健脾清湿汤联合舒耳膏耳部透药治疗外耳湿疹脾虚湿热证的疗效及对TNF-α、IL-4、IgE的影响  

Efficacy of Jianpi Qingshi Decoction combined with Shuer Ointment ear penetration therapy in the treatment of external ear eczema with spleen deficiency and damp-heat syndrome and its effect on TNF-α,IL-4 and IgE

作　　者：张康洁 孙麦青[2] 曹会云 张甜甜 夏雪园 王萌萌[1] ZHANG Kangjie;SUN Maiqing;CAO Huiyun;ZHANG Tiantian;XIA Xueyuan;WANG Mengmeng(The Second Clinical Medical College,Henan University of Chinese Medicine,Zhengzhou,Henan 450046,China;Henan Province Hospital of TCM,Zhengzhou,Henan 450002,China)

机构地区：[1]河南中医药大学第二临床医学院,河南郑州450046 [2]河南省中医院,河南郑州450002

出　　处：《湖南中医药大学学报》2022年第8期1371-1375,共5页Journal of Hunan University of Chinese Medicine

基　　金：河南省中医药科学研究专项课题(2018ZY2093)。

摘　　要：目的探讨健脾清湿汤联合舒耳膏耳部透药治疗外耳湿疹脾虚湿热证的疗效及对血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-4(interleukin-4,IL-4)及免疫球蛋白E(immunoglobulin E,IgE)的影响。方法将120例外耳湿疹脾虚湿热证患者随机分为观察组和对照组,每组60例。对照组给予氯雷他定口服联合糠酸莫米松乳膏外用治疗,观察组内服健脾清湿汤联合舒耳膏耳部透药治疗,7 d为1个疗程,均连续治疗2个疗程。观察且比较两组患者治疗前后的临床疗效、中医证候积分变化,检测血清TNF-α、IL-4、IgE的表达水平。治疗后随访3个月,计算复发率。结果观察组总有效率为91.67%,对照组总有效率为80.00%,观察组总有效率优于对照组(P<0.05)。治疗后,观察组各中医证候积分较治疗前均有降低(P<0.05),且低于对照组(P<0.05);观察组血清TNF-α、IL-4、IgE含量较治疗前均降低(P<0.05),且低于对照组(P<0.05)。观察组复发率低于对照组(P<0.05)。结论健脾清湿汤联合舒耳膏耳部透药治疗外耳湿疹脾虚湿热证疗效显著,并可降低患者血清TNF-α、IL-4、IgE水平,降低外耳湿疹复发率,提高远期疗效。Objective To investigate the effect of Jianpi Qingshi Decoction combined with Shuer Ointment ear penetration therapy in the treatment of external ear eczema with spleen deficiency and damp-heat syndrome and its effect on serum levels of tumor necrosis factor-α(TNF-α),interleukin-4(IL-4),immunoglobulin E(IgE).Methods A total of 120 patients with external ear eczema with spleen deficiency and damp-heat syndrome were randomly divided into the observation group and the control group,with 60 cases in each group.The control group was treated with loratadine tablets orally and mometasone furoate cream,the observation group was treated with Jianpi Qingshi Decoction combined with Shuer Ointment ear penetration therapy.There were two courses of treatment,7 d per course.The clinical efficacy and TCM syndrome score were observed and compared between the two groups before and after treatment,and the expression levels of serum TNF-α,IL-4 and IgE were detected.The recurrence rate was calculated after 3 months of follow-up.Results The total effective rate of the observation group was 91.67%,and that of the control group was 80.00%.The total effective rate of the observation group was better than that of the control group(P<0.05).After treatment,TCM syndrome score of observation group were lower than those before treatment(P<0.05),and lower than those of the control group(P<0.05).The content of serum TNF-α,IL-4,IgE in the observation group was significantly lower than those before treatment(P<0.05),and lower than those in the control group(P<0.05).The recurrence rate of observation group was lower than that of control group(P<0.05).Conclusion Jianpi Qingshi Decoction combined with Shuer Ointment ear penetration therapy is clearly effective in treating the external ear eczema with spleen deficiency and damp-heat syndrome and can reduce the levels of TNF-α,IL-4,IgE,reduce the recurrence rate of external ear eczema,and improve the long-term efficacy.

关 键 词：外耳湿疹 脾虚湿热证 健脾清湿汤 舒耳膏 耳部透药 血清学指标 复发率 

分 类 号：R276.1[医药卫生—中医五官科学]