Abstract: Objective: To assess the efficacy of total glucosides of paeony combined with NB-UVB in the treatment of moderate to severe psoriasis and detect the level change of serum IL-17, IL-23 and protease activated receptor 2 (PRA-2) in skin lesions. Methods: The patients with moderate to severe psoriasis from May 2019 to June 2020 in our hospital were collected, who were randomly divided into the NB-UVB group, total glucosides group, total glucosides of paeony combined with NB-UVB group. After three-month treatment, the PASI score was calculated. The levels of serum IL-17, IL-23, and PRA-2 expression were detected by ELISA and immunohistochemistry. Results: Ninety patients were collected, 30 in each group. There was no significant difference in PASI scores before treatment in the three groups. After 3-month treatment, the PASI scores, the levels of serum IL-17 and IL-23, and the PRA-2 level were lower in the total glucosides of paeony combined with NB-UVB group than in the group and total glucosides group (Ps<0.05). Conclusion: The treatment of the total glucosides of paeony combined with NB-UVB is more effective than NB-UVB or the total glucosides of paeony. The therapeutic mechanism may be related to the decrease of serum IL-17, IL-23 and PRA-2 expression in skin lesions.

Key words: total glucosides of paeony, narrow-band UV, psoriasis, PRA-2, IL-17, IL-23