自拟清痘汤联合改良颠倒散对女性痤疮的疗效及机制研究  

A Study on the Efficacy and Mechanism of Self-prepared Qingdou Decoction Combined with Modified Diandao Powder in Treating Female Acne

作　　者：季真伟 张梅 何明 王兰 贾敏 唐挺 Ji Zhenwei;Zhang Mei;He Ming;Wang Lan;Jia Min;Tang Ting(Guizhou University of Traditional Chinese Medicine,Guiyang 550002,Guizhou China;The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine,Guiyang 550001,Guizhou,China)

机构地区：[1]贵州中医药大学,贵州贵阳550002 [2]贵州中医药大学第一附属医院,贵州贵阳550001

出　　处：《贵州中医药大学学报》2024年第1期43-49,共7页Journal of Guizhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目,项目编号:82360929;国家中医药管理局-贾敏全国名老中医药专家传承工作室项目,项目编号:国中医药人教函[2022]75号;国家中医药管理局-中医优势专科建设项目,项目编号:黔中医药函[2023]2号;贵州省科学技术厅科学技术基金资助项目,项目编号:黔科合基础-ZK[2021]一般511;贵阳中医一附院新进博士启动基金,项目编号:20210601。

摘　　要：目的:观察自拟清痘汤联合改良颠倒散对女性热毒蕴肤兼脾虚饮停、气血失和型痤疮的疗效及对月经期血清脱氢表雄酮(DHEA)、硫酸脱氢表雄酮(DHEA-S)、人胰岛素生长因子-1(IGF-1)的影响。方法:采用单臂试验设计,选取2021年3月—2022年2月就诊的女性寻常痤疮患者36例作为试验组,予自拟清痘汤内服联合改良颠倒散外用,疗程为4周,比较试验组治疗前后月经期血清DHEA、DHEA-S、IGF-1的水平、皮损症状积分及中医证候积分。另选取10例健康女性作为血清对照组,与试验组治疗前月经期体内DHEA、DHEA-S、IGF-1水平进行比较。结果:试验组完成30例,对照组完成10例。试验组总有效率为90%。试验组治疗前DHEA、DHEA-S、IGF-1水平与血清对照组组间差异均具有统计学意义(P<0.05);试验组治疗前后DHEA、DHEA-S、IGF-1的水平、皮损症状积分及中医证候积分组内差异均具有统计学意义(P<0.05)。结论:自拟清痘汤内服联合改良颠倒散外用对女性热毒蕴肤兼脾虚饮停、气血失和型痤疮有效,作用机制可能与调节月经期DHEA、DHEA-S、IGF-1水平有关。Objective:To investigate the clinical efficacy of self-prepared Qingdou Decoction combined with modified Diandao Powder in the treatment of female acne vulgaris of heat toxin accumulating in the skin caused by spleen deficiency,fluid retention,disharmony of qi and blood syndrome and observe its effect on Dehydroepiandrosterone(DHEA),Dehydroepiandrosterone-sulfate(DHEA-S),Insulin-like growth factors-1(ICF-1).Methods:A single-arm trial was used.36 female patients with acne vulgaris who came to our hospital from March 2021 to February 2022 was selected as test group.These patients were given self-prepared Qingdou Decoction combined with modified Diandao Powder for external use for 4 weeks.Menstrual DHEA,DHEA-S,IGF-1 levels,score for leions and TCM syndromes were compared before and after the treatment.Another 10 healthy women were selected as a serum control group,and the levels of DHEA,DHEA-S,and IGF-1 were compared with those in the test group during the pre-treatment menstrual period.Results:30 cases completed the trial in the test group and 10 cases in the serum control group.The overall response rate of the test group was 90%.The levels of DHEA,DHEA-S and IGF-1 in the experimental group before the treatment were significantly different from those in the serum control group(P<0.05).There were significant differences in DHEA,DHEA-S,IGF-1 levels,scores for lesions and TCM syndromes before and after the treatment in the experimental group(P<0.05).Conclusions:Self-prepared Qingdou decoction for internal administration combined with modified Diandao powder for external use is effective for treating female acne vulgaris with heat toxin accumulating in the skin caused by spleen deficiency,fluid retention,disharmony of qi and blood syndrome.Its mechanism of action may be related to the regulation of DHEA,DHEA-S and IGF-1 levels in menstrual period.

关 键 词：寻常痤疮 颠倒散 DHEA DHEA-S IGF-1 

分 类 号：R275[医药卫生—中医皮科] R758.733[医药卫生—中医学]