利湿解毒止痒汤联合地奈德乳膏治疗湿热浸淫型小儿湿疹临床疗效及复发因素分析  

Clinical Effect of Lishi Jiedu Zhiyang Decoction Combined with Desonide Cream for Children with Eczema of Damp-Heat Immersion Type and Its Analysis of Recurrence Factors

作　　者：陈鲜玉 吴婵丹 胡晶晶 CHEN Xianyu;WU Chandan;HU Jingjing(Department of Dermatology,Yongkang Hospital of Traditional Chinese Medicine,Yongkang Zhejiang 321300,China)

机构地区：[1]永康市中医院皮肤科,浙江永康321300

出　　处：《新中医》2023年第19期130-135,共6页New Chinese Medicine

摘　　要：目的:观察利湿解毒止痒汤联合地奈德乳膏治疗湿热浸淫型小儿湿疹的临床疗效及复发因素分析。方法:采用随机数字表法将154例湿热浸淫型湿疹小儿患者分为治疗组与对照组各77例。对照组给予地奈德乳膏治疗,治疗组给予利湿解毒止痒汤联合地奈德乳膏治疗。比较2组临床疗效及治疗前后瘙痒程度评分、湿疹面积及严重度指数(EASI)评分、中医证候积分及血清炎症因子水平。随访6个月,比较2组复发情况及分析患儿湿疹复发的影响因素。结果:治疗组总有效率高于对照组(P<0.05)。2组治疗后瘙痒程度评分、EASI评分、中医证候积分及血清超敏C-反应蛋白(hs-CRP)、白细胞介素-10(IL-10)、白细胞介素-4(IL-4)水平均低于治疗前(P<0.05),且治疗组治疗后瘙痒程度评分、EASI评分、中医证候积分及血清炎症因子水平均低于对照组(P<0.05)。随访6个月后,有4例患儿失联,最终纳入133例,其中有59例复发(复发组),74例未复发(未复发组)。单因素分析结果显示,性别、病程、发病半年内购买新家具/新装修、家中有宠物、居住环境有烟草/粉尘暴露不影响湿疹复发(P>0.05);年龄、既往有过敏史、治疗方式、卧室使用油漆等材料、hs-CRP、IL-10、IL-4水平影响湿疹复发(P<0.05)。多因素分析结果显示,既往有过敏史、治疗方式、卧室使用油漆等材料、IL-4均为影响患儿湿疹复发的独立影响因素(P<0.05),治疗方式为保护性因素,既往有过敏史、卧室使用油漆等材料、IL-4水平为危险性因素。结论:利湿解毒止痒汤联合地奈德乳膏治疗湿热浸淫型小儿湿疹疗效确切,能有效抑制患儿炎性反应,改善患儿症状。既往过敏史、卧室使用油漆等材料、IL-4水平是影响患儿湿疹复发的独立危险因素,注意防护。Objective:To observe the clinical effect of Lishi Jiedu Zhiyang Decoction combined with Desonide Cream for eczema in children of damp-heat immersion type and analyze the influencing factors.Methods:A total of 154 cases of children with eczema of damp-heat immersion type were divided into the treatment group and the control group according to the random number table method,with 77 cases in each group.The control group was treated with Desonide Cream,and the treatment group was treated with Lishi Jiedu Zhiyang Decoction combined with Desonide Cream.The scores of itching degree and Eczema Area and Severity Index(EASI),traditional Chinese medicine syndrome(TCM) scores,and levels of inflammatory factors in serum before and after treatment,as well as the clinical effects were compared between the two groups.After six-month follow-up,the recurrence were compared between the two groups,and the influencing factors of eczema recurrence in children were analyzed.Results:The total effective rate in the treatment group was higher than that in the control group(P<0.05).After treatment,the itching degree scores,EASI scores,TCM syndrome scores,and the levels of high-sensitivity C-reactive protein(hs-CRP),interleukin 10(IL-10) and interleukin 4(IL-4) in serum in the two groups were lower than those before treatment(P<0.05),and the itching degree score,EASI score,TCM syndrome score,and levels of inflammatory factors in serum in the treatment group were lower than those in the control group(P<0.05).After six-month follow-up,4 children lost contact and ultimately 133 cases were included.Among them,59 cases recurred(the recurrence group) and 74 cases did not recur(the nonrecurrence group).The results of univariate analysis showed that gender,disease duration,purchasing new furniture or decoration within six months of onset,having pets at home,and exposure to tobacco or dust in the living environment do not affect the recurrence of eczema(P>0.05);age,previous allergic history,treatment methods,use of materials such as paint in the bed

关 键 词：湿疹 湿热浸淫型 小儿 利湿解毒止痒汤 地奈德乳膏 炎症因子 复发 影响因素 

分 类 号：R249.8[医药卫生—中医临床基础]