中药外洗、拔罐联合西药治疗慢性胆汁淤积性肝病皮肤瘙痒随机平行对照研究

Washing Medicine,Cupping Combined Western Medicine Treatment of Chronic Cholestatic Liver Disease Pruritus Randomized Parallel Group Study

[目的]观察中药外洗、拔罐联合西药治疗慢性胆汁淤积性肝病皮肤瘙痒疗效。[方法]使用随机平行对照方法,将86例门诊及住院患者按住院病志号法简单随机分为两组。两组均复方甘草酸苷,60m L/次,1次/d;还原型谷胱甘肽,1片/d,1次/d;熊去氧胆酸,1粒/次,3次/d。对照组43例炉甘石洗剂外敷（10°～15°）足底、双下肢、手掌、前臂,30min/次,1次/d。治疗组43例中药外洗（茵陈200g,苦参400g,黄柏200g,川楝子100g,赤芍300g,白鲜皮200g）,以水浸泡30min,加热煮沸,再以小火煎煮20min,得到2000m L药液,以毛巾蘸取药液擦洗瘙痒部位（足底、双下肢、手掌、前臂）,每次擦洗20～25min,3次/d;拔罐,取脾腧穴、胆俞穴、肝腧穴,留罐5min,以皮肤轻度充血为度,瘙痒部位闪罐治疗5min;西药治疗同对照组。连续治疗14d为1疗程。观测临床症状、皮肤损伤（程度、面积、瘙痒）、恢复时间、不良反应。治疗1疗程,判定疗效。[结果]治疗组痊愈7例,显效13例,有效19例,无效4例,总有效率90.70%。对照组痊愈2例,显效21例,有效10例,无效10例,总有效率76.74%。治疗组疗效优于对照组（P〈0.05）。皮肤损伤（程度、面积、瘙痒）、恢复时间（皮损好转、止痒起效）治疗组优于对照组（P〈0.05）。[结论]中药外洗、拔罐联合西药治疗慢性胆汁淤积性肝病皮肤瘙痒效果显著,值得推广。

[ Objective ] To observe the wash outside medicine, cupping combined western medicine treatment of chronic cholestatie liver disease itchy skin effect. [ Methods ] Random parallel control method, 86 cases of outpatient and inpatient inpatient Chi by Law No. simple randomized into two groups. Both groups were glyeyrrhizin, 60mL / times, 1 times / d. Glutathione, a / d, 1 times / d. Ursodeoxycholic acid, 1 / time, 3 times / d. The control group 43 cases topical calamine lotion （ 10° - 15 ° ） foot, leg, hand, forearm, 30min / times, 1 times / d. Chinese medicine treatment group, 43 cases outside wash （ Yinchen 200g,Kushen400g, Huangbai 200g, Chuanjizi 100g, Chishao300g, Baixianpi 200g ） , water immersion 30min, heated to boiling, and then to a small fire boiling 20min, get 2000mL liquid, with a towel dipped in liquid scrub itching parts （ foot, leg, hand, forearm ） , each scrub 20-25min, 3 times / d. Cupping, acupoints spleen, gall shu, liver acupoints, leaving cans 5min, the degree of skin mild hyperemia; itching site flash tank treatment 5min. Western medicine with the control group. 14d is a continuous course of treatment. Observation of clinical symptoms, skin damage index, recovery indicators adverse reactions. A course of treatment to determine efficacy. [ Results ] The cure 7 cases, 13 cases were markedly effective in 19 cases, 4 cases, the total efficiency of 90.70%. The control group recovered two cases were cured, 21 cases, 10 cases, 10 cases, the total efficiency of 76.74%. Treatment group than the control group （ P〈0.05 ） . Both groups to improve skin damage index （ P〈0.05 ） , improvement in the treatment group than the control group （ P〈0.05 ） . Recovery indicators treatment group than the control group （ P〈0.05 ） . [ Conclusion ] Wash outside medicine, cupping combined western medicine treatment of chronic eholestatic liver disease itchy skin effect is significant, it is worth promoting.