寻常型银屑病中医诊疗方案的多中心临床研究  

A Multi-Center Clinical Validation Study of Chinese Medicine Treatment Program for Psoriasis Vulgaris

作　　者：陈维文[1] 周冬梅[1] 王萍[1] 张广中[1] 刘瓦利[2] 白彦萍[3] 刘红霞 陈晴燕[5] 李斌[6] 杨素清[7] 史月君[8] 李领娥 

机构地区：[1]首都医科大学附属北京中医医院 [2]中国中医科学院广安门医院 [3]卫生部中日友好医院 [4]新疆维吾尔自治区中医医院 [5]沈阳市第七人民医院 [6]上海中医药大学附属岳阳中西医结合医院 [7]黑龙江中医药大学附属医院 [8]大连市皮肤病医院 [9]石家庄市中医院

出　　处：《中医杂志》2012年第18期1557-1561,共5页Journal of Traditional Chinese Medicine

基　　金：北京市科学技术委员会重大项目(D08050703550901)

摘　　要：目的 通过对寻常型银屑病中医治疗方案的临床验证,确定治疗方案的临床疗效,为进一步优化诊疗方案奠定基础。方法 选择寻常型银屑病患者186例,其中血热证131例,血燥证34例,血瘀证21例。按照预先制定的诊疗方案进行辨证论治,内治法血热证治以凉血解毒,血燥证治以养血解毒,血瘀证治以活血解毒。外治法有中药湿敷、中药浸浴、针灸疗法及其他疗法。在治疗的第8周和第12周观察银屑病皮损面积、严重程度指数(PASI)和不良反应。结果 在中医治疗方案实施中,中药汤剂口服是应用最多的方法,其余依次为中药软膏外用、中药药浴、中成药口服和中药湿敷。完成8周治疗的158例患者中总有效126例占79.7%,其中血热证组为78.2%,血燥证组为82.4%,血瘀证组为82.6%,各证型间疗效比较差异无统计学意义(P>0.05)。继续治疗至12周的100例患者中总有效89例占89.0%,其中血热证组为92.1%,血燥证组为89.5%,血瘀证组为77.8%,各证型间疗效比较差异无统计学意义(P>0.05)。结论 中药汤剂口服、中药软膏外用、中药药浴、中成药口服和中药湿敷是中医治疗银屑病常用的治疗方法,银屑病中医诊疗方案疗效肯定,患者依从性好。Objective To validate the Chinese medicine treatment program for psoriasis vulgaris, determine its therapeutic effect and lay foundation for further optimization. Methods Totally 186 psoriasis vulgaris patients were included, of which 131 cases were blood heat syndrome, 34 were blood dryness syndrome, and 21 were blood stasis syndrome. According to syn- drome type, they were treated with the method of cooling blood and removing toxin, nourishing blood and removing toxin and activating blood and removing toxin respectively. External treatment including moist compress, medicated bath, acupuncture were also used. Lesion area, psoriasis area and severity index （PASI） and side effect were observed on the 8th and 12th week. Results Oral administration of decoction was the most widely used Chinese medication, followed by ointment, medicated bath, oral administration of proprietary Chinese medicine and moist compress. There were 158 patients finished the eight-week treat- ment and the total effective rate was 79.7%, among which the effective rate of blood heat syndrome, blood dryness syndrome and blood stasis syndrome was 78.2%, 82.40% and 82.6% respectively, with no significant difference between different syn- dromes （P〉0.05）. There were 100 patients finished the twelve-week treatment and the total effective rate was 89.0 %, among which the effective rate of blood heat syndrome, blood dryness syndrome and blood stasis syndrome was 92.1 %, 89.5 % and 77.8%, with no significant difference between different syndromes （P〉0.05）. Conclusion Blood heat syndrome is the most common syndrome in psoriasis vulgaris. Oral administration of decoction, ointment, medicated bath, oral administration of proprietary Chinese medicine and moist compress are widely used Chinese medication for psoriasis vulgaris. Chinese medication for psoriasis is effective with good compliance.

关 键 词：银屑病 治疗方案 血热证 血燥证 血瘀证 

分 类 号：R275[医药卫生—中医皮科]