于佳家　张小卿　吴景东　顾炜

[摘要]目的：本研究旨在觀察痤疮合剂对兔耳痤疮模型外周血清炎性因子表达的影响。方法：Kligman和Fulton法制备兔耳痤疮模型，于兔耳内侧涂抹煤焦油，时间2周，待造模成功后，痤疮合剂组灌服痤疮合剂（17.52g/kg/d）30d;阳性组灌服清热暗疮胶囊（0.12g/kg/d）30d;空白组与模型组灌服同等剂量生理盐水。各组末次给药后，24h内取静脉血及局部皮肤组织病理活检。ELISA法检测各组家兔外周血清IL-3、IL-4、IL-13、TNF-α、GM-CSF水平，HE染色法观察兔耳组织病理变化。结果：痤疮合剂能有效减轻兔耳表皮层的厚度、脓肿、结节和兔耳毛囊开口收缩及扩张的程度，抑制毛囊漏斗内角质化物质的大量增殖，降低真皮炎症细胞的增生和浸润。除空白组外，各组血清IL-3、IL-4、IL-13、TNF-α和GM-CSF表达水平在造模后均显著升高，差异有统计学意义（P<0.01）;处理后，与模型组相比，痤疮合剂组和阳性组血清IL-3、IL-4、IL-13、TNF-α和GM-CSF表达水平均显著降低，差异有统计学意义（P<0.01）。结论：痤疮合剂能通过降低外周血清炎性因子浓度，调节免疫功能而改善兔耳痤疮模型的病理表现。

[关键词]痤疮合剂;兔耳痤疮模型;炎性因子;GM-CSF;白介素-3;肿瘤坏死因子α;白介素-13;白介素-4

[中图分类号]R758.73+3    [文献标志码]A    [文章编号]1008-6455（2020）08-0027-04

Experimental Study of Inflammatory Cytokines Effect of Acne Mixture Decoction on Rabbit Ear Acne Models

YU Jia-jia1，ZHANG Xiao-qing1，WU Jing-dong2，GU Wei3

（1.The First Clinical Graduate School， Liaoning University of Traditional Chinese Medicine，Shenyang 110847，Liaoning，China;2.The President's Office， the 2nd Affiliated Hospital of Liaoning University of Traditional Chinese Medicine Hospital，Shenyang 110036，Liaoning，China;3.Department of Dermatology Clinic， the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine Hospital，Shenyang 110043，Liaoning，China）

Abstract： Objective  To study the effect of Acne Mixture Decoction on the expression of inflammatory cytokines in peripheral blood of rabbit ear acne model. Methods  Rabbit ear acne model was prepared according to Kligman and Kwong method by applying coal tar to the internal surface of rabbit ears for 2 weeks. After confirming successful modeling， the mixture group was given Acne Mixture Decoction （17.52g/kg/d）， continuous dosing 30d. And the control group was given Clear Heat Acne Capsule （0.12g/kg/d）， continuous dosing 30d. The control group and the model group were given equal doses of saline solution respectively. Partial ear skin samples were biopsied within 24 hours after the last administration， and using ELISA to detect levels of IL-3， IL-4， IL-13， TNF-α and GM-CSF in all groups.  Results  Acne Mixture Decoction can significantly reduce the abscess and nodules， reduce thickness of the rabbit ear epidermal and follicle funnel expansion， inhibit proliferation of keratinized compounds in follicle funnel， and reduce dermal inflammatory cell infiltration. Except the blank group， the expression levels of serum IL-3， IL-4， IL-13， TNF-α and GM-CSF in each group were significantly increased after modeling， and the differences were statistically significant （P<0.01）. Compared with the model group， levels of IL-3， IL-4， IL-13， TNF-α and GM-CSF in the mixture group and the positive control group were significantly decreased （P<0.01）. Conclusion  Acne Mixture decoction can improve the pathological symptoms of rabbit ear acne model by reducing the concentration level of inflammatory cytokines in peripheral blood and regulating immune function.

Key words： acne mixture; rabbit ear acne model; inflammatory cytokine; GM-CSF; IL-3; TNF-α; IL-13; IL-4

痤疮属传统中医“粉刺”的治疗范畴，青春期发病率高，患者会出现不同程度和症状的皮损性临床表现，中国区患病率为39.3%[1]，欧洲为57.8%[2]。该病主要发生在皮脂丰盈的面部、胸背，轻则皮肤脓疱和丘疹，重则凹凸瘢痕，甚至引起面部皮损性毁容，给患者带来极大的情志压力负担。现代西医研究认为，炎症反应、皮脂腺角质化异常、P.Acne（痤疮丙酸杆菌）定植、皮脂分泌过多和情志心理因素等都是影响本病早期发病的机制，其中免疫功能异常是影响本病的重要病理学因素[3]。因此，本实验以……