龙牡加味汤治疗中重度特应性皮炎风湿蕴热证31例临床观察  

Longmu Jiawei Decoction(龙牡加味汤) for Moderate to Severe Atopic Dermatitis with Heat Accumulation due to Wind-damp Syndrome:A31 Cases Observation

作　　者：迟慧彦[1] 毛超一[2] 王泰一 马玉玲[3] 黄尧洲[1] 姚春海[1] 陈少君[1] 田凤艳[1] 郎娜[1] CHI Huiyan;MAO Chaoyi;WANG Taiyi;MA Yuling;HUANG Yaozhou;YAO Chunhai;CHEN Shaojun;TIAN Fengyan;LANG Na(Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing,100091;China Academy of Chinese Medical Sciences;Center of Traditional Chinese Medicine,University of Oxford)

机构地区：[1]中国中医科学院西苑医院,北京市海淀区100091 [2]中国中医科学院 [3]牛津大学中医药研究中心

出　　处：《中医杂志》2021年第18期1617-1621,共5页Journal of Traditional Chinese Medicine

基　　金：中国中医科学院西苑医院苗圃基金(2019XYMP-01)。

摘　　要：目的观察龙牡加味汤治疗中重度特应性皮炎(AD)风湿蕴热证的临床疗效及安全性。方法64敷,对照组给予氯雷他定口服加糖皮质激素外用。两组疗程均为8周。观察两组患者治疗前后的AD指数(SCORAD)评分(包括皮疹面积、皮疹严重程度、瘙痒指数与睡眠干扰度),判定临床疗效;对临床痊愈及显效患者随访2个月观察其复发情况;并记录两组患者不良反应。结果治疗组脱落1例,对照组脱落2例。治疗组31例中临床痊愈1例,显效12例,有效15例,无效3例,总有效率90.32%;对照组30例中临床痊愈0.05)。两组患者治疗后皮疹面积、皮疹严重程度、瘙痒指数与睡眠干扰度评分及SCORDA总积分均较本组治疗前显著降低(P<0.05),且治疗后治疗组患者SCORAD总积分、皮疹面积和皮疹严重度评分均显著低于对照组(P<0.05)。治疗组临床痊愈及显效患者共13例,其中复发2例(15.38%),对照组9例患者中复论龙牡加味汤在治疗中重度特应性皮炎风湿蕴热证有较好的临床疗效,可明显降低复发率,且安全性好。Objective To explore the clinical effectiveness and safety of Longmu Jiawei Decoction(龙牡加味汤,LJD)in the treatment of moderate to severe atopic dermatitis(AD)with heat accumulation due to wind-damp(HAW)syndrome.Methods Sixty-four moderate to severe AD patients with HAW syndrome were randomly divided into treatment group and control group,each with 32 cases.The treatment group was given oral administration and hydropathic cold compress of LJD,while the control group was treated with oral loratadine and external application of glucocorticoid;the course of treatment was 8 weeks.The scoring atopic dermatitis(SCORAD)tool was used to assess the rash area,severity,itching index and sleep disturbance,and the clinical effect was evaluated;the cured and markedly effective cases were followed up for 2 months to assess the recurrence rate;adverse reactions of both groups were recorded.Results There was one drop-off in the treatment group and two in the control group.Of the 31 cases in the treatment group,one case was cured;12 cases were markedly effective;15 cases were effective;and 3 cases were ineffective;the total effective rate was 90.32%.Of the 30 cases in the control group,no cases were cured,9 cases were markedly effective;14 cases were effective,and 7 cases were ineffective,with a effective rate of 76.67%.There was significant difference between groups in the total effective rate(P<0.05).The scores of rash area,rash severity,itching index,sleep disturbance and the total SCORDA score significantly decreased after treatment in both groups(P<0.05),and more decreases were seen in the treatment group than in the control group in terms of total SCORAD and the scores of rash area and rash severity(P<0.05).Two out of 13(15.38%)cured and markedly effective cases in the treatment group recurred,and there were five out of nine(55.56%)recurrence in the control group,with significant differences between groups(P<0.05).No significant adverse reactions were found in both groups.Conclusion LJD has effects on moderate to seve

关 键 词：特应性皮炎 风湿蕴热证 龙牡加味汤 复发率 皮疹 瘙痒 

分 类 号：R275.9[医药卫生—中西医结合]