Abstract: Objective　To explore the efficacy of secukinumab combined with Xijiao Dihuang decoction in the treatment of patients with plaque psoriasis, as well as its effects on immune function and inflammatory factors. Methods　A randomized, double-blind, superiority trial design was adopted. A total of 82 patients with plaque psoriasis who were admitted to Hanzhong Traditional Chinese Medicine Hospital from December 2023 to December 2024 were selected as the research subjects. They were randomly divided into the observation group and the control group using the simple ranking randomization method, with 41 cases in each group. Observation group: 24 males and 17 females, aged 24 to 58 (43.24±4.67) years, with a disease duration of (10.75±2.45) years; Administer the combination of secukinumab and Xijiao Dihuang decoction. Control group: 26 males and 15 females, aged 22 to 59 (43.29±4.65) years, with a disease duration of (10.69±2.43) years. Administer stibocizumab treatment. Both groups were treated for one month. Compare the clinical efficacy, immune function, inflammatory factors [interleukin (IL)-6, IL-8, tumor necrosis factor α (TNF-α)], traditional Chinese medicine symptom scores (scaly dryness, itching, dry mouth, desquamation), time of clinical symptom improvement, psoriasis area and severity index (PASI) score, and incidence of adverse reactions between the two groups after treatment. Statistical methods employed t-test and χ² test. Results　The total effective rate of the observation group was higher than that of the control group [92.68% (38/41) vs. 75.61% (31/41)], and the difference was statistically significant (χ²=4.479, P<0.05). After treatment, the levels of CD4⁺ and CD8⁺ in the observation group were higher than those in the control group [(36.28±5.14)% vs. (33.19±5.23)%, (35.98±5.25)% vs. (33.66±5.24)%], while the levels of IL-6, IL-8, and TNF-α were lower than those in the control group [(95.54±25.33) ng/L vs. (109.57±25.26) ng/L, (4.92±1.74) ng/L vs. (6.14±1.88) ng/L, (12.15±3.42) ng/L vs. (14.25±3.37) ng/L], and the differences were statistically significant (t=2.698, 2.003, 2.511, 3.049, and 2.801, all P<0.05). After the treatment, the scores of traditional Chinese medicine symptoms, the time for clinical symptom improvement, and the PASI score in the observation group were all lower than those in the control group (all P<0.05). The comparison of the incidence rates of adverse reactions between the two groups [17.07% (7/41) vs. 14.63% (6/41)] showed no statistically significant difference (χ²=0.091, P>0.05). Conclusion　The combination of secukinumab and Xijiao Dihuang decoction in the treatment of patients with plaque psoriasis can improve immune function and inflammatory factor levels, and the clinical efficacy is quite good.

Key words: Plaque psoriasis,  , Xijiao Dihuang , decoction,  , Sikuximab,  , Immunity,  , Inflammatory factors

摘要：

目的　探讨司库奇尤单抗联合犀角地黄汤治疗斑块状银屑病患者的疗效，以及对免疫功能、炎症因子的影响。方法　采用随机、双盲、优效性试验设计。选择2023年12月至2024年12月汉中市中医医院收治的斑块状银屑病患者82例作为研究对象，采用简单排序随机法分为观察组和对照组，各41例。观察组：男24例，女17例，年龄24～58（43.24±4.67）岁，病程（10.75±2.45）年；给予司库奇尤单抗联合犀角地黄汤治疗。对照组：男26例，女15例，年龄22～59（43.29±4.65）岁，病程（10.69±2.43）年；给予司库奇尤单抗治疗。两组均治疗1个月。比较两组治疗后的临床疗效、免疫功能、炎症因子［白介素（IL）-6、IL-8、肿瘤坏死因子α（TNF-α）］、中医症状评分（鳞屑干燥、瘙痒、口干、脱屑）、临床症状改善时间、银屑病面积与严重程度指数（PASI）评分，以及不良反应发生率。统计学方法采用t检验、χ²检验。结果　观察组总有效率高于对照组［92.68%（38/41）比75.61%（31/41）］，差异有统计学意义（χ²=4.479，P<0.05）。治疗后，观察组CD4⁺、CD8⁺均高于对照组［（36.28±5.14）%比（33.19±5.23）%、（35.98±5.25）%比（33.66±5.24）%］，IL-6、IL-8、TNF-α均低于对照组［（95.54±25.33）ng/L比（109.57±25.26）ng/L、（4.92±1.74）ng/L比（6.14±1.88）ng/L、（12.15±3.42）ng/L比（14.25±3.37）ng/L］，差异均有统计学意义（t=2.698、2.003、2.511、3.049、2.801，均P<0.05）。治疗后，观察组中医症状评分、临床症状改善时间、PASI评分均低于对照组（均P<0.05）。两组不良反应发生率比较［17.07%（7/41）比14.63%（6/41）］，差异无统计学意义（χ²=0.091，P>0.05）。结论　司库奇尤单抗联合犀角地黄汤治疗斑块状银屑病患者，可改善免疫功能与炎症因子水平，临床疗效较好。

关键词: 斑块状银屑病,  ,  , 犀角地黄汤,  ,  , 司库奇尤单抗,  ,  , 免疫功能,  ,  , 炎症因子