四逆散加减治疗寻常型痤疮的临床研究  

Clinical Study on the Treatment of Acne Vulgaris with Sini Powder (四逆散)

作　　者：谢明峰[1] 曾洁 邓羿駃 XIE Mingfeng;ZENG Jie;DENG Yijue(The First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha Hunan 410007,China)

机构地区：[1]湖南中医药大学第一附属医院,湖南长沙410007

出　　处：《中医药导报》2023年第7期101-105,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：湖南中医药大学校级基金项目(2018XJJJ46);湖南省科学技术厅创新平台与人才计划(湘科计2020SK4014)。

摘　　要：目的:以“辨体-辨病-辨证”的三辨诊疗模式为基本思路,观察四逆散加减治疗寻常型痤疮(气郁质+痰瘀结聚证)的临床疗效。方法:参照体质辨识及中医证候诊断标准,选取临床中符合气郁质+痰瘀结聚证的108例寻常型痤疮患者,根据随机数字表法分为对照组和治疗组,每组54例。对照组患者予海藻玉壶汤治疗,治疗组患者予四逆散加减治疗,评估患者中医证候积分、皮损评分、抑郁和焦虑评分、复发率及不良反应,并判定临床疗效。结果:对照组中医证候疗效总有效率为79.63%(43/54),治疗组中医证候疗效总有效率为94.44%(51/54),治疗组中医证候疗效总有效率高于对照组(P<0.05)。对照组皮损疗效总有效率为77.78%(42/54),治疗组皮损疗效总有效率为92.59%(50/54),治疗组皮损疗效总有效率优于对照组(P<0.05)。两组患者治疗后中医证候积分、皮损评分均低于治疗前(P<0.01),且治疗组患者治疗后中医证候积分、皮损评分均低于对照组(P<0.05)。两组患者治疗后、随访后抑郁评分、焦虑评分均低于治疗前,且治疗组患者下降幅度显著高于对照组(P<0.05)。对照组复发率为19.05%(8/42),治疗组复发率为4.00%(2/50),治疗组复发率显著低于对照组(P<0.05)。两组患者在治疗及随访过程中,均无相关不良反应发生。结论:基于“辨体-辨病-辨证”三辨诊疗模式在临床中运用四逆散加减治疗寻常型痤疮可提高疗效,降低复发率。Objective:To observe the clinical efficacy Sini powder in on acne vulgaris(qi stagnation and phlegm stasis accumulation syndrome)based on the three differentiation diagnosis and treatment model of"differentiation of body,disease and syndrome".Methods:According to the identification of constitution and diagnostic criteria for Chinese medicine syndromes,108 acne vulgaris patients who met the criteria of qi stagnation and phlegm stasis accumulation in clinical practice were selected and randomly divided into control group and treatment group according to the random number table method,54 cases in each group.The control group was decocted with Haizao Yuhu decoction(海藻玉壶汤),while the treatment group was treated with Sini powder.The Chinese medicine syndrome scores,skin lesion scores,depression and anxiety scores,recurrence rate,and adverse reactions were evaluated.And the clinical efficacy was evaluated.Results:The total effective rate of Chinese medicine syndrome efficacy was 79.63%(43/54)in control group and 94.44%(51/54)in treatment group.The treatment group showed higher total effective rate of Chinese medicine syndrome efficacy than control group(P<0.05).The total effective rate of skin lesion efficacy was 77.78%(42/54)in control group and 92.59%(50/54)in treatment group.The treatment group showed higher total effective rate of skin lesion efficacy than control group(P<0.05).After treatment the two groups showed lower Chinese medicine syndrome scores and skin lesion scores than those before treatment(P<0.01),and the treatment group showed lower Chinese medicine syndrome scores and skin lesion scores than control group after treatment(P<0.05).The depression score and anxiety score of the two groups of patients after treatment and follow-up were lower than before treatment,and the treatment group showed higher decrease that control group(P<0.05).The recurrence rate was 19.05%(8/42)in control group and 4.00%(2/50)in treatment group.The treatment group showed lower recurrence rate than control group(P<0.05).

关 键 词：寻常型痤疮 气郁质 痰瘀结聚证 四逆散加减 海藻玉壶汤 辨体-辨病-辨证 临床研究 

分 类 号：R275.9[医药卫生—中西医结合]