疏风散寒活血化瘀法治疗冷性荨麻疹的临床观察

Clinical Observation on Wind-Dispersing and Cold-dispelling, Blood-activating and Stasis-removing Therapy for Cold-type Urticaria

[目的]观察疏风散寒、活血化瘀法治疗冷性荨麻疹的临床疗效,并探讨其可能的作用机理。[方法]将66例患者按简单随机法随机分为两组,治疗组36例给予疏风散寒、活血化瘀中药(由麻黄、桂枝、荆芥、防风、北杏仁、生姜、大枣、丹参、当归、鸡血藤、赤芍等组成)治疗,对照组30例予以西药盐酸西替利嗪片治疗,两组均连续治疗2个疗程(20 d),疗程结束1周后统计疗效;观察两组治疗前后血液流变学各项指标的变化情况,并与38例正常对照组作比较。[结果] 治疗组总有效率为80.6%,对照组为63.3%,两组比较差异具有显著性意义(P<0.05);两组治疗后血液流变学各项指标均有改善(与治疗前比较,P<0.01),且治疗组的改善优于对照组(P<0.05),基本达到正常对照组水平(P>0.05) [结论]疏风散寒、活血化瘀法是治疗冷性荨麻疹的重要法则,所选方药是临床治疗冷性荨麻疹的有效药物;其作用机理可能与其改善患者的血液流变学指标有关。

[Objective] To observe the therapeutic effect of wind-dispersing and cold-dispelling, blood-activating and stasis-removing therapy for cold-type urticaria and to explore its possible mechamism. [Methods ] Sixty-six eases were allocated to two groups by a simple random sampling method. Group A （ n = 36） was treated with wind-dispersing and colddispelling, blood-activating and stasis-removing herbal medicine including Herba Ephedrae, Ramulus Cinnanormi, Herba Schizonepetae, Radix Saposhnikoviae, Semen Armeniacae Amanun, Rhizoma Zingiberis Recens, Fmctus Jujubae, Radix Salviae Miltiorrhizae, Radix Angelicae Sinensis, Caulis Spatholobi, Radix Paeoniae Rubra, etc. Group B （n = 30） was tw^ated with eetirizine hydrochloride tablets. The two groups were treated for two 20-day courses. One week after treatment, the therapeutic effect and the changes of hemorheological parameters before and after treatment were observed and compared with those in 38 healthy volunteers. [Resultsl The total effective rate was 80.6% in group A and 63.3% in group B, the difference being significant （ P 〈 0.05）. The hemorheological parameters were improved in the two groups after treatment as compared with those before treatment （ P 〈 0.01）. The parameters were much improved in group A as compared with those in group B （P 〈 0.05） and recovered to the level of normal group （P 〉 0.05）. [ Conclusion ] Wind-dispersing and colddispelling, blood-activating and stasis-removing therapy is an important method for cold-type urticaria and the selected herbal medicines are effective. Its therapeutic mechanism may be related to the improvement of hemorheological parameters.