益气养阴散邪法治疗肺胃热盛证玫瑰痤疮的疗效及机制研究

Clinical Effect and Partial Mechanism of Benefiting Qi and Nourishing Yin and Dispersing Pathogenic Factors Method in Treatment of Rosaceae with Heat in Lung and Stomach Syndrome

目的探讨益气养阴散邪法治疗肺胃热盛证玫瑰痤疮的临床疗效及部分机制研究。方法以2017年1月—2019年12月医院就诊的110肺胃热盛证玫瑰痤疮患者为研究对象,依据随机对照法分为观察组和对照组,每组55例。对照组患者采用甲硝唑凝胶和盐酸多西环素治疗。每日于皮损处涂抹甲硝唑凝胶,2次/d。口服盐酸多西环素,1片/次,2次/d。观察组在对照组治疗的基础上,口服益气养阴散邪汤治疗。两组持续治疗8周。比较两组治疗疗效,治疗前后中医证候积分,比较两组治疗前后Acne-QOL评分和血清IL-4、IL-17和IL-37水平。结果观察组疗效为90.91%(50/55),对照组疗效为76.36%(42/55),经χ^(2)检验,观察组疗效高于对照组(P<0.05);两组治疗后干燥、瘙痒、丘疹、红斑、肿胀、灼热和毛细血管扩张等中医证候积分较治疗前降低,观察组治疗后干燥、瘙痒、丘疹、红斑、肿胀、灼热和毛细血管扩张等中医证候积分低于对照组(P<0.05);两组治疗后Acne-QOL评分均较治疗前升高,观察组治疗后Acne-QOL评分高于对照组(P<0.05);两组治疗后血清IL-4、IL-17和IL-37水平较治疗前下降,观察组下降幅度优于对照组(P<0.05)。结论在西药常规治疗的基础上,内服益气养阴透邪汤辅助治疗,可更为快速的改善肺胃热盛证玫瑰痤疮患者的临床症状,调解人体免疫,降低炎症因子的表达,提高生活质量,增加患者自信,提高治疗疗效,值得临床借鉴。

e Objective To investigate the clinical effect and partial mechanism of benefiting Qi and nourishing Yin and disper-sing pathogenic factors method in the treatment of rosaceae with heat in lung and stomach syndrome.s Methods A total of 110 pa-tients with rosaceae with heat in lung and stomach syndrome who visited our hospital from January 2017 to December 2019 were selected as the study subjects,and were divided into observation group and control group according to the randomized control method,with 55 cases in each group.Patients in the control group were treated with metronidazole gel and doxycycline hydro-chloride.The metronidazole gel was applied on skin lesions twice a day.Doxycycline hydrochloride was taken orally,one tablet once and twice a day.The observation group on the basis of the control group added Yiqi Yangyin Sanxie Decoction(益气养阴散邪汤)orally.Both groups continued treatment for 8 weeks.We compared the therapeutic efficacy of the two groups,TCM syn-drome scores before and after treatment,Acne-QOL score and serum levels of IL-4,IL-17 and IL-37 before and after treat-ment.s Results The therapeutic effect of the observation group was 90.91%(50/55),while that of the control group was 76.36%(42/55).Byχ2 test,the therapeutic effect of the observation group was higher than that of the control group(P<0.05).Scores of TCM symptoms such as dryness,pruritus,papules,erythema,swelling,burning and telangiectasia after treatment were lower in the two groups than those before treatment.Scores of TCM symptoms such as dryness,pruritus,papules,erythema,swelling,burning and telangiectasia after treatment in the observation group were lower than those in the control group(P<0.05).Acne-QOL scores in both groups were higher after treatment than those before treatment,and those in the observation group were higher than those in the control group(P<0.05).After treatment,serum levels of IL-4,IL-17 and IL-37 in the two groups were decreased compared with those before treatment,and the decrease amplitude in the observation group was better than that in the control group(P<0.05).n Conclusion On the basis of the conventional treatment of western medicine,oral administration of Yiqi Yangyin Sanxie Decoction can more quickly improve the clinical symptoms of rosaceae patients with heat in lung and stomach syndrome,mediate human immunity,reduce the expressions of inflammatory factors,improve the quality of life,increase the confi-dence of patients and improve the therapeutic effect,worthy of clinical reference.