健脾祛湿汤治疗脾虚湿蕴型湿疹的疗效观察及对机体免疫功能的影响研究

Effect of Using Jianpi Qushi Decoction in the Treatment of Spleen Deficiency and Dampness Accumulation Type Eczema and Its Effect on Immune Function

目的:研究自拟健脾祛湿汤治疗脾虚湿蕴型湿疹的临床疗效观察及对其机体免疫功能的影响。方法:选取80例湿疹患者,将所选患者随机分为对照组和观察组。对照组给予盐酸西替利嗪片10mg,口服,每日1次;外用糠酸莫米松乳膏,每日1次;观察组患者给予制健脾祛湿汤治疗,每日1剂;外用糠酸莫米松乳膏,每日1次;2组均半个月为1个疗程,连续治疗2个疗程。将2组治疗前后血清中的T细胞的亚群(CD_4^+、CD_8^+、CD_4^+/CD_8^+)、白细胞介素-2(interleukin-2,IL-2)、白细胞介素-6(interleukin-4,IL-6)、白细胞介素-17(interleukin-10,IL-17)及白细胞介素-23(interleukin-23,IL-23)的含量进行比较;比较2组湿疹面积及严重程度评分、瘙痒程度评分、临床疗效以及治疗过程中出现的不良反应。结果:治疗后观察组IL-2、IL-6、IL-17及IL-23的降低程度较对照组更为明显(P<0.05)。治疗后观察组的CD_4^+/CD_8^+显著较对照组改善明显(P<0.05);治疗后2组EASI积分、VAS评分均较治疗前显著降低(P<0.05),并且观察组较对照组降低幅度更大(P<0.05);对照组的总有效率为78.9%,而观察组的治疗总有效率为92.9%。结论:健脾祛湿汤治疗脾虚湿蕴型湿疹的临床疗效显著,其作用机制可能与调节T淋巴细胞的失衡相关。

Objective ： To study the clinical effect of using Self-made Jianpi Qushi Decoction in the treatment of spleen defi- ciency and dampness accumulation type eczema and its effect on immune function. Methods ： 80patients with eczema were select- ed and randomly divided into controlled group and observation group, The controlled group received Xitirizine Hydrochloride Tab- lets 10mg, orally, 1 time per day. External use of Mometasone Furoate Cream, 1 time daily; The patients in the observation group were treated with Jianpi Qushi Decoction and l dose per day. External use of Mometasone Furoate Cream, l time daily. Both groups were given one course of treatment for half a month, and two courses of treatment were continuously treated. The two groups before and after treatment in the serum of T cell subsets （CD4^＋, CD8^＋, CD4^＋/CD8^＋） , interleukin-2 （IL-2）, interleu- kin 6 （IL-6）, interleukin-17 （IL-17） and intereukin-23 （IL-23） levels are compared; Comparison of the two groups of eczema and severity score, the degree of itch, the clinical efficacy and the adverse reactions during the treatment. Results ： The decrease of I1-2, I1-6, It-17and I1-23in the observation group was significantly higher than that in the controlled group （P〈 0. 05）. After treatment, the CD4./CD8^＋ of the observation group was significantly improved compared with the controlled group （P〈0.05）. EASI integral, VAS score after treatment 2group were significantly lower than before treatment （P〈0, 05）, and the observation group than the controlled group in lower amplitude （ P〈0. 05 ）. The total effective rate of the controlled group was 78. 9%, while the total effective rate of treatment was 92. 9%. Conclusion： The effect of using Jianpi Qushi Decoction in the treatment of spleen deficiency dampness accumulation type eczema is significant, and its mechanism may be related to the regula- tion of T lymphocyte imbalance.