基于络病理论应用肛周坐浴方联合曲安奈德益康唑乳膏治疗湿热下注型肛周湿疹疗效观察  

Efficacy of perianal sitz bath decoction combined with Triamcinolone Acetonide and Econazole Nitrate Cream on perianal eczema with syndrome of dampness-heat-pouring downwards based on collateral disease theory

作　　者：李源 李华[1] 祁雄飞 代红雨[1] 马建华[1] 玄权哲[1] LI Yuan;LI Hua;QI Xiongfei;Dai Hongyu;MA Jianhua;XUAN Quanzhe(Dongfang Hospital,Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学东方医院,北京100078

出　　处：《现代中西医结合杂志》2025年第6期752-756,763,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：北京中医药大学青年教师项目(2019-JYB-JS-141);北京市中医药管理局中医药“3+3”薪火传承滚动建设项目(2007-SZ-A-12)。

摘　　要：目的基于络病理论,观察肛周坐浴方治疗湿热下注型肛周湿疹患者的临床疗效及安全性。方法选取2020年9月1日—12月31日就诊于北京中医药大学东方医院肛肠科的60例湿热下注型肛周湿疹患者,采用随机数字表法随机分为观察组和对照组,每组30例。对照组予曲安奈德益康唑乳膏外用,观察组在对照组治疗基础上联合肛周坐浴方熏洗坐浴,2组均连续治疗14 d。观察比较2组患者治疗前后皮损形态、皮损直径、瘙痒程度、患处渗出评分,统计2组临床疗效、治疗结束3个月后的复发率及治疗不良反应发生情况。结果治疗后,2组患者皮损形态评分、皮损直径评分、瘙痒程度评分及患处渗出评分均较治疗前明显降低(P均<0.05),且观察组患者瘙痒程度评分及患处渗出评分均明显低于对照组(P均<0.05)。观察组临床总有效率明显高于对照组[93.3%(28/30)比73.3%(22/30),P<0.05];随访3个月,观察组复发率为10.0%(2/20),低于对照组的40.0%(4/10),但2组比较差异无统计学意义(P>0.05)。2组均未发生不良事件。结论肛周坐浴方熏洗坐浴联合曲安奈德益康唑乳膏外用能安全有效地促进湿热下注型肛周湿疹患者的皮损修复,明显减轻患处瘙痒程度,减少渗出,疗效优于单独使用曲安奈德益康唑乳膏。Objective It is to observe the clinical efficacy and safety of perianal sitz bath decoction in the treatment of patients with perianal eczema with syndrome of dampness-heat-pouring downwards based on collateral disease theory.Methods Sixty patients with perianal eczema with syndrome of dampness-heat-pouring downwards treated at the Department of Coloproctology of Dongfang Hospital of Beijing University of Chinese Medicine from September 1 to December 31,2020 were selected and randomly divided into observation group and control group by using randomized numerical table method,with 30 cases in each group.The control group was treated with application of Triamcinolone Acetonide and Econazole Nitrate Cream,and the observation group was treated with sitz bath and fumigation-washing with perianal sitz bath decoction on the basis of treatment of the control group,and both groups were continuously treated for 14 days.The scores of lesion morphology,lesion diameter,itchiness Degree and affected area exudation of patients in the two groups were observed and compared before and after the treatment,and the clinical efficacies,recurrence rates in 3 months after treatment and the occurrence rates of adverse reaction of the treatment were assessed or calculated.Results After treatment,the scores of lesion morphology,lesion diameter,itchiness Degree and affected area exudation of patients in the two groups were significantly lower than those before treatment(all P<0.05),and the scores of itchiness Degree and affected area exudation of patients in the observation group were significantly lower than those in the control group(all P<0.05).The total clinical effectiveness rate of the observation group was significantly higher than that of the control group[93.3%(28/30)VS.73.3%(22/30),P<0.05];after 3 months of follow-up,the recurrence rate of the observation group was 10.0%(2/20),which was lower than that 40.0%(4/10)of the control group,but the difference was not statistically significant between the two groups(P>0.05).There were no

关 键 词：肛周湿疹 络病理论 熏洗坐浴 肛周坐浴方 

分 类 号：R657.1[医药卫生—外科学]