火针配合针刺治疗小腿斑块状银屑病的效果观察  

Curative effect of fire acupuncture combined with acupuncture in the treatment of lower leg plaque psoriasis

作　　者：殷文浩 金梦祝 戴晴 YIN Wen-hao;JIN Meng-zhu;DAI Qing(Department of Dermatology,the First Hospital of Jiaxing,Jiaxing,Zhejiang 314001,China;不详)

机构地区：[1]嘉兴市第一医院皮肤科,浙江嘉兴314001 [2]嘉兴市第一医院针灸科

出　　处：《中华全科医学》2022年第1期117-120,共4页Chinese Journal of General Practice

基　　金：浙江省中医药科技计划项目(2015ZB114);浙江省嘉兴市科技计划项目(2019AD32242);嘉兴市中医药重点学科项目(中西医结合皮肤病与性病学)。

摘　　要：目的观察火针配合针刺治疗小腿斑块状银屑病的疗效及患者治疗前后血管内皮抑制素(ES)、血管抑制素(AS)水平的变化。方法选择2019年5月-2020年4月嘉兴市第一医院收治的105例小腿斑块状银屑病患者,采用随机数字表法分为常规治疗组、火针组及联合治疗组,每组35例。常规治疗组采用局部涂擦哈西奈德乳膏联合窄谱中波紫外线(NB-UVB)照射治疗,火针组采用火针配合针刺治疗,联合治疗组同时采用上述2组的治疗方案,3组疗程均为8周。通过银屑病皮损面积和严重程度指数(PASI)评分评价疗效,并检测治疗前及治疗4、8周血清ES、AS水平。结果治疗8周3组PASI评分均较治疗前下降(均P<0.05),治疗8周常规治疗组与火针组PASI评分比较差异无统计学意义(P>0.05),联合治疗组PASI评分低于常规治疗组与火针组(均P<0.05)。常规治疗组总有效率(54.29%)与火针组(60.00%)比较差异无统计学意义(P>0.05),联合治疗组总有效率(85.71%)高于常规治疗组与火针组(均P<0.05)。3组治疗后血清ES、AS水平均随时间推移呈上升趋势(均P<0.05),治疗4周联合治疗组血清ES水平高于常规治疗组与火针组(均P<0.05),治疗8周联合治疗组血清AS水平高于常规治疗组与火针组(均P<0.05)。结论火针配合针刺治疗小腿斑块状银屑病疗效与常规治疗相当,联合治疗可提高疗效,其作用机制可能与升高ES、AS水平,抑制血管新生有关。Objective To observe the clinical efficacy of fire acupuncture combined with acupuncture in the treatment of lower leg plaque psoriasis and the changes of endostatin(ES)and angiostatin(AS)levels before and after treatment.Methods A total of 105 patients with lower leg plaque psoriasis treated in the First Hospital of Jiaxing from May 2019 to April 2020 were selected and randomly divided into the conventional treatment group,fire acupuncture group and combined treatment group,with 35 cases in each group.The conventional treatment group was treated with external application of halcinonide cream combined with NB-UVB irradiation,the fire acupuncture group was treated with fire acupuncture combined with acupuncture,and the combined treatment group was treated with the above-mentioned treatments simultaneously.All the three groups were treated for 8 weeks.The clinical efficacy was evaluated by PASI score,and the serum levels of ES and AS were detected before treatment and 4 and 8 weeks after treatment.Results The PASI scores of the three groups decreased after 8 weeks of treatment(all P<0.05).After treatment,no significant difference in PASI score was found between the conventional treatment group and fire acupuncture group(P>0.05),but the PASI score of the combined treatment group was lower than that of the conventional treatment group and the fire acupuncture group(all P<0.05).In addition,no significant difference in the total effective rate was found between the conventional treatment group(54.29%)and fire acupuncture group(60.00%,P>0.05).The total effective rate of the combined treatment group(85.71%)was higher than that of the conventional treatment group and fire acupuncture group(all P<0.05).The serum levels of ES and AS in the three groups increased with time(all P<0.05).The serum ES level of the combined treatment group was higher than that of the conventional treatment group and fire acupuncture group after 4 weeks of treatment(all P<0.05),and the serum AS level of the combined treatment group after 8 weeks o

关 键 词：斑块状银屑病 小腿 火针 针刺 血管内皮抑制素 血管抑制素 

分 类 号：R758.63[医药卫生—皮肤病学与性病学] R245.316[医药卫生—临床医学]