翘荷汤合泻黄散加减治疗湿热蕴结证痤疮的临床观察  

Modified Qiaohetang and Xiehuangsan in Treatment of Acne Due to Dampness-heat Accumulation

作　　者：杨彩瑞 薛思思 周瑞荣 曾雯芳 周湘 田子琦 成秀梅 YANG Cai-rui;XUE Si-si;ZHOU Rui-rong;ZENG Wen-fang;ZHOU Xiang;TIAN Zi-qi;CHENG Xiu-mei(Graduate School of Hebei University of Chinese Medicine,Shijiazhuang 050200,China;School of Integrated Traditional Chinese and Western Medicine,Hebei University of Chinese Medicine,Shijiazhuang 050200,China;Traditional Chinese Hall,Hebei University of Chinese Medicine,Shijiazhuang 050200,China)

机构地区：[1]河北中医学院研究生院,石家庄050200 [2]河北中医学院中西医结合学院,石家庄050200 [3]河北中医学院国医堂,石家庄050200

出　　处：《中国实验方剂学杂志》2021年第22期119-124,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：河北省中医药管理局科研计划项目(2020151)。

摘　　要：目的:观察翘荷汤合泻黄散加减治疗湿热蕴结证痤疮的临床疗效及对炎症因子和性激素水平的影响。方法:将168例符合要求的患者,按随机数字表法分为观察组和对照组各84例。两组患者均外用阿达帕林凝胶,1次/d。对照组口服金花消痤丸,4 g/次,3次/d。观察组口服翘荷汤合泻黄散加减,1剂/d。两组疗程均为8周。进行治疗前后综合痤疮分级系统(GAGS)评分、皮损计数、湿热蕴结证评分和皮肤病生活质量指数量表(DLQI)评分;检测治疗前后白细胞介素-8(IL-8),IL^(-1)0,IL^(-1)7和干扰素-γ(IFN-γ),游离睾酮(FT),雌二醇(E2)和性激素结合球蛋白(SHBG)水平;进行安全性评价。结果:治疗后观察组GAGS,湿热蕴结证和DLQI评分均低于对照组(P<0.01);观察组炎性皮损(丘疹、脓疱)数、非炎性皮损数和总皮损数均低于对照组(P<0.01);观察组IL-8,IL^(-1)7和IFN-γ水平均低于对照组(P<0.01),IL^(-1)0水平高于对照组(P<0.01);观察组患者E2和SHBG水平均高于对照组(P<0.01),FT水平低于对照组(P<0.05);观察组疾病疗效总有效率为93.67%(74/79),高于对照组的81.82%(63/77)(χ^(2)=5.121,P<0.05);观察组中医证候疗效总有效率为92.41%(73/79),高于对照组的79.22%(61/77)(χ^(2)=5.595,P<0.05);本研究未发现与服用中药相关的不良反应。结论:翘荷汤合泻黄散加减联合阿达帕林凝胶治疗痤疮湿热蕴结证患者可减少皮损数目,减轻皮损严重程度,改善中医症状,提高了生活质量,并能调节痤疮炎症反应和性激素,疾病疗效和中医证候疗效均显著,且安全。Objective:To observe the clinical efficacy of modified Qiaohetang and Xiehuangsan in the treatment of acne due to dampness-heat accumulation and its influence on the levels of inflammatory factors and sex hormones. Method: One hundred and sixty-eight eligible patients were divided into an observation group(84 cases)and a control group(84 cases)according to the random number table. Adapalene gel was applied externally in both groups,one time per day. In the control group,Jinhua Xiaocuo pills was taken orally,4 g per time,three times a day. In the observation group,the modified Qiaohetang and Xiehuangsan was provided for oral administration,one bag per day. The treatment lasted for eight weeks. The Global Acne Grading System(GAGS)score,skin lesion count,dampness-heat accumulation syndrome score,and Dermatology Life Quality Index(DLQI)score were recorded before and after treatment,followed by the detection of interleukin-8(IL-8),IL^(-1)0,IL^(-1)7,interferon-γ(IFN-γ),free testosterone(FT),estradiol(E2)and sex hormone binding globulin(SHBG)before and after treatment as well as the safety evaluation. Result: The GAGS,dampnessheat accumulation syndrome,and DLQI scores of the observation group were lower than those of the control group(P<0.01). The counts of inflammatory skin lesions(papule and pustule),non-inflammatory skin lesions,and total skin lesions in the observation group declined in contrast to those in the control group(P<0.01). The IL-8,IL^(-1)7,IFN-γ and FT levels of the observation group were decreased as compared with those of the control group(P<0.05,P<0.01),while the IL^(-1)0,E2,and SHBG levels were increased(P<0.01). The overall response rate in clinical symptom alleviation of the observation group was 93.67%(74/79),which was higher than81.82%(63/77) of the control group (χ^(2)=5.121, P<0.05). The overall response rate in dampness-heat accumulation syndrome relief of the observation group was 92.41%(73/79),still higher than 79.22%(61/77)of the control group(χ^(2)=5.595,P<0.05). No adverse reactions

关 键 词：痤疮 湿热蕴结证 翘荷汤 泻黄散 炎症反应 性激素 

分 类 号：R289[医药卫生—方剂学] R75[医药卫生—中药学]