祛风汤坐浴联合复方亚甲蓝注射液治疗慢性肛周湿疹的疗效

Clinical research of Qufeng decoction hip bath combined with compound methylene blue injection in treatment of chronic perianal eczema

目的探讨祛风汤坐浴联合复方亚甲蓝注射液肛周封闭治疗慢性肛周湿疹的疗效及其可能的作用机制。方法选择解放军总医院第一医学中心中医肛肠科2016-01至2020-12收治的慢性肛周湿疹患者100例,随机分为治疗组和对照组,每组50例。两组均采用复方亚甲蓝注射液在肛周湿疹区域封闭治疗,治疗组在此基础上采用祛风汤坐浴2周,观察两组治疗前后临床症状评分、生活质量评分、血清中白细胞介素2(IL-2)、白细胞介素4(IL-4)、白细胞介素10(IL-10)及血清中总免疫球蛋白E(IgE)检测值变化,评定有效率及复发率。结果治疗后两组瘙痒、皮损(面积及形态)、生活质量评分均较治疗前有改善,差异有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05),治疗后两组血清IL-2、IL-4、IL-10及IgE水平均较治疗前明显改善,差异有统计学意义(P<0.05),且治疗组以上指标改善均优于对照组,差异有统计学意义(P<0.05),临床疗效及治疗后第1个月复发率两组之间比较差异无统计学意义,治疗组第3、6个月复发率(4.26%、6.38%)均低于对照组(24.39%、34.15%),差异有统计学意义(P<0.05),两组患者在治疗期间均未发生严重不良反应。结论治疗组临床疗效确切,且无严重不良反应。其作用机制可能与降低血清中IL-4、IL-10、IgE,提高IL-2水平有关。

Objective To observe the clinical efficacy of Qufeng decoction bath combined with compound methylene blue injection for chronic perianal eczema,and to explore its potential mechanism.Methods A total of 100 patients with chronic perianal eczema from January 2016 to December 2020 were randomly divided into the observation group and the control group(50 cases in each group).Both groups were treated with local blocking treatment of compound methylene blue injection,while the observation group was given Qufeng decoction hip bath for two weeks.The score of clinical symptoms,DLQI score,and the serum levels of IL-2,IL-4,IL-10 and IgE were observed in the two groups before and after treatment,and the clinical efficacy and recurrence rates were compared between two groups after the treatment.Results Pruritus,skin lesion(area and shape)and DLQI score of two groups were improved with significant difference(P<0.05),but had no significant difference between two groups(P>0.05).After treatment,the serum levels of IL-2,IL-4,IL-10 and IgE were significantly improved in both groups(P<0.05),and the improvement of serum IL-2,IL-4,IL-10 and IgE in the observation group were obviously better than the control group with significant difference(P<0.05).There was no significant difference in the clinical efficacy and recurrence rates at 1 st month after treatment between two groups(P>0.05).The recurrence rates at the 3 rd and 6 th month after treatment of the observation group were obviously lower than the control group.The recurrence rates of the observation group and the control group were 4.26%and 24.39%respectively at the 3 rd month after treatment,and 6.38%and 34.15%respectively at the 6 th month,with significant difference(P<0.05).There were no serious adverse events in the two groups.Conclusion The treatment of chronic perianal eczema with Qufeng decoction hip bath combined with compound methylene blue injection has obvious curative effect,and no serious adverse events.The potential mechanism may be related with the decrease of serum IL-4,IL-10,and IgE levels and the increase of serum IL-2 level.