自拟凉血止痒方辨证加减配合西医治疗寻常型银屑病血热证急性期临床观察

Clinical St udy of Dialectical Addition and Subtraction of Self-made Liangxue Zhiyang Decoction Combined with Western Medicine on Acute Stage of Psoriasis Vulgaris with Blood Heat Type

目的观察自拟凉血止痒方辩证加减配合西医治疗寻常型银屑病血热证急性期临床效果。方法研究对象选取寻常型银屑病血热证急性期患者80例,采用随机数字表法将患者分为对照组和观察组,分别采用维胺酯口服单用和与自拟凉血止痒方辨证加减联用治疗;比较两组患者临床疗效,治疗前后银屑病严重程度指数(PASI)积分,血清细胞因子改变和疾病复发率等。结果观察组患者临床疗效显著优于对照组(P<0.05);观察组患者治疗后PASI积分显著优于对照组和治疗前(P<0.05);同时观察组患者治疗后血清细胞因子水平均显著优于对照组和治疗前(P<0.05);观察组患者疾病复发率显著低于对照组(P<0.05)。结论自拟凉血止痒方辨证加减配合西医治疗寻常型银屑病血热证急性期可有效缓解皮损程度,改善血清细胞因子指标,并有助于降低远期复发风险。

Objective： To investigate clinical effects of dialectical addition and subtraction of self-made Liangxue Zhiyang decoction combined with western medicine on acute stage of psoriasis vulgaris with blood heat type.Methods： 80 patients with acute stage of psoriasis vulgaris with blood heat type were chosen in the period from October 2012 to December 2014 in our hospital and randomly divided into the control group（40 patients） with acitretin used alone and TCM group（40 patients） with dialectical addition and subtraction of Liangxue Zhiyang decoction on the treatment basis of the control group. The clinical efficacy,the psoriasis severity index（PASI）score,serum cytokine levels before and after treatment and the recurrence rate of both groups were compared. Results： The clinical efficacy of TCM group was significantly better than that of the control group（P〈0.05）. The PASI scores after treatment of TCM group was significantly better than that of the control group and than that before treatment（P〈0.05）. The serum cytokine levels after treatment of TCM group was significantly better than that of the control group and that before treatment（P〈0.05）. The recurrence rate of TCM group was significantly lower than that of the control group（P〈0.05）. Conclusion： Dialectical addition and subtraction of self-made Liangxue Zhiyang decoction combined with western medicine on acute stage of psoriasis vulgaris with blood heat type can efficiently relieve the degree of skin lesions,improve serum cytokines and is helpful to reduce the risk of long-term recurrence.