利湿解毒汤联合箍围消散法治疗老年下肢丹毒湿热毒蕴证的临床疗效观察  

Clinical effect observation of Lishi Jiedu Decoction combined with gather and disappear method in the treatment of elderly erysipelas in lower limb of damp heat toxin accumulation syndrome

作　　者：乔楠 杨旭 方勇 丁晓雯 倪毓生 QIAO Nan;YANG Xu;FANG Yong;DING Xiaowen;NI Yusheng(Affiliated Traditional Chinese Medicine Hospital of Nantong University,Nantong Hospital Affiliated of Nanjing University of Chinese Medicine,Nantong Hospital of Traditional Chinese Medicine,Nantong 226001,China)

机构地区：[1]南通大学附属中医院,南京中医药大学南通附属医院,南通市中医院,南通226001

出　　处：《中华中医药杂志》2025年第1期457-462,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：江苏省中医药科技计划发展项目重点项目(No.ZD202231);江苏省中医药科技发展委托专项(No.2022WTZX08);第二批江苏省名老中医药专家传承工作室建设项目(No.苏中医科教[2016]6号)。

摘　　要：目的:观察利湿解毒汤联合箍围消散法治疗老年下肢丹毒湿热毒蕴证的临床疗效。方法:选取老年下肢丹毒患者70例,按随机数表法分为A组25例、B组22例、C组23例,3组均予抗生素治疗,其中A组予利湿解毒汤联合箍围消散法,B组予箍围消散法,C组予硫酸镁湿敷。观察患者临床症状体征指标(红肿范围、肤色、肤温、疼痛)、炎症指标[白细胞计数(WBC)、C反应蛋白(CRP)、血沉(ESR)、白介素6(IL-6)、肝素结合蛋白(HBP)]、中医临床疗效判定、用药时间、复发率、安全性指标和不良反应。结果:3组治疗前临床症状体征指标和炎症指标差异无统计学意义,治疗后3组均有所改善(P<0.05),A组临床症状体征指标改善、复发率优于C组(P<0.05),与B组相当;炎症指标改善、用药时间、中医临床疗效判定有效率优于B、C组(P<0.05),B组与C组相当。3组安全性指标均未见异常,3组均未见明显不良反应。结论:利湿解毒汤联合箍围消散法治疗老年下肢丹毒湿热毒蕴证,内外合治,能够有效的控制炎症,改善局部症状,缩短用药时间,降低复发率,安全有效,值得进一步推广。Objective:To observe the clinical efficacy of Lishi Jiedu Decoction combined with gather and disappear method in the treatment of elderly lower limb erysipelas with dampness heat toxin accumulation syndrome.Methods:Seventy elderly patients with erysipelas in lower limb were selected and randomly divided into group A of 25 cases,group B of 22 cases and group C of 23 cases.All groups were treated with antibiotics.Group A was treated with Lishi Jiedu Decoction combined with gather and disappear method for external application,Group B was treated with gather and disappear method for external application,while group C was treated with magnesium sulfate for wet application.Observe the clinical symptoms and signs of patients(redness and swelling range,skin color,skin temperature,pain),laboratory indicators(WBC,CRP,ESR,IL-6,HBP),traditional Chinese medicine clinical efficacy evaluation,medication time,recurrence rate,safety indicators,and adverse reactions.Results:There was no statistically significant difference in clinical symptom and sign indicators and inflammation indicators among the three groups before treatment.After treatment,all three groups showed improvement(P<0.05).Group A had better clinical symptom and sign indicators improvement and recurrence rate than Group C(P<0.05),which was comparable to Group B.The improvement of inflammation indicators,medication time,and effective rate of traditional Chinese medicine clinical efficacy judgment were better than Group B and Group C,and Group B was comparable to Group C.There were no abnormalities in the safety indicators of the three groups,and no significant adverse reactions were observed in all three groups.Conclusion:The combination of Lishi Jiedu Decoction and gather and disappear method in the treatment of elderly lower limb erysipelas can effectively control inf lammation,improve local symptoms,shorten medication time,reduce recurrence rate,safe and effective.It worth further promotion.

关 键 词：下肢丹毒 利湿解毒汤 箍围消散法 外治法 

分 类 号：R275.9[医药卫生—中西医结合]