清热健脾利湿方联合常规西药治疗脾虚湿蕴型慢性湿疹临床研究  

Clinical Study on Qingre Jianpi Lishi Prescription Combined with Conventional Western Medicine for Chronic Eczema of Spleen Deficiency and Dampness Accumu⁃lation Type

作　　者：魏飞 路斌 WEI Fei;LU Bin(Zhoukou Hospital of Traditional Chinese Medicine,Zhoukou Henan 466000,China)

机构地区：[1]周口市中医院,河南周口466000

出　　处：《新中医》2024年第15期115-119,共5页New Chinese Medicine

基　　金：河南省医学科技攻关计划联合共建立项项目(LHGJ20200241)。

摘　　要：目的:观察清热健脾利湿方联合常规西药治疗脾虚湿蕴型慢性湿疹的临床疗效。方法:选取96例慢性湿疹患者,按随机数字表法分为对照组和研究组各48例。对照组给予常规西药治疗,研究组在对照组基础上给予清热健脾利湿方治疗。评价2组临床疗效,统计复发率,比较2组治疗前后中医证候评分、瘙痒严重程度评估量表(12-PSS)评分、湿疹面积及严重程度指数(EASI)评分,检测2组皮肤屏障功能指标、免疫功能及炎症因子水平。结果:研究组总有效率为97.92%,高于对照组83.33%(P<0.05)。研究组复发率为7.69%,低于对照组66.67%(P<0.05)。治疗后,2组中医证候评分较治疗前降低(P<0.05),且研究组中医证候评分低于对照组(P<0.05)。治疗后,2组12-PSS、EASI评分较治疗前降低(P<0.05),且研究组12-PSS、EASI评分低于对照组(P<0.05)。治疗后,2组经皮水分丢失(TEWL)较治疗前降低,研究组TEWL低于对照组(P<0.05);2组角质层含水量、皮脂含量较治疗前升高,研究组角质层含水量、皮脂含量高于对照组(P<0.05)。治疗后,2组Th1/Th2、白细胞介素-6受体(IL-6R)、白细胞三烯B4 (LTB4)、Fas配体(Fas-L)水平较治疗前降低(P<0.05);且研究组Th1/Th2、IL-6R、LTB4、Fas-L水平低于对照组(P<0.05)。结论:清热健脾利湿方联合常规西药治疗脾虚湿蕴证慢性湿疹患者,可改善皮肤屏障功能,调节外周血细胞免疫平衡,降低炎症因子水平,改善瘙痒程度,缓解病情,提升临床疗效,降低复发率。Objective:To observe the clinical effect of Qingre Jianpi Lishi Prescription combined with conventional western medicine on chronic eczema of spleen deficiency and dampness accumulation type.Methods:A total of 96 cases of patients with chronic eczema were selected and divided into the control group and the study group by random number table method,with 48 cases in each group.The control group was treated with conventional western medicine,and the research group was additionally given Qingre Jianpi Lishi Prescription based on the treatment of the control group.The clinical effects in the two groups were evaluated;the recurrence rates were analyzed;traditional Chinese medicine(TCM)syndrome scores,12-Item Pruritus Severity Scale(12-PSS)scores,Eczema Area and Severity Index(EASI)scores before and after treatment were compared between the two groups. The skin barrier function indexes,immune function and inflammatory factors in the two groups were detected. Results: The total effectiverate in the study group was 97.92%,which was higher than that of 83.33% in the control group (P<0.05).The recurrence rate was 7.69% in the study group, lower than that of 66.67% in the control group (P<0.05). After treatment,TCM symptom scores in the two groups were reduced when compared with thosebefore treatment (P<0.05), and the TCM symptom score in the study group was lower than that in thecontrol group (P<0.05). After treatment,the scores of 12-PSS and EASI in the two groups were decreasedwhen compared with those before treatment (P<0.05), and the scores of 12-PSS and EASI in the studygroup were lower than those in the control group (P<0.05). After treatment, the Trans Epidermal WaterLoss (TEWL) in the two groups was declined when compared with that before treatment,and the TEWL inthe study group was lower than that in the control group (P<0.05). The cuticle water content and sebumcontent in the two groups were increased when compared with those before treatment, and the cuticlewater content and sebum content in the study group were

关 键 词：慢性湿疹 清热健脾利湿方 皮肤屏障功能 细胞免疫平衡 白细胞介素-6受体 白细胞三烯B4 

分 类 号：R758.23[医药卫生—皮肤病学与性病学]