肠风穴雷火灸联合亚甲蓝混合液肛周封闭治疗脾虚湿热型慢性肛周湿疹的疗效观察  

Therapeutic Effect of Moxibustion with Immediate Effect at Changfeng Points Combined with Methylene Blue Mixed Liquid Perianal Sealing for Chronic Perianal Eczema of Spleen Deficiency and Damp Heat Type

作　　者：徐海霞 赵长胜[1] 张妍[1] 张天鹏[2] 刘春景[3] XU Hai-Xia;ZHAO Chang-Sheng;ZHANG Yan;ZHANG Tian-Peng;LIU Chun-Jing(Tangshan Fengrun District People’s Hospital,Tangshan 063000 Hebei,China;Shijiazhuang Traditional Chinese Medicine Hospital,Shijiazhuang 050000 Hebei,China;Tangshan Maternal and Child Health Hospital,Tangshan 063000 Hebei,China)

机构地区：[1]唐山市丰润区人民医院,河北唐山063000 [2]石家庄市中医院,河北石家庄050000 [3]唐山市妇幼保健院,河北唐山063000

出　　处：《广州中医药大学学报》2020年第10期1944-1949,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：河北省中医药管理局中医药类科研计划课题资助项目(编号:2020402)。

摘　　要：【目的】观察肠风穴雷火灸联合亚甲蓝混合液肛周封闭治疗脾虚湿热型慢性肛周湿疹的临床疗效,并探讨其可能的作用机制。【方法】将84例脾虚湿热型慢性肛周湿疹患者随机分为观察组和对照组,每组各42例。2组患者均接受健康宣教和亚甲蓝混合液肛周封闭治疗。对照组给予肛周局部外涂丁酸氢化可的松乳膏治疗,每天2次,连续治疗12周;观察组给予肠风穴雷火灸治疗,每日1次,每周5次,连续治疗12周。治疗12周后,观察2组患者治疗前后肛周瘙痒程度评分、肛周皮损形态及面积评分、皮肤病生活质量指数评分的变化情况,以及血清白细胞介素2(IL-2)、白细胞介素5(IL-5)、白细胞介素10(IL-10)、肿瘤坏死因子α(TNF-α)的水平,并评价2组的临床疗效。【结果】(1)研究过程中,观察组失访1例,对照组失访2例。最终观察组41例、对照组40例纳入疗效统计。(2)治疗后,2组患者肛周瘙痒程度、皮损面积及形态、生活质量指数评分均明显改善(P<0.05),且观察组在改善肛周瘙痒程度、皮损面积及形态、生活质量指数评分方面均明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者血清IL-2、IL-5、IL-10、TNF-α水平均明显改善(P<0.05),且观察组在改善血清IL-2、IL-5、IL-10、TNF-α水平方面均明显优于对照组,差异有统计学意义(P<0.05)。(4)观察组总有效率为90.24%(37/41),对照组为75.00%(30/40)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。【结论】肠风穴雷火灸联合亚甲蓝混合液肛周封闭治疗脾虚湿热型慢性肛周湿疹,能明显改善患者的临床症状,提高其生活质量,其作用机制可能与降低血清IL-5、IL-10、TNF-α水平,提高血清IL-2水平有关。Objective To observe the clinical effect of moxibustion with immediate effect at Changfeng points combined with methylene blue mixed liquid perianal sealing for the treatment of chronic perianal eczema of spleen deficiency and damp heat type,and to explore its possible mechanism. Methods Eighty-four patients with chronic perianal eczema of spleen deficiency and damp heat type were randomly divided into observation group and control group,42 cases in each group. All patients in the two groups received health education and methylene blue mixed perianal sealing treatment, additionally, the control group received perianal external use of hydrocortisone butyrate cream, twice a day, for 12 continuous weeks, and the observation group received moxibustion with immediate effect at Changfeng points,once a day,5 times a week,for 12 continuous weeks. After 12 weeks of treatment,the changes in perianal pruritus degree scores,shape and area scores of perianal skin lesions,skin disease quality of life index scores,and the serum levels of interleukin(IL)-2,IL-5,IL-10,tumor necrosis factor α(TNF-α)were observed in the two groups before and after treatment, and the clinical efficacy was evaluated. Results(1)During the trial,one case was lost to follow-up from the observation group,and 2 cases from the control group. Finally,41 cases in the observation group and 40 cases in the control group were included in the curative effect statistics.(2)After treatment, the scores of perianal pruritus degree, area and shape of perianal skin lesions,and quality of life index in the two groups were significantly improved(P<0.05),and the improvement in scores of perianal pruritus degree,area and shape of perianal skin lesions and quality of life index in the observation group was significantly superior to that of the control group(P<0.05).(3)After treatment,the serum levels of IL-2,IL-5,IL-10 and TNF-α in the two groups were significantly improved(P<0.05),and the improvement in serum levels of IL-2,IL-5,IL-10 and TNF-α of the observation grou

关 键 词：雷火灸 慢性肛周湿疹 脾虚湿热型 肠风穴 亚甲蓝 炎症因子 

分 类 号：R246.9[医药卫生—针灸推拿学]