渗湿和里汤内服结合外洗治疗脾虚湿蕴型慢性湿疹的临床研究  

Clinical Study on the Oral Administration and External Washing withShenshi Heli Decoction for the Treatment of Chronic Eczema withSpleen Deficiency and Dampness Accumulation Syndrome

作　　者：李佳凤 吴凡伟 毛妮 LI Jia-Feng;WU Fan-Wei;MAO Ni(Shenzhen Bao’an Traditional Chinese Medicine Hospital Group,Shenzhen 518000 Guangdong,China;The Seventh Clinical Medical School,Guangzhou University of Chinese Medicine,Shenzhen 518000 Guangdong,China)

机构地区：[1]广州中医药大学附属宝安中医院,广东深圳518000 [2]广州中医药大学第七临床医学院,广东深圳518000

出　　处：《广州中医药大学学报》2023年第5期1134-1139,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20182129);深圳市科创委资助项目(编号:JCYJ20180302144457509)。

摘　　要：【目的】探讨渗湿和里汤内服结合外洗治疗脾虚湿蕴型慢性湿疹的临床疗效。【方法】将70例脾虚湿蕴型慢性湿疹患者随机分为治疗组和对照组,每组各35例。治疗组给予渗湿和里汤内服加外洗治疗,对照组给予口服地氯雷他定片加外用糠酸莫米松乳膏治疗,疗程为4周。观察2组患者治疗前后湿疹面积及严重程度指数(EASI)评分、瘙痒程度视觉模拟量表(VAS)评分、皮肤病生活质量指数(DLQI)评分的变化情况,并评价2组患者的临床疗效、复发情况和安全性。【结果】(1)治疗4周后,治疗组的愈显率为85.7%(30/35),对照组为60.0%(21/35),组间比较,治疗组的疗效明显优于对照组(P<0.05)。(2)治疗1周后,2组患者的EASI、VAS、DLQI评分均较治疗前下降,其中DLQI评分差异有统计学意义(P<0.05),而EASI、VAS评分差异均无统计学意义(P>0.05);治疗4周后,2组患者的EASI、VAS、DLQI评分均较治疗前和治疗1周后明显下降(P<0.05);组间比较,治疗组在治疗1周后对DLQI评分及治疗4周后对EASI、VAS、DLQI评分的下降幅度均明显优于对照组(P<0.05或P<0.01)。(3)治疗6周后随访,治疗组的复发率为5.71%(2/35),明显低于对照组的31.4%(11/35),差异有统计学意义(P<0.01)。(4)治疗过程中,2组患者均无明显不良反应发生,具有较高的安全性。【结论】渗湿和里汤内服结合外洗治疗脾虚湿蕴型慢性湿疹疗效确切,可有效缓解患者的临床症状,减少复发情况,其疗效优于口服地氯雷他定片加外用糠酸莫米松乳膏,且无明显不良反应。Objective To investigate the clinical efficacy of oral administration and external washing with Shenshi Heli Decoction(mainly with the actions of draining dampness and harmonizing the interior)for the treatment of chronic eczema with spleen deficiency and dampness accumulation syndrome.Methods Seventy cases of chronic eczema patients with spleen deficiency and dampness accumulation syndrome were randomly divided into the treatment group and the control group,with 35 cases in each group.In the treatment group,the patients were given oral administration and external washing with Shenshi Heli Decoction,while the patients in the control group were given oral administration of Desloratadine Tablets plus external application of Mometasone Furoate Cream for a period of 4 weeks.The changes of eczema area and severity index(EASI)scores,itching visual analogue scale(VAS)scores and dermatology life quality index(DLQI)scores in the two groups were observed before and after treatment.Moreover,the clinical efficacy,recurrence and safety in the two groups were evaluated.Results(1)After 4 weeks of treatment,the cured and markedly effective rate of the treatment group was 85.7%(30/35)and that of the control group was 60.0%(21/35).The intergroup comparison showed that the therapeutic efficacy of the treatment group was significantly superior to that of the control group(P<0.05).(2)After one week of treatment,the EASI,VAS and DLQI scores of patients in both groups were decreased compared with those before treatment,the difference in DLQI scores was statistically significant(P<0.05),while the differences in EASI and VAS scores were not statistically significant(P>0.05).After 4 weeks of treatment,the EASI,VAS and DLQI scores of both groups were significantly decreased compared with those before treatment and after one week of treatment(P<0.05).The intergroup comparison showed that the decrease degree of DLQI scores after one week of treatment and the decrease degree of EASI,VAS and DLQI scores after 4 weeks of treatment in the treatm

关 键 词：慢性湿疹 脾虚湿蕴型 渗湿和里汤 外洗 湿疹面积及严重程度指数(EASI) 皮肤病生活质量指数(DLQI) 

分 类 号：R758.23[医药卫生—皮肤病学与性病学]