疏风透疹汤联合银翘三黄膏治疗肺癌靶向药物相关性皮疹的临床观察

Clinical Observation of Shufeng Touzhen Decoction Combined with Yinqiao Sanhuang Ointment on Lung Cancer Targeted Drug-related Rash

[目的]观察疏风透疹汤联合银翘三黄膏治疗肺癌靶向药物相关性皮疹的临床疗效。[方法]选择于石家庄市中医院治疗的80例肺癌靶向药物所致相关性皮疹患者,治疗时间为2021年1月至2022年1月,以随机数字表法分组,西医组40例患者给予常规西医治疗,观察组40例患者在西医组基础上给予疏风透疹汤联合银翘三黄膏治疗,治疗前后分别检测两组患者可溶性血管细胞黏附分子-1(soluble vascular cell adhesion molecule-1,sVCAM-1)、白细胞介素-17A(interleukin-17A,IL-17A)、高迁移率族蛋白1(high mobility group protein 1,HMGB1)、胸腺基质淋巴细胞生成素(thymic stromal lymphopoietin,TSLP)、辅助性T细胞1/辅助性T细胞2(T helper cell 1/T helper cell 2,Th1/Th2)比例、T细胞亚群CD4^(+)、CD8^(+)水平;并检测角质层含水量、经皮水分丢失(transepidermal water loss,TEWL)、皮脂含量;进行皮疹面积、皮疹颜色、瘙痒、抑郁-焦虑-压力量表中文简版(depression anxiety and stress scale-21,DASS-21)及皮肤病生活质量指标调查表(dermatology life quality index,DLQI)评价,给予皮疹分级及临床疗效评价。[结果]观察组患者sVCAM-1、IL-17A、HMGB1、TSLP水平低于西医组(P<0.05),CD4^(+)水平高于西医组(P<0.05),Th1/Th2、CD8^(+)水平、TEWL水平低于西医组(P<0.05)。观察组患者角质层含水量、皮脂含量高于西医组(P<0.05),皮疹颜色、皮疹面积、瘙痒评分低于西医组(P<0.05),皮疹分级优于西医组(P<0.05),观察组DASS-21、DLQI评分低于西医组(P<0.05)。观察组患者总有效率(97.50%)高于西医组(82.50%)(P<0.05)。[结论]以疏风透疹汤及银翘三黄膏治疗肺癌靶向药物相关性皮疹患者,可调节Th1/Th2平衡及免疫功能,抑制炎症,改善皮肤屏障功能,缓解负性情绪,提升疗效和生活质量。

[Objective]To observe the clinical effect of Shufeng Touzhen Decoction combined with Yinqiao Sanhuang Ointment in the treatment of lung cancer targeted drug-related rash.[Methods]Eighty patients with lung cancer-related skin rashes caused by targeted drugs were selected from Shijiazhuang Hospital of Traditional Chinese Medicine.The treatment time was from January 2021 to January 2022,and they were grouped by random number table method.Forty patients in western medicine group received conventional western medicine treatment,the other 40 patients in observation group were treated with Shufeng Touzhen Decoction combined with Yinqiao Sanhuang Ointment on the basis of western medicine group.The soluble adhesion molecule-1(sVCAM-1),interleukin-17A(IL-17A),high mobility group box protein(HMGB1),thymic stromal lymphopoietin(TSLP),T helper cell 1/T helper cell 2(Th1/Th2)ratio,T cell subsets CD4^(+),CD8^(+)levels;stratum corneum water content and skin water loss(TEWL),sebum content;rash area,rash color,pruritus,depression anxiety stress scale(DASS-21),and dermatology life quality index(DLQI)were evaluated to grade and evaluate the clinical efficacy.[Results]The levels of sVCAM-1,IL-17A,HMGB1 and TSLP in observation group were lower than those in western medicine group(P<0.05),the levels of CD4^(+)were higher than those in western medicine group(P<0.05),the levels of Th1/Th2,CD8^(+)and TEWL were lower than those in western medicine group(P<0.05).Corneum water content and sebum content in observation group were higher than those in western medicine group(P<0.05),The skin rash color,skin rash area and itch score were lower than those in western medicine group(P<0.05),the skin rash grading was better than those in western medicine group(P<0.05),DASS-21 and DLQI scores in iobservation group were lower than those in western medicine group(P<0.05).The total effective rate of observation group(97.50%)was higher than that of western medicine group(82.50%),and the difference was statistically significant(P<0.05).[Conclusion]Patients with rashes associated with lung cancer targeted drugs were treated with Shufeng Touzao Decoction and Yinqiao Sanhuang Ointment,which can regulate Th1/Th2 balance,immune function,inhibit inflammation,improve skin barrier function,relieve negative emotions,and improve efficacy and quality of life.