小儿湿疹外治中药聚类分析及临床疗效观察

Clinical Observation and Cluster Analysis of Traditional Chinese Medicine for External Treatment of Eczema in Children

目的:通过查阅中药外治小儿湿疹的相关文献,探析中药外治小儿湿疹的用药特点及规律,研制新的小儿湿疹外用方,并观察新方临床疗效。方法:检索2009年1月至2019年3月有关中药外治小儿湿疹的相关文献,将符合纳入标准文献中的中药按照功效分类,进行频次统计,然后进行系统聚类分析,根据聚类分析结果结合临床经验自拟外治新方;随机抽取符合纳入标准的湿疹患儿60例,随机分为对照组与治疗组各30例,脱落5例,对照组采用炉甘石洗剂,治疗组采用自拟新方湿敷,比较治疗第1周、第2周患儿临床症状积分及临床疗效。结果:根据文献研究聚类分析形成的湿疹外用新方组成为黄柏、苦参、白鲜皮、金银花、野菊花、马齿苋、甘草;治疗两周后两组患儿皮损面积和瘙痒程度与治疗前比较差异均有统计学意义(P<0.05);治疗第1周两组患儿皮损面积比较差异无统计学意义(P>0.05),治疗第2周治疗组患儿皮损面积小于对照组,差异有统计学意义(P<0.05),瘙痒程度治疗第1周、第2周,治疗组均低于对照组,差异有统计学意义(P<0.05);治疗组总有效率高于对照组,差异有统计学意义(P<0.05)。结论:自拟湿敷新方能够起到燥湿收敛、祛风止痒的作用,可有效减小小儿湿疹面积,减轻瘙痒程度,临床疗效优于炉甘石洗剂。

Objective:By consulting the relevant literature of external treatment of eczema in children with traditional Chinese medicine,analyzing the medication characteristics and laws of external treatment of eczema in children with traditional Chinese medicine,to develop a new external prescription for eczema in children,and observe the clinical efficacy of the new prescription.Methods:Through searching the relevant literature of external treatment of eczema in children with traditional Chinese medicine from January,2009 to March,2019,traditional Chinese medicines in the literature that met the inclusion criteria were classified according to the efficacy,to conduct frequency statistics and systematic cluster analysis,new external prescription was made by combining the results of cluster analysis and clinical experience;sixty children who met the inclusion criteria were randomly chosen and allocated to the control group and the treatment group,30 cases each group,five cases dropped,the control group adopted calamine lotion,and the treatment group wet compressing of selfmade new prescription,to compare clinical symptom scales and clinical effects after one week and two weeks of treatment.Results:According to the literature research and cluster analysis,the new prescription of exzema for external application contained Huangbo(cortex phellodendri),Kushen(lightyellow sophora root),Baixianpi(densefruit pittany root-bark),honeysuckle flower,wild chrysanthemum,herba portulacae and licorice;the difference showed no statistical meaning in lesion area at the first week of treatment between both groups(P>0.05),the treatment group was less than the control group at the second week of treatment,and the difference was statistically significant(P<0.05).Itching degrees,the treatment group was lower than the control group in itching degrees at the first week and the second week of treatment,the difference showed statistical meaning(P<0.05);the treatment group was higher than the control group in total effective rate,and the difference showed statisticalmeaning(P<0.05).Conclusion:Selfmade new prescriptions for wet compressing could dry the dampness,constrict,dispel wind and relieve itching,it could effectively alleviate eczema areas and itching degrees,and its clinical effects are superior to these of calamine lotion.