麻黄连翘赤小豆汤加减对慢性湿疹患者的临床疗效  

Clinical effects of Modified Mahuang Lianqiao Chixiaodou Decoction on patients with chronic eczema

作　　者：王庆兴 张步鑫 徐胜东 王丽 李静 刘爱民 WANG Qing-xing;ZHANG Bu-xin;XU Sheng-dong;WANG Li;LI Jing;LIU Ai-min(Department of Dermatology,Henan Provincial Hospital of Traditional Chinese Medicine/The Second Hospital Affiliated to Henan University of Chinese Medicine,Zhengzhou 450002,China)

机构地区：[1]河南省中医院/河南中医药大学第二附属医院皮肤科,河南郑州450002

出　　处：《中成药》2024年第9期2943-2949,共7页Chinese Traditional Patent Medicine

基　　金：国家自然科学基金(81874471);全国老中医药专家学术经验继承工作项目(国中医药办人教函[2022]76号);河南省中医专科诊疗中心项目(豫卫中医函[2024]2号);河南省中医药青苗人才培养项目(豫卫中医函[2021]16号);河南省卫生健康委国家中医临床研究基地科研专项项目(2021JDZX2031)。

摘　　要：目的探讨麻黄连翘赤小豆汤加减对慢性湿疹患者的临床疗效。方法195例患者随机分为中药组、西药组和联合组,每组65例,中药组给予麻黄连翘赤小豆汤加减,西药组给予盐酸左西替利嗪,联合组给予麻黄连翘赤小豆汤加减联合盐酸左西替利嗪,疗程3周。检测临床疗效、临床指标(EASI评分、DQOLS评分、中医证候评分、PINS)、皮肤生理功能指标(OCTS、TEWL、WCTC)、炎性因子(EOT、EOS、NK-κB、CCR3)、T淋巴细胞亚群(Treg、Th1、Th17、Th22)、p38MAPK信号通路指标(ERK1、ERK2、MEK1、MEK2)、复发率、不良反应发生率变化。结果联合组总有效率高于中药组、西药组(P<0.05),复发率更低(P<0.05)。治疗后,联合组EASI评分、中医证候评分、PINS、TEWL、炎性因子、Th1、Th17、Th22、p38MAPK信号通路指标低于其他2组(P<0.05),DQOLS评分、OCTS、WCTC、Treg更高(P<0.05)。中药组不良反应发生率低于其他2组(P<0.05)。结论基于“四位一体”疗法的麻黄连翘赤小豆汤加减可安全有效地减轻慢性湿疹患者皮损程度,提高皮肤生理功能,改善炎性因子、T淋巴细胞亚群水平,调节p38MAPK信号通路,联合盐酸左西替利嗪具有协同增效的作用。AIM To investigate the clinical effects of Modified Mahuang Lianqiao Chixiaodou Decoction on patients with chronic eczema.METHODS One hundred and ninety-five patients were randomly assigned into Chinese medicine group(65 cases)for 3-week administration of Modified Mahuang Lianqiao Chixiaodou Decoction,western medicine group(65 cases)for 3-week administration of Levocetirizine Hydrochloride,and combined group(65 cases)for 3-week administration of both Modified Mahuang Lianqiao Chixiaodou Decoction and Levocetirizine Hydrochloride.The changes in clinical effects,clinical indices(EASI score,DQOLS score,TCM syndrome score,PINS score),skin physiological function indicesssss(OCTS,TEWL,WCTC),inflammatory factors(EOT,EOS,NK-κB,CCR3),T lymphocyte subsets(Treg,Th1,Th17,Th22),p38MAPK signaling pathway indices(ERK1,ERK2,mMEK 1,MEK2),recurrence rate and incidence of adverse reactions were detected.RESULTS The combined group demonstrated higher total effective rate than the Chinese medicine group and the western medicine group(P<0.05),along with lower recurrence rate(P<0.05).After the treatment,the combined group displayed lower EASI score,TCM syndrome score,PINS,TEWL,inflammatory factors,Th1,Th17,Th22 and p38MAPK signaling pathway indices than the control group(P<0.05),along with higher DQOLS score,OCTS,WCTC,Treg(P<0.05).The Chinese medicine group exhibited lower incidence of adverse reactions than the other two groups(P<0.05).CONCLUSION For the patients with chronic eczema,Modified Mahuang Lianqiao Chixiaodou Decoction can safely and effectively alleviate skin lesion degree,enhance skin physiological functions,improve T lymphocyte subset,inflammatory factors levels,and regulate p38MAPK signaling pathway based on“Four-in-One”therapy,which exhibits synergistic effect when combined with Levocetirizine Hydrochloride.

关 键 词：麻黄连翘赤小豆汤 盐酸左西替利嗪 慢性湿疹 “四位一体”疗法 

分 类 号：R287[医药卫生—中药学]