养血解毒祛湿汤治疗寻常型银屑病血燥夹湿证患者的临床疗效观察

Observation on Clinical Efficacy of Yangxue Jiedu Qushi Decoction for the Treatment of Psoriasis Vulgaris with Blood Dryness Complicated with Dampness Syndrome

【目的】观察养血解毒祛湿汤治疗寻常型银屑病血燥夹湿证患者的临床疗效。【方法】将60例寻常型银屑病血燥夹湿证患者随机分为观察组和对照组,每组各30例。2组患者均给予外涂卡泊三醇软膏治疗,在此基础上,观察组给予口服养血解毒祛湿汤治疗,对照组给予口服消银颗粒治疗,疗程为8周。观察2组患者治疗前后银屑病皮损面积和严重性指数(PASI)评分、瘙痒程度视觉模拟量表(VAS)评分、皮肤病生活质量指数(DLQI)评分、体表受累面积(BSA)评分、中医主要证候评分、皮肤镜下表现评分的变化情况,并于治疗8周后对2组患者的临床疗效和安全性作出评价。【结果】(1)治疗8周后,观察组的总有效率为96.7%(29/30),对照组为90.0%(27/30),2组总有效率比较(卡方检验),差异无统计学意义(Ρ>0.05);但观察组的总体疗效明显优于对照组,组间比较(秩和检验),差异有统计学意义(Ρ<0.05)。(2)治疗后,2组患者的PASI、DLQI、VAS、BSA评分及中医主要证候评分、皮肤镜下表现评分均较治疗前明显改善(Ρ<0.05),且观察组对PASI、DLQI、VAS、BSA评分及中医主要证候评分、皮肤镜下表现评分的改善作用均明显优于对照组,差异均有统计学意义(Ρ<0.05)。(3)治疗期间,2组患者均未出现明显的不良反应。【结论】养血解毒祛湿汤治疗寻常型银屑病血燥夹湿证患者疗效确切,能有效改善患者的皮损情况及皮肤镜下血管的表现情况,显著减轻患者的瘙痒症状,提高患者的生活质量,且安全性好。

Objective To observe the clinical efficacy of Yangxue Jiedu Qushi Decoction in treating psoriasis vulgaris differentiated as blood dryness complicated with dampness syndrome.Methods Sixty patients of psoriasis vulgaris with blood dryness complicated with dampness syndrome were randomly divided into the observation group and the control group,with 30 patients in each group.Both groups were treated with topical application of Calcipotriol Ointment,and additionally,the observation group was given oral use of Yangxue Jiedu Qushi Decoction,while the control group was given oral a use of Xiaoyin Granules.The treatment for both groups lasted for 8 weeks.The changes in the psoriasis area and severity index(PASI)score,pruritus visual analogue scale(VAS)scores,dermatology life quality index(DLQI)scores,body surface area affected by psoriasis(BSA)scores,traditional Chinese medicine(TCM)main syndrome scores and dermoscopic manifestation scores in the two groups were observed before and after treatment.After 8 weeks of treatment,the clinical efficacy and safety of the two groups were evaluated.Results(1)After 8 weeks of treatment,the overall effective rate of the observation group was 96.7%(29/30)and that of the control group was 90.0%(27/30).The intergroup comparison showed that the difference of total effective rate assessed by Chi-square test between the two groups was not statistically significant(Ρ>0.05),but the overall efficacy of the observation group was significantly superior to that of the control group,and the difference of overall efficacy assessed by rank sum test was statistically significant(Ρ<0.05).(2)After treatment,the scores of PASI,DLQI,VAS,BSA,TCM main syndromes and dermoscopic performance in both groups were significantly improved in comparison with those before treatment(Ρ<0.05),and the effect on improving the scores of the observation group was significantly superior to that of the control group,and the difference was statistically significant(Ρ<0.05).(3)During the treatment period,there were no significant adverse effects occurring in the two groups.Conclusion Yangxue Jiedu Qushi Decoction exerts certain effect in treating psoriasis vulgaris with blood dryness complicated with dampness syndrome,and is effective on improving the skin lesions and dermoscopic vascular manifestations,significantly allieviating pruritus symptoms and improving the quality of life of the patients with high safety.