海藻玉壶汤加减治疗囊肿性痤疮血瘀痰凝证的疗效观察

Clinical Observation of Cystic Acne Caused by Blood Phlegm Stasis Treated with Haizaoyuhutang Recipe

目的观察海藻玉壶汤加减治疗囊肿性痤疮血瘀痰凝证的疗效及安全性。方法将114例囊肿性痤疮血瘀痰凝证患者随机分为中药组、西药组和中西药组,各38例。分别口服海藻玉壶汤加减,维胺酯胶囊和海藻玉壶汤加减联合维胺酯胶囊,疗程均为8周。观察各组治疗后4周、8周皮肤客观指标(DOI)、皮肤病生活质量指数(DLQI)和中医辨证囊肿性痤疮痰热血瘀证(中医证候)积分;检测血清干扰素γ(IFN-γ)、白细胞介素1(IL-1)和白细胞介素6(IL-6)的变化;比较各组有效率、复发率和安全性指标。结果治疗4周、8周,中西药组有效率分别为54.84%和80.65%,高于同期中药组(31.43%,48.57%)和西药组(27.27%,54.84%)(P均<0.05);中药组与西药组同期相比差异无统计学意义(P>0.05)。中西药组DOI、DLQI,中医证候积分和血清指标改善优于同期中药组与西药组;安全性评价西药组<中西药组<中药组(P均<0.05)。复发率中西药组<中药组<西药组(P均<0.05)。结论海藻玉壶汤加减治疗囊肿性痤疮血瘀痰凝证的有效率与西药维胺酯胶囊差异无统计学意义,且复发率和安全性评价优于维胺酯胶囊;海藻玉壶汤加减联合维胺酯胶囊具有协同增效的作用,疗效优于单用海藻玉壶汤加减和维胺酯胶囊,复发率低。

Objective To explore the therapeutic effect and security in treatment of the cystic acne（CA）caused by blood phlegm stasis with haizaoyuhutang recipe.Methods A total 114 CA caused by blood phlegm stasis patients were randomly divided into the traditional Chinese medicine（TCM）group, the western medicine（WM）group and the combined group,38 cases in each group.The TCM group was treated with haizaoyuhutang recipe; the vitamin capsule was applied in the WM group; the haizaoyuhutang recipe and vitamin capsule was adopted in combined group, a course of 8 weeks.The dermatology objective index（DOI）,dermatology life quality index（DLQI）and traditional Chinese medicine syndrome CA caused by phlegm blood stasis（TCM symptoms）were applyied to estimate the efficacy of the three group before and after treatment.The Interferon-γ（IFN-γ）, Interleukin 1（IL-1）and Interleukin 6（IL-6）were detected; the efficiency, recurrence rate and safety index were compared in the three groups.Results The efficiency of combined group was 54.84%,80.65% better than the TCM group was 31.43%,48.57% and the WM group was 27.27%,45.45%（P all〈0.05）in 4 and 8 weeks.The combined group DOI,DLQI, TCM symptoms,IFN-γ, IL-1and IL-6 were better than the others（P all〈0.05）.There was no significant difference between the TCM group and WM group（P〉0.05）.The comparision ofthe security： the WM group〈the combined group〈the TCM group（P〈0.05）; the comparision of the recurrence rate： the combined group〈the TCM group〈the WM group（P all〈0.05）.Conclusion Haizaoyuhutang recipe treating the cystic acne blood phlegm stasis is effective.Compared with chemical medicine, vitamin capsule has no obvious difference, indicating its effectiveness.The recurrence rate and safety evaluation of Haizaoyuhutang recipe were superior to that of the viamin capsules.The haizaoyuhutang recipe combined with vitamin capsule has synergistic effect, which were better than single use the haizaoyuhutang recipe or vitamin capsule, and low recurrence rate.