针刺配合耳背割治治疗血瘀型银屑病:随机对照研究

Acupuncture combined with auricle cutting method for blood stasis-type psoriasis:a randomized controlled trial

目的:验证针刺配合耳背割治对血瘀型银屑病的临床疗效。方法:将56例血瘀型银屑病患者随机分为针割组、割治组、针刺组和对照组,每组14例。4组均在口服中药汤剂常规治疗基础上,针割组予针刺+耳背割治;割治组予模拟针刺+耳背割治;针刺组予针刺+模拟耳背割治;对照组予模拟针刺+模拟耳背割治。针刺取大椎、肺俞、肝俞、膈俞等穴,行常规操作;模拟针刺仅刺入真皮层,使毫针倾倒,但不脱落;耳背割治:取患者一侧耳背心用针进行割治放血;模拟耳背割治:取患者一侧耳背心约偏离0.5cm处为模拟割治部位。均每日1次,7次为一疗程,共进行2个疗程。观察患者治疗前后银屑病皮损面积和严重程度指数(PASI)评分,并比较各组疗效。结果:针割组有效率[57.1%(8/14)]高于割治组[14.3%(2/14)]、针刺组[7.1%(1/14)]和对照组[0.0%(0/14),均P<0.05]。各组患者PASI评分治疗后均降低(均P<0.05),针割组优于其他3组(均P<0.05)。经析因分析,耳背割治的主效应,P<0.05;针刺的主效应,P<0.05;针刺和耳背割治的交互效应,P<0.05。结论:针刺疗法、耳背割治配合口服中药汤剂均可降低血瘀型银屑病的PASI评分,具有明显疗效,且耳背割治、针刺疗法交互作用配合口服中药汤剂疗效最为显著。

Objective To verify the clinical efficacy of acupuncture combined with auricle cutting method for treatment of blood stasis-type psoriasis. Methods Fifty-six cases of blood stasis-type psoriasis were randomly di- vided into a combined therapy group, a auricle cutting group, an acupuncture group and a control group, 14 cases in each one. Based on regular treatment of TCM decoction in four groups, the combined therapy group was treated with acupuncture and auricle cutting method, and the auricle cutting group was treated with sham-acupuncture and auricle cutting, and the acupuncture group was treated with acupuncture and sham auricle cutting, and the control group was treated with sham-acupuncture and sham auricle cutting. The acupuncture was applied at Dazhui （GV 14）, Feishu （BL 13）, Ganshu （BL 18） and Geshu （BL 17）, etc. , and manipulated with routine technique; in the sham acupuncture, the needle was inserted into dermis layer so that the needles could be swung without being dropped out. In the auricle cutting, erbeixin （P〈） of unilateral auricle was selected and cut by Chan needle to perform bloodletting; in the sham auricle cutting, the neighborhood approximately 0.5 cm next to erbeixin （P〈） of auricle was selected as cutting area. The treatment was given once a day, seven days as a treatment session for totallytwo sessions. Psoriasis area and severity index （PASI） before and after treatment was observed and efficacy of each group was compared. Results The effective rate was 57.1〈 （8/14） in the combined therapy group, which was superior to 14.3N （2/14） in the auricle cutting group, 7.1% （1/14） in the acupuncture group and 0.0〈 （0/14） in the control group （all P〈0.05）. The scores of PASI were all decreased in each group after the treat- ment （all P〈0.05）, which was the most significant in the combined therapy group （all P〈0.05）. After factorial analysis, the main effect was P〈0.05 in the auricle cutting, P〈0.05 in the acupuncture and P〈0.05 in interac- tion effect of combined therapy. Conclusion The scores of PASI of blood stasis-type psoriasis could be effectively reduced by acupuncture, auricle cutting method and TCM decoction, among which the interaction effect of auricle cutting and acupuncture combined with TCM decoction is the most significant.