中药汤剂联合糖皮质激素治疗血热型色素性紫癜性皮肤病的临床研究

Clinical study on the treatment of blood heat pigmentary purpuric dermatosis by Chinese decoction combined with glucocorticoid

目的:比较中药汤剂联合糖皮质激素和单独使用糖皮质激素治疗血热型色素性紫癜性皮肤病(PPD)的临床效果。方法:选择于新疆医科大学第四附属医院治疗的96例血热型PPD作为研究对象。将所有患者随机分为对照组和观察组,每组48例。对照组患者服用糖皮质激素(醋酸泼尼松),观察组服用中药汤剂和糖皮质激素。2周为1个疗程,两组均治疗2个疗程。分析两组的疗效及症状、体征改善情况。比较两组治疗前后的血液黏度(低切、中切、高切)及血浆黏度。结果:观察组的总有效率为95.83%(46/48),显著高于对照组的83.33%(40/48)(P<0.01)。治疗1个疗程及2个疗程后,两组患者的瘙痒程度及斑疹、皮疹评分均较治疗前显著降低(P<0.01);治疗1个疗程后,观察组的斑疹、皮疹评分显著低于对照组(P<0.05),治疗2个疗程后,观察组的瘙痒程度及斑疹、皮疹评分显著低于对照组(P<0.01)。治疗2个疗程后,观察组的全血黏度(高切、中切和低切)及血浆黏度均较治疗前显著降低(P<0.01),对照组的全血黏度(中切和低切)较治疗前显著降低(P<0.01,P<0.05);治疗2个疗程后,观察组的全血黏度(高切、中切和低切)及血浆黏度均显著低于同期对照组(P<0.05)。两组患者的不良反应发生率差异比较无统计学意义。结论:相比于单独服用糖皮质激素,中药汤剂联合糖皮质激素治疗PPD具有更好的疗效,更有效改善患者临床症状及血液流变学指标,且不会增加用药不良反应。

Objective:To compare the clinical effect of combined Chinese decoction and glucocorticoid and glucocorticoid alone in treatment of blood heat pigmentary purpuric dermatosis.Methods:A total of 96 patients with blood heat pigmentary purpuric dermatosis in the Fourth Affiliated Hospital of Xinjiang Medical University were selected as research objects.All patients were randomly divided into control group and observation group,with 48 cases in each group.The control group was given glucocorticoid(Prednisone acetate).The observation group was given Chinese decoction and glucocorticoid.The two groups were treated for 2 treatment courses,the two weeks as one treatment course.The efficacy and improvement of clinical symptoms and signs in two groups were analyzed.The whole blood viscosity(low shear,middle shear and high shear)and plasma viscosity in two groups before and after treatment were compared.Results:The total effective rate was 95.83%(46/48)in observation,which was significant higher than that of control group 83.33%(40/48)(P<0.01).One course and two courses after treatment,the pruritus,and macula and rash scores in two groups were significant lower than those of prior treatment(P<0.01).One course after treatment,macula and rash scores in observation group were significant lower than those of control group(P<0.05).Two courses after treatment,the pruritus,and macula and rash scores in observation group was significant lower than that of control group(P<0.01).Two courses after treatment,the whole blood viscosity(low shear,middle shear and high shear)and plasma viscosity in observation group was significant lower than that of prior treatment(P<0.01),and the whole blood viscosity(middle shear and low shear)in control group was significant lower than that of prior treatment(P<0.01,P<0.05).Two courses after treatment,the whole blood viscosity(low shear,middle shear and high shear)and plasma viscosity in observation group was significant lower than that of control group(P<0.05).The dfference in incidence of adverse reaction of two groups had not statistical significance.Conclusion:Compared glucocorticoid alone,chinese decoction combined with glucocorticoid has better efficacy,and can more effectively improve clinical symptoms and hemorheological indexes,and can not increase the adverse phenomenon.