龙胆泻肝汤加减联合西药治疗急性湿疹(湿热内蕴证)的临床观察

The Clincal Observation of Modified Longdan Xiegan Decoction Combined with Cetirizine on Damp-heat Acute Eczema

目的观察龙胆泻肝汤加减联合西替利嗪治疗急性湿疹(湿热内蕴证)的疗效及对炎症因子和细胞免疫功能的影响。方法将80例患者按照随机数字表法分为治疗组和对照组,每组40例,对照组给予口服西替利嗪治疗,治疗组给予口服西替利嗪和龙胆泻肝汤加减治疗,比较两组患者治疗后的临床疗效,采用酶联免疫吸附法测定血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和白细胞介素-8(IL-8),流式细胞仪测定T细胞亚群CD4^+、CD8^+细胞,并观察不良反应。结果治疗组的总有效率为92.50%,显著高于对照组的72.50%(P<0.05)。治疗后,两组TNF-α、IL-6和IL-8细胞因子低于治疗前(P<0.05),且治疗组显著低于对照组(P<0.05);治疗后,两组患者的T细胞CD4^+、CD8^+高于治疗前,且治疗组显著高于对照组,差异均有统计学意义(P<0.05)。两组患者均出现大便稀、胃痛、口干、嗜睡、乏力等轻微不良反应,差异无统计学意义(P>0.05)。结论龙胆泻肝汤加减联合西替利嗪治疗急性湿疹(湿热内蕴证),通过减轻炎症反应,调节机体免疫功能,提高临床疗效,不良反应轻。

Objective： To study the curative effects of Modified Longdan Xiegan Decoction combined with cetirizine on damp-heat acute eczema and the influence on inflammatory factors and cellular immune function.Methods： 80 cases were divided into the treatment group and the control group with the random number table method,40 cases in each group. The control group was given oral cetirizine treatment,while the treatment group was given oral cetirizine combined with Modified Longdan Xiegan Decoction. After treatment,the clinical effects of both were compared. Enzyme linked immunosorbent assay was used to detected TNF-α,IL-6 and IL-8;flow cytometry was used to detect CD4＋and CD8＋of T-cell subsets and adverse reactions were observed. Results： The total effective rate of the treatment group was 92.50%,which was significantly higher than that of the control group72.50%（P 0.05）. Before treatment,there was no statistically significant difference between the two groups in TNF-α,IL-6,IL-8,CD4＋and CD8＋of T-cell subsets（P 0.05）. After treatment,TNF-α,IL-6 and IL-8 of the two groups were lower than those before treatment,and the treatment group was significantly lower than the control group;after treatment,CD4＋and CD8＋of T-cell subsets of the two groups were higher than those before treatment,and the treatment group was significantly higher than the control group. The difference was statistically significant（P 0.05）. Mild adverse reactions were found in the two groups,such as stool,stomach pain,dry mouth,drowsiness,fatigue,and so on;the difference was not statistically significant（P 0.05）. Conclusion： Modified Longdan Xiegan Decoction combined with cetirizine on damp-heat acute eczema regulates immune function and improves clinical efficacy with mild adverse reactions by reducing inflammatory reaction.