消银2号方药浴在不同温度和时间对寻常型银屑病的影响

Effect of Xiaoyin Prescription 2 herbal bath in different temperature and time conditions to treat patients with psoriasis vulgaris

目的：探讨消银2号方治疗寻常型银屑病患者最佳的洗浴温度和时间。方法选取120例符合寻常型银屑病诊断标准的住院患者纳入试验。按随机序列表分为4组，每组30例。采用2＆#215;2析因设计将4组患者分别使用消银2号方剂药浴的4种治疗方案，试验1组（ A1 B1）采用42℃药浴30 min；试验2组（ A1 B2）采用42℃药浴20 min；试验3组（ A2 B1）采用38℃药浴30 min；试验4组（ A2 B2）采用38℃药浴20 min。分别在入院时和出院时采用银屑病皮损面积及严重程度量表（ PASI评分表）、生活质量指数（ DLQI）、焦虑自评量表（ SAS）对患者状况进行评定。结果120例寻常型银屑病患者治疗后PASI评分、DLQI指数、SAS评分分别为（11．33＆#177;5．68），（4．78＆#177;3．50），（24．23＆#177;6．72）分，低于治疗前的（25．51＆#177;10．26），（11．60＆#177;5．70），（42．37＆#177;8．40）分，差异有统计学意义（t 分别为23．105，17．174，40．558；P＜0．01）。试验1组患者治疗前后PASI评分差值为（16．59＆#177;6．46）分，高于其他3组，差异有统计学意义（F＝4．242，P＜0．01）；DLQI指数差值和SAS评分差值分别为（8．27＆#177;5．15），（19．93＆#177;4．73）分，高于试验4组的（5．47＆#177;3．25），（16．30＆#177;4．82）分，差异有统计学意义（P＜0．05）。在PASI、DLQI、SAS三方面，消银2号方洗浴时间因素的主效应及时间与温度的交互作用差异无统计学意义（ P ＞0．05），仅温度的主效应差异有统计学意义（ F分别为11．380，6．335，9．168；P＜0．01）。结论银屑病皮损面积及严重程度的改善、生活质量改善、焦虑状况改善三方面，温度对药浴的影响效果大于时间。考虑到时间因素对患者的经济和治疗时间的影响等问题，42℃联合20 min中药洗浴的方案更为合理，值得临床推广。

Objective By applying the factorial design to ascertain the best temperature and time of bathing using Xiaoyin Prescription 2 in treating patients with psoriasis vulgaris .Methods According to the inclusion criteria 120 cases with psoriasis vulgaris were selected .They were randomly divided into 4 treatment groups with 30 people for each group .Group 1 （ A1 B1 ） was treated with 42℃bathing for 30 minutes;Groups 2 （ A1 B2 ） was treated with 42℃bathing for 20 minutes;Groups 3 （ A2 B1 ） was treated with 38℃bathing for 30 minutes;Groups 4 （A2B2） was treated with 38℃bathing for 20 minutes.All of the patients were investigated by the Psoriasis Area and Severity Index （ PASI ） , Dermatology Life Quality Index （ DLQI ） and Self Rating Anxiety Scale （SAS）.Results The PASI score, DLQI index and SAS score of the 120 patients were （11.33 ＆#177; 5.68）, （4.78 ＆#177;3.50）, （24.23 ＆#177;6.72）, respectively, after the treatment, and （25.51 ＆#177;10.26）, （11.60 ＆#177; 5.70）, （42.37 ＆#177;8.40）, respectively, before the treatment, which were significantly different （t=23.105, 17.174, 40.558, respectively;P＆lt;0.01）.For Group 1, the PASI score difference before and after treatment was （16.59 ＆#177;6.46） that was significantly higher than the other three groups （F=4.242,P＆lt;0.01）.The score difference of DLQI and SAS were （8.27 ＆#177;5.15）, （19.93 ＆#177;4.73）, higher than Group 4 whose score were （5.47 ＆#177;3.25）, （16.30 ＆#177;4.82）.The differences were significant （P ＆lt;0.05）.There was no significant interaction for time and temperature and no significant main effect of time factor （ P＆gt;0.05 ） .Only the main effect of temperature was statistically significant （ F =11.380, 6.335, 9.168, respectively; P ＆lt;0.01 ）.＆amp;nbsp;Conclusions The main effect of bathing temperature to treat patients with psoriasis vulgaris is higher than the bathing time in PASI, DLQI and SAS.Taking into account the time factor and expenditure for the patients , a herbal bathing temperature of 42 ℃ for 20 minutes is more reasonable and is worthy of promoting in clinical situations .