毫火针联合中药治疗肝肾不足型白癜风疗效观察及对中医证候积分及皮损面积的影响

Observations on the Efficacy of Filiform-fire Needling plus Chinese Herbal Medicine for Vitiligo of Liver-kidney Deficiency Type and Its Effect on the TCM Syndrome Score and Skin Lesion Area

目的观察毫火针联合中药治疗肝肾不足型白癜风的临床疗效及对患者中医证候积分及皮损面积的影响。方法将80例肝肾不足型白癜风患者,随机分为观察组和对照组,每组40例。两组均采用基础治疗,对照组予自拟补肾活血汤温服,观察组在对照组治疗基础上联合毫火针治疗。比较两组治疗前后中医证候积分、皮损面积、血清指标[白细胞介素-1β(IL-1β)、趋化因子9(CXCL9)、细胞间黏附分子1(ICAM-1)]、皮肤病理活检结果,并比较两组临床疗效。结果两组治疗后中医证候积分均明显低于治疗前(P<0.05),且观察组明显低于对照组(P<0.05)。治疗4周后、治疗8周后、治疗后,两组皮损面积均明显低于治疗前(P<0.05),且观察组低于对照组(P<0.05)。两组治疗后血清IL-1β、CXCL9、ICAM-1水平均较治疗前降低(P<0.05),且观察组明显低于对照组(P<0.05)。皮肤病理活检结果显示,观察组皮损区黑色素细胞增生活跃比例为72.5%,明显高于对照组的45.0%(P<0.05)。观察组中医证候总有效率为87.5%,明显高于对照组的60.0%(P<0.05)。观察组西医临床总有效率为85.0%,明显高于对照组的65.0%(P<0.05)。结论毫火针联合中药治疗肝肾不足型白癜风,可更好减轻患者中医证候、减少皮损面积,能更好地调节患者相关免疫炎症指标、促进黑色素细胞增生,疗效显著。

Objective To investigate the clinical efficacy of filiform-fire needling plus Chinese herbal medicine for vitiligo of liver-kidney deficiency type and its effect on the traditional Chinese medicine(TCM)syndrome score and skin lesion area in the patients.Methods Eighty patients with vitiligo of liver-kidney deficiency type were randomized to observation and control groups,with 40 cases in each group.Both groups received basic treatment.The control group was treated with self-made Bushen Huoxue decoction taken at warm condition and the observation group,with filiform-fire needling in addition.The TCM syndrome scores,skin lesion areas,serum indicators(interleukin-1β(IL-1β),chemokine 9(CXCL9)and intercellular adhesion molecule 1(ICAM-1))and skin biopsy results were compared between the two groups before and after treatment.Results After treatment,the TCM syndrome score decreased significantly in the two groups compared with before(P<0.05)and was significantly lower in the observation group than in the control group(P<0.05).After treatment,the skin lesion area decreased significantly in the two groups compared with before(P<0.05)and was lower in the observation group than in the control group(P<0.05).After treatment,serum IL-1β,CXCL9 and ICAM-1 levels decreased in the two groups compared with before(P<0.05)and were significantly lower in the observation group than in the control group(P<0.05).Skin biopsy results showed that the proportion of melanocytes in the skin lesion area was 72.5%in the observation group,which was significantly higher than 45.0%in the control group(P<0.05).The total efficacy rate based on TCM syndrome was 87.5%in the observation group,which was significantly higher than 60.0%in the control group(P<0.05).The total efficacy rate based on clinical practice of Western medicine was 87.5%in the observation group,which was significantly higher than 60.0%in the control group(P<0.05).Conclusions Filiform-fire needling plus Chinese herbal medicine can better relieve TCM syndrome,decrease the skin lesion area,regulate related Immune-inflammatory indicators and promote melanocytic proliferation with a good effect in treating patients with vitiligo of liver-kidney deficiency type.