解毒生肌汤熏洗坐浴联合紫草油治疗慢性肛周湿疹患者的临床观察

Clinical Efficacy of Jiedu Shengji Decoction by Fumigation,Washing,and Sitz Bath Combined with Comfrey Oil in the Treatment of Chronic Perianal Eczema

目的探讨解毒生肌汤熏洗坐浴联合紫草油治疗慢性肛周湿疹的临床疗效。方法选取2020年9月—2021年3月期间渭南市第二医院、渭南市中医医院、渭南市第一医院收治的100例慢性肛周湿疹患者,按随机数字表法分为治疗组和对照组,每组各50例。对照组给予他克莫司治疗,治疗组给予解毒生肌汤熏洗坐浴联合紫草油治疗。治疗2周后,观察比较两组患者复发率、临床疗效,治疗前后皮肤病生活质量指数(Dermatology Life Quality Index,DLQI)、症状评分(瘙痒程度、皮疹形态及皮疹面积)、炎性因子[肿瘤坏死因子-α(Tumor Necro⁃sis Factor-α,TNF-α)、血清白细胞介素-2(Interleukin-2,IL-2)、白细胞介素-10(Interleukin-10,IL-10)]。结果治疗后两组患者DLQI评分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组DLQI评分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者瘙痒程度、皮疹面积、皮疹形态、总分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组瘙痒程度、皮疹面积、皮疹形态、总分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者IL-2水平较治疗前升高,IL-10、TNF-α水平较治疗前降低,差异有统计学意义(P<0.05);且治疗组IL-2水平明显高于对照组,IL-10、TNF-α水平明显低于对照组,差异有统计学意义(P<0.05)。治疗组总有效率94.00%(47/50)高于对照组80.00%(40/50),差异有统计学意义(P<0.05)。治疗组复发率6.00%(3/50)明显低于对照组22.00%(11/50),差异有统计学意义(P<0.05)。结论解毒生肌汤熏洗坐浴联合紫草油治疗慢性肛周湿疹能够有效地缓解患者临床不适,改善患者生活质量,同时减轻炎症反应,使复发率降低,疗效明显。

Objective To explore the clinical efficacy of Jiedu Shengji Decoction by fumigation,washing,and sitz bath combined with comfrey oil in the treatment of chronic perianal eczema.Methods A total of 100 patients with chronic perianal eczema treated at The Second Hospital of Weinan,Weinan Traditional Chinese Medicine Hospital,and The First Hospital of Weinan between September 2020 and March 2021 were enrolled and divided into a treatment group and a con⁃trol group according to a random number table,with 50 patients in each group.The control group received treatment with ta⁃crolimus,while the treatment group received Jiedu Shengji Decoction by fumigation,washing,and sitz bath combined with comfrey oil.After two weeks of treatment,the recurrence rate,clinical efficacy,Dermatology Life Quality Index(DLQI),symptom scores(itching intensity,rash morphology,and rash area),and inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-2(IL-2),and interleukin-10(IL-10)]were observed and compared between the two groups.Results After treatment,the DLQI scores of both groups decreased compared with those before treatment(P<0.05),and the treatment group was significantly lower than the control group(P<0.05).After treatment,itching intensity,rash area,rash morphology,and total symptom scores in both groups decreased compared with those before treatment(P<0.05),and the treatment group exhibited significantly lower itching intensity,rash area,rash morphology,and total symptom scores than the control group(P<0.05).After treatment,the IL-2 levels increased,while IL-10 and TNF-αlevels decreased in both groups compared with those before treatment(P<0.05).Furthermore,the IL-2 levels in the treatment group were significantly higher,while IL-10 and TNF-αlevels were significantly lower than those in the control group(P<0.05).The total effective rate in the treatment group was 94.00%(47/50),significantly higher than the 80.00%(40/50)in the control group(P<0.05).The recurrence rate in the treatment group was 6.00%(3/50),significantly lower than the 22.00%(11/50)in the control group(P<0.05).Conclusion Jiedu Shengji Decoction by fumigation,washing,and sitz bath combined with comfrey oil in the treatment of chronic perianal eczema is effective in relieving clinical discomfort,im⁃proving the quality of life,reducing inflammation,lowering the recurrence rate,and demonstrating significant therapeutic ef⁃ficacy.