麻黄细辛附子汤结合针灸治疗局限性硬皮病的临床疗效  

Clinical Effect of Mahuang Xixin Fuzitang Combined with Acupuncture and Moxibustion in Treatment of Localized Scleroderma

作　　者：万彬彬[1] 肖卫红[1] 胡刚明[2] 邹亮[1] WAN Binbin;XIAO Weihong;HU Gangming;ZOU Liang(Wuhan No.1 Hospital,Wuhan 430022,China;Hanchuan People's Hospital/Hanchuan Hospital of Wuhan University People's Hospital,Hanchuan 431600,China)

机构地区：[1]武汉市第一医院,武汉430022 [2]汉川市人民医院/武汉大学人民医院汉川医院,湖北汉川431600

出　　处：《中国实验方剂学杂志》2022年第18期93-98,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金青年科学基金项目(81700142)。

摘　　要：目的观察麻黄细辛附子汤结合针灸治疗局限性硬皮病的临床疗效。方法将2019年9月至2021年10月于武汉市第一医院就诊的95例局限性硬皮病患者通过随机数字表法分为对照组(47例)何观察组(48例),对照组予以积雪苷片、肝素钠软膏治疗,观察组以积雪苷片、肝素钠软膏+麻黄细辛附子汤结合针灸治疗,两组患者治疗时间均为8周。观察两组患者临床治疗疗效、治疗前后中医证候(局部皮肤硬化、皮肤纹路消失、皮损色素加深、肌肤甲错等)积分、血清可溶性白细胞介素-2α受体(sIL-2R)及肿瘤坏死因子-α(TNF-α)水平变化、血细胞沉降率(ESR)及嗜酸性粒细胞(EO)水平变化、不良反应发生情况。结果治疗8周后,对照组患者总有效率为82.98%(39/47),观察组治疗总有效率为95.83%(46/48),观察组总有效率明显高于对照组,差异具有统计学意义(χ^(2)=4.1664,P<0.05);治疗前,两组患者中医证候(局部皮肤硬化、皮肤纹路消失、皮损色素加深、肌肤甲错等)积分、sIL-2R及TNF-α、ESR、EO水平比较,差异无统计学意义。治疗后,与本组治疗前比较,两组患者中医证候(局部皮肤硬化、皮肤纹路消失、皮损色素加深、肌肤甲错等)积分、sIL-2R及TNF-α、ESR、EO水平均明显改善(P<0.05);与对照组治疗后比较,观察组患者治疗后中医证候(局部皮肤硬化、皮肤纹路消失、皮损色素加深、肌肤甲错等)积分、sIL-2R及TNF-α、ESR、EO水平优于对照组(P<0.05)。治疗期间,观察组出现1例肝功能异常,1例恶心呕吐;对照组出现1例恶心呕吐,1例肾功能异常,1例肝功能异常,观察组(4.17%)与对照组(6.38%)总不良反应比较,差异无统计学意义(χ^(2)=0.2339,P=0.06286)。结论麻黄细辛附子汤结合针灸治疗局限性硬皮病的临床效果显著,治疗安全、可靠。Objective To observe the clinical effect of Mahuang Xixin Fuzitang combined with acupuncture and moxibustion in the treatment of localized scleroderma.Method A total of 95 patients with localized scleroderma treated in Wuhan No.1 Hospital from September 2019 to October 2021 were assigned into a control group(47 patients)and an observation group(48 patients)by random number table method.The control group was treated with Centella triterpenes tablets and heparin sodium cream,and the observation group was additionally treated with Mahuang Xixin Fuzitang combined with acupuncture and moxibustion.Both groups were treated for 8 weeks,and the clinical effect was compared between groups.The traditional Chinese medicine(TCM)syndrome score(local skin sclerosis,loss of skin texture,darkening of skin pigment,scaly dry skin,etc.),serum levels of soluble interleukin-2 receptor(sIL-2R)and tumor necrosis factor-alpha(TNF-α),erythrocyte sedimentation rate(ESR),and eosinophil count(EO)were compared between before and after treatment as well as between groups.Additionally,the adverse reactions were recorded.Result The observation group had higher total effective rate than the control group[95.83%(46/48)vs.82.98%(39/47),χ^(2)=4.1664,P<0.05].Before treatment,the TCM syndrome score,sIL-2R,TNF-α,ESR,and EO showed no significant differences between the two groups.The 8 weeks of treatment improved the TCM syndrome score,sIL-2R,TNF-α,ESR,and EO.Moreover,the observation group was superior to the control group in these indicators(P<0.05).During the treatment,the observation group showed 1 case of abnormal liver function and 1 case of nausea and vomiting,and the control group had 1 case of nausea and vomiting,1 case of abnormal renal function,and 1 case of abnormal liver function.The total adverse reactions of the observation group(4.17%)and the control group(6.38%)had no significant difference(χ^(2)=0.2339,P=0.06286).Conclusion Mahuang Xixin Fuzitang combined with acupuncture and moxibustion is safe and effective in the treatment of lo

关 键 词：局限性硬皮病 麻黄细辛附子汤 针灸 中医证候积分 疗效 不良反应 

分 类 号：R22[医药卫生—中医基础理论] R242[医药卫生—中医学] R2-031R287R593.25