金鱼外洗方对不同中医体质小儿异位性皮炎的疗效观察

Therapeutic Effect of Jin Yu Waixi Recipe for Pediatric Atopic Dermatitis Children with Different Traditional Chinese Medical Constitutions

【目的】观察自拟金鱼外洗方外用治疗不同中医体质小儿异位性皮炎的临床疗效。【方法】选取180例1~6岁异位性皮炎患者,按照脾虚质、湿滞质、心火偏盛质3种不同体质类型分组,每组60例,每种体质再随机分为治疗组和对照组各30例。治疗组以金鱼外洗方配合赛庚啶片治疗,对照组单纯以赛庚啶片治疗。2组均以7 d为1个疗程,共治疗4个疗程。观察各组治疗前后瘙痒、睡眠、皮损面积、皮损严重度的积分和SCORAD评分的变化情况,评价各组疗效及安全性。【结果】(1)治疗后,治疗组脾虚质、湿滞质、心火偏盛质患儿的瘙痒程度、睡眠状况(心火偏盛质除外)、皮损面积、皮损严重程度及SCORAD评分均有改善(P<0.01);对照组3种不同体质类型患儿的瘙痒程度、睡眠状况(脾虚质和湿滞质除外)、皮损面积(脾虚质和心火偏盛质除外)、皮损严重程度(心火偏盛质除外)及SCORAD评分也均有改善(P<0.05或P<0.01)。组间比较,治疗组3种不同体质类型患儿在睡眠状况(心火偏盛质除外)、皮损面积、皮损严重程度的改善上均优于对照组(P<0.01)。(2)疗效方面:治疗组3种不同体质类型患儿的疗效与对照组比较,差异均无统计学意义(P>0.05)。(3)研究过程中,2组患儿均未发现明显的不良反应。【结论】与单纯内服赛庚啶片的患者相比,金鱼外洗方外用配合赛庚啶片内服能有效缓解不同体质类型异位性皮炎相关症状,明显改善患者病情;金鱼外洗方对于脾虚质和湿滞质异位性皮炎患者,重在改善患者的睡眠状况、皮损面积和皮损严重程度;而对于心火偏盛质异位性皮炎患者,则重在改善皮损面积、皮损严重程度。

Objective To observe the clinical effect of external application of Jin Yu Waixi Recipe（JYWP）on treating atopic dermatitis children with different traditional Chinese medical constitutions. Methods Children aged 1-6 years old meeting the diagnostic criteria and inclusion criteria of atopic dermatitis were differentiated into 3 kinds of traditional Chinese medical constitutions（spleen deficiency type,dampness accumulation type,and heart-fire hyperactivity type）,60 cases in each constitution type. And then patients with each constitution type were divided into treatment group and control group, 30 cases in each group. The treatment group was treated with JYWP combined with cyproheptadine tablets,and the control group was treated with cyproheptadine tablets alone. Seven days constituted one treatment course and the treatment lasted for 4 courses. The clinical efficiency and safety were evaluated with the changes of pruritus,sleep,psoriasis area,psoriasis severity,and Scoring Atopic Dermatitis Index（SCORAD） scores before and after treatment. Results（1）After treatment,the pruritus, sleep（except for heart-fire hyperactivity type）, psoriasis area, psoriasis severity, and SCORAD scores of the treatment group of the 3 constitutions were much improved（P 0.01）;the pruritus,sleep（except for spleen deficiency type and dampness accumulation type）,psoriasis area（except for spleen deficiency type and heart-fire hyperactivity type）,psoriasis severity（except for heart-fire hyperactivity type）,and SCORAD scores of the control group of the 3 constitutions were also improved（P 0.05 or P 0.01）. The results of inter-group comparison showed that the treatment group had better effect on improving sleep（except for heartfire hyperactivity type）, psoriasis area, psoriasis severity, and SCORAD scores than the control group（P 0.01）.（2） The differences of the therapeutic effect between the two groups with 3 constitutions were insignificant（P 0.05）.（3）During the treatment,no adverse reaction was found in the two groups. Conclusion Compared with oral use of cyproheptadine hydrochloride tablets alone, external application of JYWP combined with oral use of cyproheptadine hydrochloride tablets can effectively relieve the symptoms of atopic dermatitis patients with different constitution types. External application of JYWP is effective on relieving psoriasis,is more beneficial to the improvement of sleep status, psoriasis area and psoriasis severity of patients with the constitutions of spleen deficiency type and dampness accumulation type,and is more beneficial to the improvement of psoriasis area and psoriasis severity of patients with the constitution of heart-fire hyperactivity.