龙胆泻肝汤加减联合针灸治疗肝火炽盛证单纯疱疹病毒性角膜炎  

Clinical Efficacy of Addition and Subtraction Therapy of Longdan Xiegan Tang Combined with Acupuncture on Herpes Simplex Keratitis(HSK) with Syndrome of Exuberance of Liver Fire

作　　者：鲁士友[1] 宿艳[2] LU Shi-you;SU Yan(The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Ji＇nan 250011, China;The Second People＇s Hospital of Ji＇nan, Ji＇nan 250005, China)

机构地区：[1]山东中医药大学附属医院,济南250011 [2]济南市第二人民医院,济南250005

出　　处：《中国实验方剂学杂志》2018年第15期216-221,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：山东省自然科学基金项目(ZR2015HM062)

摘　　要：目的：观察龙胆泻肝汤加减联合针灸治疗肝火炽盛证单纯疱疹病毒性角膜炎（HSK）的疗效及机体免疫炎症因子的调节作用。方法：将120例HSK患者随机按数字表法分为观察组和对照组,各60例。两组患者均给予局部抗病毒治疗。对照组56例（59眼）,采用针灸治疗,1次/d,6次/周。观察组55例（58眼）,在对照组治疗的基础上采用龙胆泻肝汤加减内服,1剂/d。两组患者均连续治疗4周。进行治疗前后主要症状、体征评分、视力检查和角膜荧光染色,并计算病损面愈合指数;检查治疗前后T细胞亚群（CD3＋,CD4＋,CD8＋,CD4＋/CD8＋）,自然杀伤细胞（NK）,白细胞介素-2（IL-2）,IL-10,干扰素-γ（IFN-γ）和核转录因子-κB（NF-κB）水平。结果：治疗后观察组患者各主要症状、体征评分均低于对照组（P〈0.01）;治疗后观察组的视力改善优于对照组,观察组视力恢复正常率为77.59%,好于对照组的57.63%（χ2=5.313,P〈0.05）;经秩和检验,治疗后观察组患者角膜病损面愈合指数优于对照组（P〈0.05）,观察组患者临床疗效优于对照组（P〈0.05）;观察组患者NK,CD3＋,CD4＋和CD4＋/CD8＋比值均高于对照组,CD8＋低于对照组（P〈0.05）;观察组IL-2和IFN-γ水平均高于对照组,IL-10和NF-κB水平均低于对照组（P〈0.01）。结论：采用龙胆泻肝汤加减内服联合针灸治疗肝火炽盛型HSK临床疗效优于单纯针灸治疗,并能起到调节机体免疫炎症因子反应作用。Objective： To discuss the clinical efficacy of addition and subtraction therapy of Longdan Xiegan Tang combined with acupuncture for herpes simplex keratitis（HSK） with syndrome of exuberance of liver fire and observe its regulation effect on immune inflammatory factors. Method： One hundred and twenty patients with HSK were randomly divided into control group and observation group by random number table. Both groups received local antiviral treatment. Patients in control group（56 cases and 59 eyes） received acupuncture,1 time/day,6 times/week. Based on the treatment in control group,the patients in observation group（55 cases and 58 eyes） got addition and subtraction therapy of Longdan Xiegan Tang,1 dose/day. The treatment was continued for 4 weeks in both groups. Before and after treatment,the main symptoms,signs,visual examination and fluorescent staining to corneal were detected and healing index of lesion surface were calculated. In addition,the levels of T cell subgroups（CD3＋,CD4＋,CD8＋,CD4＋/CD8＋）,natural killer cells（NK）,interleukin-2（IL-2）,interleukin-10（IL-10）,interferon-γ（IFN-γ） and nuclear transcription factor-κB（NF-κB） were detected.Result： After treatment,the scores of main symptoms and signs in observation group were lower than those in control group（P 〈 0. 01）. After treatment,the ameliorate of vision was superior to that in control group; rate of vision recovery in observation group was 77. 59%,higher than 57. 63% in control group（χ2= 5. 313,P 〈 0. 05）.In rank sum test,the healing index of lesopm surface in observation group was better than that in control group after treatment（P 〈 0. 05）,and the clinical efficacy was also superior to that in control group（P 〈 0. 05）. Levels of NK,CD3＋,CD4＋,CD4＋/CD8＋,IL-2 and IFN-γ were all higher than those in control group,while levels of CD8＋,IL-10 and NF-κB were lower than those in control group（P 〈 0. 05,P 〈 0. 01）. Conclusion： Addition and subtraction therapy o

关 键 词：单纯疱疹病毒性角膜炎 肝火炽盛证 龙胆泻肝汤 针灸 免疫功能 炎症因子 

分 类 号：R289[医药卫生—方剂学] R276[医药卫生—中药学]