健脾除湿方治疗慢性湿疹临床研究  

Clinical Efficacy of Jianpi Chushi Prescription in Treatment of Chronic Eczema

作　　者：王中元 王赛[2] WANG Zhongyuan WANG Sai(The People＇s Hospital of Xiuwu County Xiuwu, Henan China 454310 The Second Affiliated Hospital to Henan University of Chinese Medieine,Zhengzhou Henan China 450002)

机构地区：[1]修武县人民医院,河南修武454310 [2]河南中医药大学第二附属医院/河南省中医院,河南郑州450002

出　　处：《中医学报》2017年第7期1319-1321,共3页Acta Chinese Medicine

基　　金：河南省科技攻关重点项目(112102310076)

摘　　要：目的:观察健脾除湿方治疗慢性湿疹脾虚湿蕴证的疗效及其对血清中肿瘤坏死因子-α(tumor necrosis factor alpha-α,TNF-α)、白细胞介素-1(Interleukin-1,IL-1)和白细胞介素-18(Interleukin-18,IL-18)水平的影响。方法:将124例慢性湿疹患者随机分成治疗组和对照组,每组62例。对照组口服盐酸西替利嗪片,每次1片,每天1次。治疗组在对照组基础上采用健脾除湿方治疗,方药组成:人参12 g,茯苓10 g,白术9 g,莲子肉20 g,砂仁12 g,薏苡仁12 g,苦参9 g,白鲜皮9 g,白扁豆10 g,山药10 g,滑石9 g,泽泻10 g,萆薢12 g,甘草9 g,每天1剂,常规水煮分早晚内服。两组疗程均为1个月。比较两组症状评分、湿疹面积和严重程度指数(eczema area and severity index,EASI)及临床疗效,并检测两组血清中TNF-α、IL-1和IL-18水平。结果:治疗后,治疗组皮疹形态、皮疹面积评分及EASI评分明显低于对照组,差异有统计学意义(P<0.01);治疗组有效率为91.94%,明显高于对照组的77.42%,差异有统计学意义(P<0.05);治疗组治疗后血清中TNF-α、IL-1和IL-18显著低于对照组,差异有统计学意义(P<0.01),结论:在西药治疗基础上加用健脾除湿方治疗慢性湿疹脾虚湿蕴证疗效显著,且能改善患者瘙痒程度,减小皮疹面积等临床症状,其作用机制可能与降低血清中TNF-α、IL-1和IL-18水平相关。Objective：To investigate the clinical efficacy of Jianpi Chushi Prescription in treatment of chronic Eczema with Spleen Deficiency and Dampness Retention Syndrome and the influence on serum levels of tumor necrosis factor（TNF）-α,interleukin（IL）-1 and IL-18.Methods：124 cases of patients with chronic Eczema were randomly divided into control group（62 cases）and treatment group（62 cases）.All patients of the control group were given with Cetirizine hydrochloride tablet,1 tablet each time,once a day.In addition to that of the control group,the treatment group was treated with Jianpi Chushi Prescription.Ingredients：Ginseng 12 g,Poria 10 g,Atractylodes 9 g,Lotus seeds 20 g,Amomum 12 g,Coix Seed 12 g,Sophora 9 g,Cortex dictamni 9 g,White Hyacinth Bean 10 g,Yam 10 g,Steatite 9 g,Alisma 10 g,Licorice 9 g,1 dose per day,oral administration.The treatment course of both groups was 1 month.The scores of symptoms and EASI and efficacy were compared between two groups.Serum levels of TNF-α,IL-1,and IL-18 were detected in both groups.Results：The scores of the severity of pruritus,rash area,rash form and EASI were obviously lower than those of control group（P〈0.01）.The total clinical efficiency of the treatment group was91.94%,which was significantly higher than that（77.42%）of the control group（P〈0.05）.The serum levels of TNF-α,IL-1and IL-18 of the treatment group were was remarkably lower than those of control group respectively after treatment（P〈0.01）.Conclusion：Basen on the treatment of western medicine,the clinical efficacy of Jianpi Chushi Prescription in treatment of chronic Eczema with Spleen Deficiency and Dampness Retention Syndrome has a significant clinical efficacy,which may be related to the inhibiting effect on the serum levels of TNF-α,IL-1 and IL-18.

关 键 词：慢性湿疹 健脾除湿方 盐酸西替利嗪 脾虚湿蕴证 中医药治疗 中西医结合 

分 类 号：R275.958.23[医药卫生—中西医结合]