桃红四物汤加味联合针刺治疗烧伤后创面瘙痒

Taohong Siwu Decoction Combined with Acupuncture Treating Wound Itching After Burn

目的:探讨桃红四物汤加味联合针刺治疗烧伤后创面瘙痒的临床疗效。方法:将92例烧伤后创面瘙痒患者按随机数字表法分成观察组(n=46)与对照组(n=46)。观察组给予桃红四物汤加味联合针刺治疗,对照组口服赛庚啶片。所有患者均治疗8周。比较两组临床疗效,治疗前后采用温哥华瘢痕量表(vancouver scar scale,VSS)评估烧伤瘢痕改善情况。选用视觉模拟评分法(visual analog scale,VAS)及四项目瘙痒问卷(four-item itching questionnaire,FIIQ)评价烧伤创面瘙痒程度,治疗前后采取酶联免疫法检测两组患者瘙痒介质[白细胞介素-2(interleukin,IL-2)、白三烯B4(leukotriene B4,LTB4)]血清水平。结果:观察组止痒有效率为97.83%(45/46),与对照组73.91%(34/46)比较,差异有统计学意义(P<0.05)。两组治疗后VSS、VAS评分及FIIQ中各项(瘙痒部位、程度、频率和睡眠影响)评分均较治疗前显著降低(P<0.05),且观察组治疗后VSS、VAS评分和FIIQ各项目评分较对照组均显著降低(P<0.05)。两组治疗后血清IL-2、LTB4水平均较治疗前显著下降(P<0.05),且观察组治疗后以上瘙痒介质血清浓度均显著低于对照组(P<0.05)。结论:桃红四物汤加味联合针刺治疗烧伤后创面瘙痒可有效减轻患者瘙痒症状,下调血清中瘙痒介质表达,疗效确切。

Objective:To investigate the clinical effect of Taohong Siwu Decoction combined with acupuncture on wound healing after burn wounds.Methods:92 patients with burn wounds after burns were randomly divided into observation group(n=46) and control group(n=46).The observation group was treated with Taohong Siwu Decoction combined with acupuncture,and the control group was treated with cyproheptadine tablets combined with acupuncture.All patients were treated for 8 weeks.The clinical efficacy of the two groups was compared.Before and after treatment,the Vancouver scar scale(VSS) was used to evaluate the improvement of burn scars.The visual analog scale(VAS) and the four-item itching questionnaire were used.FIIQ) evaluated the degree of itching in burn wounds.The serum levels of pruritic mediators [interleukin(IL-2) and leukotriene B4(LTB4)] were measured by enzyme-linked immune-sorbent assay(ELISA) before and after treatment.RESULTS:The effective rate of itching in the observation group was 97.83%(45/46),which was statistically significant compared with the control group(73.91%(34/46))(P<0.05).The scores of VSS,VAS score and FIIQ(itch position,degree,frequency and sleep effect) were significantly lower than those before treatment(P<0.05),and VSS,VAS score and FIIQ were observed in the observation group.The scores of the above items were significantly lower than those of the control group(P<0.05).The levels of serum IL-2 and LTB4 in the two groups were significantly lower than those before treatment(P<0.05),while the serum concentrations of the above pruritus in the observation group were significantly lower than those in the control group(P<0.05).Conclusion:Taohong Siwu Decoction combined with acupuncture treatment of wound pruritus after burn can effectively alleviate the symptoms of pruritus in patients and down-regulate the expression of pruritic medium in serum.