清心消痤饮治疗青春期后女性痤疮疗效观察及对血清睾酮、硫酸脱氢表雄酮水平的影响  

Effect of Qingxin Xiaocuo decoction on female acne after puberty and its influence on serum testosterone and dehydroepiandrosterone sulfate

作　　者：李婷 王文娟 李兰英 胡阳 俞爱华 王海瑞 LI Ting;WANG Wenjuan;LI Lanying(Department of Dermatology,Nanxiang Hospital,Jiading District,Shanghai 201802)

机构地区：[1]上海市嘉定区南翔医院皮肤科,上海201802 [2]上海市嘉定区中医医院外科,上海201800 [3]上海市第四人民医院皮肤科,上海200082

出　　处：《河北中医》2020年第4期512-516,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：上海市卫生和计划生育委员会中医药科研专项2016—2017年度课题计划(编号:2016LP001);上海市卫生和计划生育委员会中医薄弱领域专科建设项目(编号:BRZK2016014);嘉定区卫生计生系统医学重点学科(项目)(编号:ZD06)。

摘　　要：目的观察清心消痤饮治疗青春期后女性痤疮临床疗效及对血清睾酮(T)、硫酸脱氢表雄酮(DHEAs)水平的影响。方法将80例青春期后女性痤疮患者按照随机数字表法分为2组。2组均予阿达帕林凝胶外用,对照组40例加用盐酸多西环素肠溶胶囊联合螺内酯片口服,治疗组40例加用清心消痤饮口服。2组疗程均为8周。比较2组治疗前后皮损评分、中医证候评分、血清T、DHEAs水平的变化,并统计临床疗效,另选40例青春期后健康女性检测血清T、DHEAs进行对照。结果 2组愈显率比较差异无统计学意义(P> 0. 05)。治疗后2组皮损评分均较本组治疗前降低(P <0. 05),2组组间比较差异无统计学意义(P>0. 05)。治疗后2组各项中医证候评分及总分均较本组治疗前降低(P <0. 05);治疗后治疗组各项中医证候评分及总分均低于对照组(P <0. 05)。2组治疗前血清T、DHEAs水平均高于健康组(P <0. 05)。治疗后2组血清T、DHEAs水平均较本组治疗前降低(P <0. 05),治疗后治疗组血清DHEAs水平低于对照组(P <0. 05)。治疗组不良反应发生率低于对照组(P <0. 05)。结论青春期后女性痤疮发病与雄激素水平升高有关,清心消痤饮能有效改善皮疹,缓解症状,调节患者血清雄激素T、DHEAs水平,临床疗效确切,不良反应少。Objective To observe the effect of Qingxin Xiaocuo decoction on female acne after puberty and its influence on serum testosterone( T) and dehydroepiandrosterone sulfate( DHEAs). Methods 80 cases of female acne patients after puberty were randomly divided into two groups according to the random number table method.Both groups were treated by adapalene gel for external use. 40 cases in the control group were treated by doxycycline hyclate enteric-coated capsules combined with spironolactone tablets orally. 40 cases in treatment group were treated by Qingxin Xiaocuo decoction. Both groups were treated for 8 weeks. The changes of skin lesion score,TCM syndrome score,serum T and DHEAs levels were compared between the two groups before and after treatment,and the clinical efficacy was counted. Another 40 cases of healthy women after puberty were selected to detect serum T and DHEAs for control. Results There was no significant difference in the markedly effective rate between the two groups( P > 0. 05). After treatment,the skin lesion scores of the two groups were lower than those in the group before treatment( P < 0. 05),but there was no significant difference between the two groups( P > 0. 05). After treatment,the scores and total scores of TCM syndromes in the two groups were lower than those in the group before treatment( P < 0. 05). The scores and total scores of TCM syndromes in the treatment group were lower than those in the control group( P < 0. 05). The levels of serum T and DHEAs before treatment in the two groups were higher than those in the healthy group( P < 0. 05). After treatment,the levels of serum T and DHEAs in the two groups were lower than those before treatment( P < 0. 05),and the level of serum DHEAs in the treatment group was lower than that in the control group( P < 0. 05). The incidence of adverse reactions in the treatment group was lower than that in the control group( P < 0. 05). Conclusion The incidence of female acne after puberty is related to the increase of androgen level. Qingxin Xia

关 键 词：清心 寻常痤疮 中药疗法 雄激素类 

分 类 号：R758.733.053.1[医药卫生—皮肤病学与性病学]