陈氏清肝解毒汤治疗肝经郁热型带状疱疹临床观察  

Clinical observation of Chen's Qinggan Jiedu Decoction in treating herpes zoster with stagnation heat of liver channe

作　　者：王臬[1] 蔡惠群[1] 陈诗吟[2] 张洁[3] WANG Nie;ZHANG Yi;CHEN Shiyin(Department of Preventive Medicine,Shanghai Traditional Chinese Medicine Hospital,Shanghai 200000,China;Department of Traditional Chinese Medicine,Shanghai Traditional Chinese Medicine Hospital,Shanghai 200000,China)

机构地区：[1]上海市中医医院治未病科,上海200071 [2]上海市中医医院中医外科,上海200071 [3]上海市中医医院中医特色诊疗中心,上海200071

出　　处：《四川中医》2024年第6期174-177,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：上海市进一步加快中医药传承创新发展三年计划项目(编号:ZY(2021~2023)-0204);上海市中医非药物疗法示范中心建设项目(编号:ZY(201~2023)-2004-02);陈氏外科特色诊疗技术的传承与发展(编号:02ZY13.093302)。

摘　　要：目的:观察陈氏清肝解毒汤治疗肝经郁热型带状疱疹的临床效果。方法:选择上海市中医医院治未病科2020年1月~2022年12月带状疱疹患者75例进行研究,随机将其分为两组,其中对照组(n=37)接受盐酸伐昔洛韦片+甲钴胺片+炉甘石洗剂治疗,治疗组(n=38)加用陈氏清肝解毒汤,均实施为期10d治疗。观察两组10d治疗结束后的临床治疗效果;对比治疗前后的症状量化评分;对比治疗前,治疗后3d, 7d, 10d疼痛情况(VAS)评分;对比水疱停止增加时间、病灶结痂时间和脱痂时间;对比治疗前后血清水痘-带状疱疹病毒IgM抗体(VZV-IgM);对比不良反应情况;对比治疗后3个月带状疱疹后遗神经痛(PHN)的发生率。结果:治疗组10d治疗结束后临床疗效总有效率为90.32%,且高于对照组80.00%(P<0.05);10d药物治疗完成后,治疗组症状量化评分低于对照组(P<0.05);治疗后7d, 10d,治疗组疼痛低于优于对照组(P<0.05);与对照组相比,治疗组患者经药物治疗后水疱未增多、病灶结痂及脱痂时间均较低(P<0.05)。10d药物治疗完成后,治疗组患者VZV-IgM低于对照组(P<0.05);两组不良反应发生率相同(P>0.05)。治疗组治疗后3个月PHN发生率低于对照组(P<0.05)。结论:陈氏清肝解毒汤加入西药治疗后,不仅能有效改善肝经郁热型带状疱疹患者临床疗效,同时对病程缩短、疼痛减轻及减少PHN发生均有积极作用。Objective:To observe the clinical effect of Chen's Qinggan Jiedu Decoction in the treatment of herpes zoster with stagnating heat of liver channel.Methods:75patients with herpes zoster who received treatment in the Department of Treatment and Treatment of Shanghai Hospital of Traditional Chinese Medicine from January 2020to December 2022were selected as the study objects,and were divided into control group(n=37)and treatment group(n=38)by random number table method.The control group took valaciclovir hydrochloride tablets and mecobalamine tablets for external calamine lotion,and the treatment group took Chenshi Qinggan Jiedu decoction on the basis of the control group.The clinical efficacy of the two groups was compared.Symptom quantification scores were compared before and after treatment.The VAS scores were compared before treatment,at 3d,7d and 10d after treatment.The time of vesicle stop increasing,scab formation and scab removal were compared.Serum varicella zoster virus IgM antibodies(VZV-IgM)were compared before and after treatment.The adverse reactions were compared.The incidence of postherpetic neuralgia(PHN)3months after treatment was compared.Results:The total effective rate of the treatment group was 90.32%,and that of the control group was 80.00%.The curative effect of the treatment group was better than that of the control group(P<0.05).After treatment,the quantitative score of symptoms in the treatment group was better than that in the control group(P<0.05).The pain level(VAS)of the two groups was the same at 3days after treatment(P>0.05).At 7and 10days after treatment,the pain of the treatment group was lower than that of the control group(P<0.05).The time of vesicle stopping increase,scab formation and descab formation in treatment group were lower than those in control group(all P<0.05).After treatment,the VZV-IgM in treatment group was lower than that in control group(P<0.05).The incidence of adverse reactions was the same in both groups(P>0.05).The incidence of PHN 3months after treatment in t

关 键 词：陈氏清肝解毒汤 带状疱疹 肝经郁热 中医外科 

分 类 号：R572.12[医药卫生—消化系统]