自拟苦参汤外敷联合依巴斯汀治疗湿疹临床分析

Clinical Analysis of Kushen Decoction Combined with Ebastine in Treatment of Eczema

目的:探讨自拟苦参汤外敷辅助依巴斯汀治疗湿疹的临床疗效和可能机制。方法:选取慢性湿疹患者110例,以随机数字表分为两组,每组55例;对照组采用依巴斯汀联合复方氟米松软膏外敷疗法,观察组采用依巴斯汀联合自拟苦参汤外敷疗法。对比两组患者的临床疗效及治疗前后的皮损与瘙痒评分;同时,取患者皮损组织,以ELISA试剂盒检测Th1细胞因子IL-2、INF-γ,Th2细胞因子IL-4、IL-10及补体IgE的含量。结果观察组患者的痊愈率和总有效率均高于对照组,且痊愈率具有统计学差异(χ2=4.807,P=0.028)。治疗前,两组患者的EASI与瘙痒评分均无显著差异(t=1.855,0.368;P=0.0.87,0.702);治疗后,观察组EASI与瘙痒评分均显著低于对照组(t=11.847,19.586,P=0.000)。治疗前两组患者皮损组织的IL-2、INF-γ、IL-4、IL-10、IgE水平无显著差异(t=0.196,0.075,0.098,0.160,0.030;P=0.806,0.931,0.922,0.821,0.954);治疗后,观察组IL-2、INF-γ水平显著高于对照组(t=2.685,2.896;P=0.038,0.026),IL-4、IL-10、IgE水平显著低于对照组(t=2.790,2.518,3.356;P=0.031,0.042,0.014)。结论:自拟苦参汤在纠正慢性湿疹患者Th1/Th2细胞功能失调方面具有一定作用,利于控制改善病情、提高治疗效果。

Objective ： To explore the clinical effect and correlative mechanism of Chinese medicine Kushen Decoction for the treatment of eczema. Methods： 110 cases of patients with eczema were selected and divided into 2 groups randomly （ n1 = n2 = 55 ）. Patients in control group were treated with Ebastine and Flumetasone, while patients in observation group were treated with Ebastine and Kushen Decoction. Clinical effect and eczema score were recorded and compared between groups. At the same time, the pathological skin tissue of patients were extracted and detected for L-2, INF- γ, 1L-4, IL- 10 and IgE levels. Results： The cure rate and effective rate of observation group were both higher than those of control group, and the difference of cure rate got significance （ X2 = 4. 807, P = 0. 028 ）. There was no signifi- cant difference between groups in EASI and pruritus score before treatment （ t = 1. 855,0. 368 ; P = 0.0.87,0. 702） while those of observation group were both significantly lower than those of control group after treatment （ t = 11. 847, 19. 586, P = 0. 000）. There was no significant difference between groups in IL- 2, INF-γ, IL- 4, IL- 10 and IgE levels be- fore treatment （t =0. 196, 0. 075,0. 098, 0. 160, 0. 030; P = 0. 806, 0. 931,0. 922, 0. 821,0.954） while IL- 2 and INF - γlevels of observation group were significantly higher （ t = 2. 685, 2. 896 ; P = 0.038, 0. 026）, and IL - 4, IL - 10 and IgE levels were significantly lower than those of control group （ t = 2. 790, 2. 518, 3. 356 ; P = 0. 031, 0. 042, 0. 014）. Conclusion： Chinese medicine Kushen Decoction has positive effect on correcting the disproportionality of Th1/ Th2, which is benefit to control illness condition and improve the therapeutic effect of eczema.