银屑病辩证论治临床研究的中药用药规律及疗效评价分析  

Rules of traditional Chinese medicine treatment and treatment effect evaluation of psoriasis vulgaris in reported articles

作　　者：王瑞平 强燕 李欣[2] 孙晓颖[2] 周蜜[2] 华亮[2] 李斌 WANG Ruiping;QIANG Yan;LI Xin;SUN Xiaoying;ZHOU Mi;HUA Liang;LI Bin(Clinical Research and Innovation Transfer Center,Shanghai Dermatology Hospital,Shanghai 200443,China;Department of Dermatology,Yueyang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海市皮肤病医院临床研究与创新转化中心,上海200443 [2]上海中医药大学附属岳阳中西医结合医院皮肤科,上海200437

出　　处：《世界临床药物》2021年第2期119-126,共8页World Clinical Drug

基　　金：国家重点研发计划“中医药现代化研究”重点专项(2018YFC1705301);国家自然科学基金(81874470);上海市临床重点专科建设项目-中医皮肤病科(shslczdzk05001);上海市体育科技项目(20Q001);上海市申康医院发展中心管理研究项目(2020SKMR-32)。

摘　　要：目的分析银屑病中药治疗临床研究文献,探讨研究特点、临床用药规律和临床综合疗效,为规范开展银屑病临床研究提供参考。方法根据设定的关键词,检索国内外文献期刊数据库,共检索到文献657篇,经评阅纳入259篇文献,摘录文献的发表年份和地区、临床用药及疗效等信息,应用SAS9.2软件进行统计分析。结果 259篇文献包括银屑病血热证189篇(72.97%),银屑病血瘀证92篇(35.52%)和银屑病血虚证48篇(18.53%)。中药治疗银屑病辨证论治使用频率最高5味药分别为赤芍、生地、土茯苓、紫草和丹参(血热证),丹参、红花、桃仁、莪术和鸡血藤(血瘀证),当归、土茯苓、丹参、鸡血藤和生地(血虚证)。不同年份、不同地区银屑病各证型中药辩证治疗规律有所区别,但也存在关联性。血热证治疗4周和8周,试验组痊愈率显著高于对照组[相对危险度(relative risk,RR)分别为1.62和1.61],试验组有效率高于对照组(RR均为1.13);血瘀证治疗4周和8周试验组痊愈率(RR分别为1.39和1.21)及有效率(RR分别为1.58和1.12)均显著高于对照组;血虚证治疗8周试验组痊愈率(RR为1.71)及有效率(RR为1.11)均显著高于对照组。结论银屑病中药辩证治疗以清热凉血、活血化瘀和养血润燥解毒为主,疗效确切。但研究存在不同区域、不同年份之间的差异以及评价时间点不一致等问题,今后需进一步规范研究设计,提高银屑病中医辨证论治疗效评价的规范性和科学性。Objective To explore the feature of clinical trial design,rules of traditional Chinese medicine (TCM) prescription and treatment effect of psoriasis vulgaris based on published papers,and to provide standardized guideline for future randomized clinical trial for psoriasis vulgaris treatment research.Methods A total of 657 published papers on psoriasis vulgaris clinical research were identified and extracted by literature database searching with preset key words,and 259 papers were finally included in final analysis.SAS9.2 was used for data analysis.Results In the 259 papers,189 papers were focused on psoriasis of blood-heat syndrome (72.97%),92 papers were psoriasis of blood stasis syndrome (35.52%) and 48 papers were psoriasis of blood-deficiency syndrome (18.53%).For the 3 types of psoriasis treatment,the top 5 types of TCM herbs were (Radix Paeoniae Rubra,Radix Rehmanniae,Smilax Glabra,Radix Arnebiae and Radix Salviae Miltiorrhizae),(Salvia Miltiorrhiza,Safflower,Peach Kernel,Zedoary Turmeric and Caulis Spatholobus) and (Angelica Sinensis,Smilax Glabra,Radix Salviae Miltiorrhizae,Caulis Spatholobus and Radix Rehmanniae),respectively.And there were different in different study years and study regioins.The cure rate for blood-heat type in treatment group was higher than that in control group after treatment for 4 weeks and 8 weeks[relative risk (RR) were 1.62 and 1.61],and the effect rate for blood-heat type was similar for treatment group and control group (RR was 1.13).The cure rate (RR were 1.39 and 1.21) and effective rate (RR were 1.58 and 1.12) of the experimental group were significantly higher than those of the control group after 4 and 8 weeks of treatment for blood stasis type.The cure rate (RR was 1.71) and effective rate (RR was 1.11) of the experimental group were significantly higher than those of the control group for blood deficiency type.Conclusion The traditional Chinese medicine treatment of psoriasis mainly includes clearing heat and cooling blood,promoting blood circulation and removing bloo

关 键 词：银屑病 中药辩证治疗 用药规律 疗效评价 

分 类 号：R758.63[医药卫生—皮肤病学与性病学] R917[医药卫生—临床医学]