发展银屑病中医理论体系。 | 蒯仂 王瑞平 李欣 秦万章 罗楹 杨涵 李斌 | 2023 | 世界临床药物2023，44，3： | 1 |
| 13 | 银屑胶囊联合阿维A治疗对寻常型银屑病患者免疫功能的影响显示文摘目的 分析银屑胶囊联合阿维A治疗对寻常型银屑病患者免疫功能的影响。方法 选择寻常型银屑病患者98例,按照随机数字表法分组为单一用药组(n=49)和联合用药组(n=49)。单一用药组使用阿维A治疗,联合用药组在单一用药组的基础上采用银屑胶囊治疗。对比2组疗效、免疫功能[T淋巴细胞亚群(CD3+、CD4+、CD8+)]、银屑病面积与严重性指数(PASI评分)、炎性因子[白细胞介素-4(IL-4)、肿瘤坏死因子α(TNF-α)]、不良反应变化。结果 联合用药组总有效率93.88%(46/49)较单一用药组77.55%(38/49)高,差异有统计学意义(P<0.05);与单一用药组比较,治疗后联合用药组CD3+、CD4+水平高,且CD8+水平低,差异有统计学意义(P<0.05);与单一用药组比较,治疗后联合用药组浸润、鳞屑、红斑评分较低,差异有统计学意义(P<0.05);与单一用药组比较,治疗后联合用药组IL-4水平高,且TNF-α水平低,差异有统计学意义(P<0.05);联合用药组不良反应4.08%(2/49)较单一用药组18.37%(9/40)低,差异有统计学意义(P<0.05)。结论 银屑胶囊、阿维A联合应用对寻常型银屑病疗效显著,可以提高免疫力,改善疾病严重程度,缓解炎症反应,且能降低不良反应。 | 董永华 赖小丽 | 2023 | 哈尔滨医药2023，43，4： | 0 |
| 14 | 强力宁联合小剂量阿维A治疗银屑病120例临床研究观察显示文摘目的:探讨强力宁联合小剂量阿维A治疗银屑病的临床疗效。方法:选取2014年7月~2016年1月在我院接受治疗的寻常型银屑病患者120例为研究对象,分为强力宁联合阿维A组及强力宁联合小剂量阿维A组,每组60例。比较治疗前后两组临床疗效、肝肾功能、血脂及用药不良反应情况。结果:强力宁联合小剂量阿维A组治疗总有效率为73.3%,显著高于强力宁联合阿维A组(P〈0.05),差异有统计学意义。治疗过程中不良反应发生率为6.6%,显著低于强力宁联合阿维A组(P〈0.05)。结论:强力宁联合小剂量阿维A治疗寻常型银屑病疗效好,毒副作用少,值得临床推广。 | 卢金 陈晋广 | 2016 | 北方药学2016，13，8： | 0 |
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