清热除湿汤加减联合放血拔罐在急性湿疹皮损治疗中的临床应用  

Clinical Application of Qingre Chushi Decoction Combined with Blood-letting Cupping in the Treatment of Acute Eczema

作　　者：高存志 翁志洁 王岩 杨晓丽[1] GAO Cunzhi;WENG Zhijie;WANG Yan;YANG Xiaoli(Department of Dermatology,Qinhuangdao Hospital of Traditional Chinese Medicine,Qinhuangdao 066000,Hebei,China;Department of Outpatient,Qinhuangdao Hospital of Traditional Chinese Medicine,Qinhuangdao 066000,Hebei,China;Department of Blood Transfusion,Qinhuangdao Hospital of Traditional Chinese Medicine,Qinhuangdao 066000,Hebei,China)

机构地区：[1]秦皇岛市中医医院皮肤科,河北秦皇岛066000 [2]秦皇岛市中医医院门诊部,河北秦皇岛066000 [3]秦皇岛市中医医院输血科,河北秦皇岛066000

出　　处：《中国美容医学》2022年第6期110-114,共5页Chinese Journal of Aesthetic Medicine

基　　金：秦皇岛市科学技术研究与发展计划(编号:202004A114)。

摘　　要：目的:研究清热除湿汤加减联合放血拔罐对急性湿疹皮损疗效及血清T淋巴细胞亚群、Th2相关细胞因子水平的影响。方法:选择秦皇岛市中医医院收治的96例急性湿疹患者作为研究对象,将其随机分为观察组(48例)和对照组(48例)。两组采取常规西医治疗,观察组清热除湿汤联合放血拔罐治疗,对照组放血拔罐治疗。观察两组治疗3周后临床疗效、比较治疗前后CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、IL-4、IL-5、IL-13、IL-31水平。以ROC曲线及非条件Logistic逐步回归分析急性湿疹短期疗效的影响因素。结果:治疗后,两组瘙痒、皮损面积、皮损形态评分均较治疗前降低,且观察组更低(P<0.05);治疗后,观察组CD4^(+)水平高于对照组,CD8^(+)、IL-4、IL-31水平低于对照组(P<0.05);经ROC分析,CD4^(+)、CD8^(+)、IL-4、IL-31预测急性湿疹皮损短期疗效曲线下面积为分别为0.776、0.790、0.819、0.691;经Logistic回归性分析显示CD4^(+)≥34.114%、CD8^(+)<26.825%、IL-4<12.525 pg/ml、IL-31<22.040 pg/ml是治疗湿疹取得较好短期疗效的独立影响因素。结论:清热除湿汤联合放血拔罐治疗湿疹能促进细胞免疫平衡恢复,减轻炎症反应,具有推广价值。Objective To study the effect of Qingre Chushi decoction combined with blood-letting cupping on acute Eczema and the levels of T lymphocyte and TH2 related cytokines.Methods 96 patients with acute eczema in Qinhuangdao Hospital of traditional Chinese medicine were randomly divided into observation group(48 cases)and control group(48 cases).Two groups were treated with conventional Western medicine,observation group was treated with heat-clearing and dampness-removing decoction combined with blood-letting cupping,and control group was treated with blood-letting cupping.The levels of differentiation cluster 3,CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+),IL-4,IL-5,IL-13 and IL-31 were compared before and after treatment.ROC curve and unconditional logistic regression were used to analyze the influencing factors of short-term efficacy of acute eczema.Results After treatment,Pruritus,Lesion area and lesion morphological score in the two groups were lower than those before treatment,and the observation group was lower(P<0.05).The level of CD4^(+)in the observation group was higher than that in the control group,and the levels of CD8^(+),IL-4 and IL-31 in the observation group were lower than those in the control group(P<0.05),ROC analysis showed that the area under the curve of CD4^(+),CD8^(+),IL-4 and IL-31 in predicting the short-term efficacy of acute eczema lesions were 0.776,0.790,0.819 and 0.691,respectively(P<0.05),Logistic regression analysis confirmed that Qingre Chushi decoction combined with bloodletting and cupping can achieve good short-term therapeutic effect.Meanwhile,CD4^(+)≥34.114%,CD8^(+)<26.825%,IL-4<12.525 pg/ml,IL-31<22.040 pg/ml were the independent influencing factors of better short-term efficacy in the treatment of eczema.Conclusion Qingre Chushi decoction combined with bloodletting and cupping in the treatment of eczema can promote the recovery of cellular immune balance and reduce the inflammatory reaction,which has promotion value.

关 键 词：急性湿疹 清热除湿汤 放血拔罐 免疫细胞 炎性因子 

分 类 号：R758.23[医药卫生—皮肤病学与性病学]