青石止痒软膏联合消风止痒汤加减治疗神经性皮炎的疗效评价  

Clinical Effect of Qingshi Zhiyang Ointment Combined with Modified Xiaofeng Zhiyang Decoction in Treating Neurodermatitis

作　　者：李纬[1] 张丰川[1] 李元文[1] 

机构地区：[1]北京中医药大学东方医院,北京100078

出　　处：《中国实验方剂学杂志》2017年第21期194-199,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：北京市科技计划课题项目(Z131100002513013)

摘　　要：目的:观察青石止痒软膏联合消风止痒汤加减辨证治疗神经性皮炎的临床疗效,及对瘙痒介质和炎症因子的影响。方法:将160例患者随机按数字表法分为西医组和中医组各80例。西医组外用糠酸莫米松乳膏,均匀涂于患处,每天早晚各1次;口服氯雷他定片,10 mg/次,1次/d。中医组外用青石止痒软膏,将药物轻揉于患处,每天早晚各1次;内服消风止痒汤加减,1剂/d,两组疗程均为21 d。进行治疗前后瘙痒程度采用视觉模拟评分(VAS),皮损程度采用湿疹面积及严重度指数(EASI)评分,中医证候评分,生活质量采用皮肤病生活质量(DIQL)量表评价,检测治疗前后5-羟色胺(5-HT),组胺,P物质(SP),β-内啡肽(β-EP),白细胞介素-6(IL-6),IL-8和肿瘤坏死因子-α(TNF-α)水平。结果:中医组临床疗效总有效率为95.95%,高于西医组的84.93%(χ~2=5.173,P<0.05);中医组中医证候疗效总有效率为95.95%,高于西医组的78.08%(χ2=10.419,P<0.01);治疗后中医组患者的瘙痒VAS,EASI,中医证候和DIQL评分均低于西医组(P<0.01);治疗后中医组5-HT,组胺,SP,β-EP水平均低于西医组(P<0.01);治疗后中医组IL-6,IL-8和TNF-α水平均低于西医组(P<0.01)。结论:与西医常规治疗方案相比较,采用消风止痒汤加减内服联合青石止痒软膏外用治疗神经性皮炎能减轻患者瘙痒,改善皮损症状,降低中医证候评分,提高患者的生活质量,能调节引起瘙痒的化学介质和免疫炎症因子,临床疗效和中医证候疗效均优于西医常规疗法。Objective： To observe the clinical effect of Qingshi Zhiyang ointment combined with modified Xiaofeng Zhiyang decoction treating neurodermatitis, and its impact on itching medium and inflammatory factors. Method： One hundred and sixty patients were randomly divided into western medicine （TCM） group in 80 cases and traditional Chinese medicine （TCM） group in 80 cases. Patients in western medicine group was given Mometasic Fumarate cream twice daily, and loratadine tablets, 10 mg/time, 1 time/day. A course of treatment was 21 days. Patients in TCM group was given Qingshi Zhiyang ointment twice daily, and modified Xiaofeng Zhiyang decoction, 1 dose/day. A course of treatment was 21 days. Before and after treatment, itching degree was evaluated by visual simulation score （VAS） , degree of skin damage was evaluated by eczema area and severity index （EASI）, scores of TCM syndromes was graded, and quality of life was graded by quality of skin care （DIQL）. And before and after treatment, levels of serotonin （5-HT）, histamine, substance P （SP）, beta- endorphin （β-EP）, interleukin-6 （ IL-6）, IL-8 and tumor necrosis factor-α （TNF-α） were detected. Result ： The total effect rate of clinical efficacy of TCM group was 95.95% , which was higher than 84.93% in western medicine group （X2 = 5. 173, P 〈 0.05）. The total effect rate of TCM symptoms in TCM group was 95.95% , which was higher than 78.08% in western medicine group （X2= 10. 419, P 〈0.01 ）. After treatment, scores of VAS, EASI, TCM symptoms and DIQL in TCM group were all lower than those in western medicine group （P 〈 0.01 ）. And levels of 5-I-IT, histamine, SP, β-EP, IL-6, IL-8 and TNF-α were all lower than those in western medicine group （P 〈0.01）. Conclusion： Compared with routine western medicine therapy, Qingshi Zhiyang ointment combined with modified Xiaofeng Zhiyang decoction can reduce itching of patient, ameliorate skin lesions, reduce scores of TCM syndromes, improve the quality of lif

关 键 词：神经性皮炎 消风止痒汤 青石止痒软膏 瘙痒介质 炎症因子 

分 类 号：R287[医药卫生—中药学]