湿热毒清汤联合西医治疗对肛周湿疹湿热下注证患者临床症状、炎症反应的影响

Effect of Shire Duqing Decoction combined with western medicine on clinical symptoms and inflammatory reaction of patients with perianal eczema

目的观察湿热毒清汤联合西医治疗对肛周湿疹湿热下注证患者临床症状、炎症反应的影响。方法前瞻性选取2020年1月至2022年5月首都医科大学附属北京中医医院收治的118例肛周湿疹湿热下注证患者为对象,采用简单随机法分为两组,对照组与观察组,各59例。对照组采用西医治疗,观察组采用湿热毒清汤联合西医治疗。比较两组疗效、病情评分、皮肤病生活质量量表(DLQI)评分、中医症候积分、炎症因子[白细胞介素(IL)-2、干扰素-γ(INF-γ)、IL-4、IL-10]的差异。结果治疗后,观察组总有效率达91.53%,高于对照组的77.97%,差异有统计学意义(P<0.05)。治疗后,两组肛门瘙痒、肛周湿疹面积、肛周皮疹形态及肛周渗液评分均较治疗前下降,且观察组肛门瘙痒、肛周湿疹面积、肛周皮疹形态及肛周渗液评分分别为(0.74±0.18)、(0.81±0.22)、(0.67±0.21)、(0.64±0.15)分,均低于对照组[(1.33±0.28)、(1.17±0.29)、(1.25±0.23)、(1.03±0.19)分],差异均有统计学意义(P<0.05)。治疗后,两组DLQI评分、中医症候积分均较治疗前下降,且观察组DLQI评分、中医症候积分分别为(0.68±0.12)、(7.14±0.45)分,均低于对照组[(1.24±0.16)、(10.98±1.74)分],差异均有统计学意义(P<0.05)。治疗后,两组IL-2、INF-γ均较治疗前升高,IL-4、IL-10较治疗前下降,且观察组IL-2、INF-γ分别为(42.23±5.03)、(40.78±6.59)ng/L,均高于对照组[(35.63±4.87)、(31.52±5.22)ng/L],观察组IL-4、IL-10分别为(30.14±4.25)、(8.14±1.21)ng/L,均低于对照组[(36.23±5.11)、(10.32±1.58)ng/L],差异均有统计学意义(P<0.05)。结论湿热毒清汤联合西医治疗肛周湿疹湿热下注证可有效减轻患者肛门瘙痒,促进康复,可能与调节炎症反应有关。

Objective To observe the effect of Shire Duqing decoction combined with western medicine on the clinical symptoms and inflammatory reaction of patients with perianal eczema with damp heat downpour syndrome.Methods A total of 118 patients with perianal eczema and eczema syndrome admitted to Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University from January 2020 to May 2022 were prospectively selected and divided into two groups by simple random method,control group and observation group,with 59 patients in each group.The control group was treated with western medicine,and the observation group was treated with dampness-heat toxic decoction combined with western medicine.The difference of efficacy,disease score,skin disease quality of life scale(DLQI)score,traditional chinese medical symptom score and inflammatory factors[interleukin(IL)-2,interferon γ(INF-γ),IL-4,IL-10]were compared between the two groups.Results The total effective rate in the observation group was 91.53%,higher than that in the control group(77.97%),the difference was statistically significant(P<0.05).After treatment,the scores of anal itching,area of perianal eczema,morphology of perianal eczema,and perianal exudation in the two groups decreased were lower than those before treatment,and the scores of anal itching,area of perianal eczema,morphology of perianal eczema,and perianal exudation in the observation group were(0.74±0.18),(0.81±0.22),(0.67±0.21),and(0.64±0.15)points,respectively,which were lower than those in the control group[(1.33±0.28),(1.17±0.29),(1.25±0.23),and(1.03±0.19)points,respectively],the differences were statistically significant(P<0.05).After treatment,the DLQI score and TCM syndrome scores in the two groups were lower than those before treatment,and the DLQI score and TCM syndrome scores in the observation group were(0.68±0.12)and(7.14±0.45)points,respectively,which were lower than those in the control group[(1.24±0.16)and(10.98±1.74)points],the differences were statistically significant(P<0.05).After treatment,the level of IL-2 and INF-γin both groups were higher than those before treatment,the level of IL-4 and IL-10 in both groups were lower than those before treatment,and the levels of IL-2 and INF-γ in the observation group were(42.23±5.03)and(40.78±6.59)ng/L,respectively,which were higher than those in the control group[(35.63±4.87)and(31.52±5.22)ng/L],the levels of IL-4 and IL-10 in the observation groups were(30.14±4.25)and(8.14±1.21)ng/L,respectively,which were significantly lower than those in the control group[(36.23±5.11)and(10.32±1.58)ng/L],the differences were statistically significant(P<0.05).Conclusion Shire Duqing Decoction combined with western medicine can effectively relieve the anal itching of patients with perianal eczema and promote recovery,which may be related to the regulation of inflammatory reaction.