加减龙胆泻肝汤治疗艾滋病皮肤瘙痒湿热内蕴证的疗效及机制研究  

Study on the efficacy and mechanism of modified Longdan Xiegan Decoction in treating AIDS skin pruritus damp-heat syndrome

作　　者：张予晋 王军文[2] 王江蓉[3] 邓玉霞 张毅[4] 刘晶晶[4] 邓晓军 欧松 谭瑶 ZHANG Yujin;WANG Junwen;WANG Jiangrong;DENG Yuxia;ZHANG Yi;LIU Jingjing;DENG Xiaojun;OU Song;TAN Yao(The Second Affiliated Hospital of Hunan University of Chinese Medicine,Changsha,Hunan 410005,China;Hunan University of Chinese Medicine,Changsha,Hunan 410208,China;Shanghai Public Health Clinical Center,Shanghai 200093,China;Sichuan Academy of Traditional Chinese Medicine,Chengdu,Sichuan 610042,China;The Third People's Hospital of Hengyang City,Hengyang,Hunan 421005,China)

机构地区：[1]湖南中医药大学第二附属医院,湖南长沙410005 [2]湖南中医药大学,湖南长沙410208 [3]上海市公共卫生临床中心,上海200093 [4]四川省中医药科学院,四川成都610042 [5]衡阳市第三人民医院,湖南衡阳421005

出　　处：《湖南中医药大学学报》2022年第4期680-684,共5页Journal of Hunan University of Chinese Medicine

基　　金：国家中医药管理局中医药行业科研专项(201507005);湖南省教育厅项目(20C1424);湖南省中医药科研计划项目(2020101)。

摘　　要：目的 探析加减龙胆泻肝汤对艾滋病皮肤瘙痒患者生活质量及血清IgE、嗜酸性粒细胞(EOS)水平的影响,初步观察《艾滋病皮肤瘙痒中医诊疗方案》的疗效,并探讨作用机制。方法 选取艾滋病合并皮肤瘙痒湿热内蕴证患者149例,采取多中心、随机、双盲、双模拟的方法分为观察组(74例)和对照组(75例)。观察组予加减龙胆泻肝汤配方颗粒、氯雷他定胶囊安慰剂、复方甘草酸苷胶囊安慰剂治疗,对照组予氯雷他定胶囊、复方甘草酸苷胶囊、加减龙胆泻肝汤配方颗粒安慰剂治疗,观察治疗前及2周后患者症状体征积分、皮肤生活质量指数(DLQI)评分及血清IgE、EOS水平变化。结果 治疗后,对照组和观察组的症状体征积分、DLQI均较前下降(P<0.05),观察组的症状体征积分、DLQI均低于对照组(P<0.05)。两组血清IgE、EOS水平均较治疗前有所下降(P<0.05),且观察组下降水平优于对照组(P<0.05)。结论 诊疗方案中加减龙胆泻肝汤可以改善艾滋病伴瘙痒性丘疹患者瘙痒、皮损等症状体征,提升患者生活质量,其作用机制可能与降低EOS计数及血清IgE水平有关。Objective To explore the effect of modified Longdan Xiegan Decoction on the quality of life and serum IgE and eosinophil(EOS) levels in patients with AIDS skin pruritus,and preliminarily verify the efficacy and mechanism of TCM Diagnosis and Treatment Plan for AIDS Skin Pruritus.Methods 149 cases of AIDS complicated with skin pruritus damp-heat syndrome were divided into treatment group(74 cases) and control group(75 cases) by multicenter,random,double-blind and double simulation method.The treatment group was treated with modified Longdan Xiegan Decoction formula granule,loratadine capsule placebo and compound glycyrrhizin capsule placebo,the control group was treated with loratadine capsule,compound glycyrrhizin capsule and modified Longdan Xiegan Decoction formula granule placebo.Symptom and sign scores,dermatology life quality index(DLQI) score,serum IgE and EOS levels were observed before and 2 weeks after treatment.Results After treatment,the symptom and sign scores and DLQI of the control group and the treatment group were lower than before treatment(P<0.05),and the symptom and sign scores and DLQI of the treatment group were lower than those of the control group(P<0.05).The levels of serum IgE and EOS in the two groups were lower than those before treatment(P<0.05),while the decrease was more obvious in the treatment group than control group(P<0.05).Conclusion Modified Longdan Xiegan Decoction in the diagnosis and treatment plan can improve the symptoms and signs such as pruritus and skin lesions of AIDS patients with pruritus papules,and improve the quality of life of patients.Its mechanism may be related to reducing the eosinophil count and serum IgE level.

关 键 词：艾滋病 皮肤瘙痒 加减龙胆泻肝汤 皮肤生活质量指数 IgE 嗜酸性粒细胞 临床观察 

分 类 号：R269[医药卫生—中西医结合]