益肾固本汤联合西替利嗪治疗荨麻疹的疗效及机制  

Efficacy of Yishen Guben Decoction combined with cetirizine in the treatment of chronic urticaria and its mechanism

作　　者：金震[1] 胡军[2] 牛朝志 JIN Zhen;HU Jun;NIU Chaozhi(Department of Dermatology,Anqing Traditional Chinese Medicine Hospital,Anqing 246004,China;Department of Dermatology,Anqing Municipal Hospital,Anqing 246000,China;Department of Dermatology,Anqing 116 Hospital,Anqing 246003,China)

机构地区：[1]安庆市中医医院皮肤科,安庆246004 [2]安庆市立医院皮肤科,安庆246000 [3]安庆116医院皮肤科,安庆246003

出　　处：《西北药学杂志》2023年第3期151-155,共5页Northwest Pharmaceutical Journal

基　　金：国家中医药管理局中医药传承与创新项目(国中医药人教发[2017]9号)。

摘　　要：目的 探讨益肾固本汤联合西替利嗪治疗慢性荨麻疹(chronic urticaria,CU)的疗效,并探讨其可能的作用机制。方法 将86例CU患者随机分为对照组(n=43)与观察组(n=43)。对照组口服盐酸西替利嗪片,观察组在对照组治疗的基础上加服益肾固本汤,2组均连续用药4周。比较2组的疗效和安全性及治疗前后2组的7 d荨麻疹活动度(the 7-day urticaria activity score,UAS7)评分、皮损症状总积分(total lesion symptom score,TSS)、表虚症积分和慢性荨麻疹生活质量量表(chronic urticaria quality of life scale,CU-Q2oL)评分,并测定血清补体C3、血清补体C4和白细胞介素-4(interleukin-4,IL-4)、干扰素-γ(interferon-γ,IFN-γ)水平,随访2组治疗后UAS7<7分者3个月后的复发情况。结果 观察组总有效率(95.00%)显著高于对照组(78.05%),P<0.05。治疗后,观察组UAS7评分、TSS评分、表虚症积分和CU-Q2oL评分显著低于对照组(P<0.05)。观察组血清C3、C4及IFN-γ显著高于对照组(P<0.05),IL-4水平显著低于对照组(P<0.05)。观察组复发率(17.24%)显著低于对照组(45.00%),P<0.05。2组不良反应发生率比较差异无统计学意义(P>0.05),且治疗前后血常规、肝肾功能等均无明显异常。结论 益肾固本汤联合西替利嗪治疗CU可提高疗效,能明显缓解症状,改善患者的生活质量,降低复发率,其作用机制可能与调节C3、C4、IFN-γ和IL-4水平有关。Objective To investigate the effect of Yishen Guben Decoction combined with cetirizine in the treatment of chronic urticaria(CU),and explore the possible mechanism of action.Methods A total of 86 patients with CU were randomly divided into control group(n=43)and observation group(n=43).The control group were treated with Cetirizine Hydrochloride Tablets,and the observation group were treated with Yishen Guben Decoction on the basis of the control group.The both groups were treated for 4 weeks.The efficacy and safety of the 2 groups were compared.The 7-day urticaria activity score(UAS7),total lesion symptom score(TSS),surface deficiency score and chronic urticaria quality of life scale(CU-Q2oL)score were performed before and after treatment,and the serum complement C3,C4,interleukin-4(IL-4)and interferon-γ(IFN-γ)were measured.The recurrence of patients with UAS7<7 in the 2 groups was followed up for 3 months.Results The total effective rate of the observation group was 95.00%,which was significantly higher than 78.05%of the control group(P<0.05).After treatment,the UAS7,TSS score,superficial deficiency score and CU-Q2oL score in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the serum C3,C4 and IFN-γlevels in observation group were significantly higher than those in control group(P<0.05),and the IL-4 levels were significantly lower than those in control group(P<0.05).The recurrence rate of the observation group was 17.24%,which was significantly lower than 45.00%of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the 2 groups(P>0.05),and there was no obvious abnormality in blood routine,liver and kidney function before and after treatment.Conclusion Yishen Guben Decoction combined with cetirizine in the treatment of CU can improve the efficacy,relieve symptoms,improve the quality of life of patients,and reduce the recurrence rate.The mechanism may be related to the regulation of C3,C4,IFN-γand IL-

关 键 词：慢性荨麻疹 益肾固本汤 西替利嗪 补体 白细胞介素-4 干扰素-Γ 

分 类 号：R976[医药卫生—药品]