加味五味消毒饮联合放血拔罐疗法治疗湿热毒蕴型面部激素依赖性皮炎的疗效及对患者皮肤功能、皮质醇、炎症因子水平的影响

Clinical effect of modified Wuwei Xiaodu decoction combined with bloodletting and cupping therapy on the treatment of facial hormone-dependent dermatitis with damp-heat toxic accumulation type and its effect on skin function,cortisol and inflammatory facto

目的观察加味五味消毒饮联合放血拔罐疗法治疗湿热毒蕴型面部激素依赖性皮炎的临床疗效,以及其对患者皮肤功能、皮质醇、炎症因子水平的影响。方法将98例面部激素依赖性皮炎患者按随机数字表法分为2组。对照组49例予放血拔罐疗法治疗;治疗组49例在对照组的基础上加用五味消毒饮治疗。2组均治疗4周后统计疗效,比较2组治疗前后皮肤水分流失(TEWL)值、表皮水含量、表皮油脂含量及血清皮质醇、肿瘤坏死因子α(TNF-α)、γ-干扰素(IFN-γ)、白细胞介素4(IL-4)水平变化情况。结果治疗组总有效率93.88%,对照组总有效率71.43%,治疗组疗效优于对照组(P<0.05); 2组治疗后与本组治疗前比较TEWL值均明显降低(P<0.05),表皮水含量及表皮油脂含量均明显升高(P<0.05),且治疗组治疗后TEWL值、表皮水含量及表皮油脂含量改善均优于对照组(P<0.05); 2组治疗后与本组治疗前比较皮质醇水平均明显升高(P<0.05),TNF-α、IFN-γ及IL-4水平均明显降低(P<0.05),且治疗组治疗后皮质醇、TNF-α、IFN-γ及IL-4水平改善均优于对照组(P<0.05)。结论加味五味消毒饮联合放血拔罐疗法治疗湿热毒蕴型面部激素依赖性皮炎疗效确切,可明显改善皮肤功能,增加外周皮质醇水平,降低炎症因子水平,抑制炎症反应。

Objective To observe the effect of modified Wuwei Xiaodu decoction combined with bloodletting and cupping therapy on the treatment of facial hormone-dependent dermatitis with damp-heat toxic accumulation type and its effect on skin function, cortisol and inflammatory factors. Methods 98 patients with facial hormone-dependent dermatitis were randomly divided into two groups according to random numble table method. 49 patients in control group were treated by bloodletting and cupping therapy. 49 patients in treatment group were treated by Wuwei Xiaodu decoction on the basis of the control group. After 4 weeks of treatment, the skin water loss（TEWL）,epidermal water content, epidermal oil content, serum cortisol, tumor necrosis factor-alpha （TNF-α）, interferon-gamma（IFN-γ）and interleukin-4（IL-4） levels were compared between the two groups. Results The total effective rate was 93.88 % in the treatment group and 71.43 % in the control group. The therapeutic effect of the treatment group was better than that of the control group （ P 〈0.05）. The TEWL value of the two groups decreased significantly after treatment（ P 〈0.05）, the water content of epidermis and the oil content of epidermis increased significantly（ P 〈 0.05）, and the improvement of TEWL value, water content of epidermis and oil content of epidermis in the treatment group were better than those in the control group （ P 〈0.05）. The levels of cortisol were significantly higher in the 2 groups after treatment than in the group before treatment （ P 〈0.05）, and the levels of TNF-α, IFN-γ and IL-4 were significantly lower （ P 〈0.05）, and the levels of cortisol, TNF-α, IFN-γ and IL-4 in the treatment group were significantly lower than those in the control group （ P 〈0.05）. Conclusion The modified Wuwei Xiaodu decoction combined with bloodletting and cupping therapy is effective in treating facial hormone-dependent dermatitis with damp-heat toxic accumulation type, which can significantly improve skin function, increase peripheral cortisol levels, reduce inflammatory factor levels and inhibit inflammatory response.