参地清热燥湿汤外洗联合常规西药治疗湿疹临床研究

Clinical Study on External Washing with Shendi Qingre Zaoshi Decoction Combined with Routine Western Medicine for Eczema

目的:观察自拟参地清热燥湿汤联合常规西药治疗湿疹的临床疗效及对血清炎症因子水平的影响。方法:选取530例湿疹患者,按随机数字表法分为观察组和对照组各265例。对照组给予丙酸氟替卡松乳膏、盐酸西替利嗪片等常规西药治疗,观察组在对照组基础上加用参地清热燥湿汤外洗治疗。2组均治疗4周,观察2组临床疗效、不良反应及复发情况,以及治疗前后中医证候积分、瘙痒评分、炎症因子[肿瘤坏死因子-α (TNF-α)、干扰素-γ (IFN-γ)及白细胞介素(IL)-4、IL-6]水平。结果:观察组总有效率为93.96%,对照组为87.17%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组中医证候主、次症积分均较治疗前降低(P<0.05),且观察组主、次症积分均低于对照组(P<0.05)。治疗2、4周后,2组瘙痒评分均较治疗前降低并呈下降趋势(P<0.05),且观察组相同时间点瘙痒评分均低于对照组(P<0.05)。治疗后,2组血清TNF-α、IL-4、IL-6水平均较治疗前降低(P<0.05),IFN-γ水平较治疗前升高(P<0.05);且观察组TNF-α、IL-4、IL-6水平低于对照组(P<0.05),IFN-γ水平高于对照组(P<0.05)。观察组不良反应发生率为9.81%,对照组为12.83%,2组比较,差异无统计学意义(P>0.05)。观察组复发率为10.44%,对照组为20.35%,2组比较,差异有统计学意义(P<0.05)。结论:参地清热燥湿汤外洗联合常规西药治疗湿疹能有效抑制机体炎症反应,改善临床症状,提高治疗效果,降低复发率。

Objective:To observe the clinical effect of therapy of self-formulated Shendi Qiangre Zaoshi Decoction combined with western medicine on eczema and its influence on inflammatory factors in serum.Methods:A total of 530 patients with eczema were selected and divided into the observation group and the control group according to the random number table method,with 265 cases in each group.The control group was given routine western medicine for treatment,including Fluticasone Propionate Cream and Cetirizine Hydrochloride Tablets,and the observation group was additionally treated with external washing with Shendi Qiangre Zaoshi Decoction based on the treatment of the control group.The two groups were treated for four weeks.The clinical effects,incidence of adverse reactions,recurrence and traditional Chinese medicine(TCM)syndrome scores,scores of itching and levels of inflammatory factors including tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),interleukin-4(IL-4)and interleukin-6(IL-6)were observed before and after treatment in the two groups.Results:The total effective rate was 93.96%in the observation group and 87.17%in the control group,the difference being significant(P<0.05).After treatment,the TCM syndrome scores of primary and secondary symptoms in the two groups were decreased when compared with those before treatment(P<0.05),and the scores of primary and secondary symptoms in the observation group were lower than those in the control group(P<0.05).After two and four weeks of treatment,the scores of itching in both groups were decreased when compared with those before treatment and showed a downward trend(P<0.05),and the score of itching at the same time point in the observation group was lower than that in the control group(P<0.05).After treatment,the levels of serum TNF-α,IL-4 and IL-6 in both groups were decreased when compared with those before treatment(P<0.05),and the IFN-γlevels were increased when compared with those before treatment(P<0.05);the levels of TNF-α,IL-4 and IL-6 in the observation group were lower than those in the control group(P<0.05),and the IFN-γlevel was higher than that in the control group(P<0.05).The incidence of adverse reactions was 9.81%in the observation group and 12.83%in the control group,there being no significance in the difference(P>0.05).The recurrence was 10.44%in the observation group and 20.35%in the control group,the difference being significant(P<0.05).Conclusion:The therapy of Shendi Qingre Zaoshi Decoction combined with routine western medicine for eczema can effectively inhibit the inflammatory responses of the body,improve the clinical symptoms,enhance the curative effect and reduce the recurrence.