当归饮子加味联合咪唑斯汀治疗血虚风燥型荨麻疹的疗效及对生活质量的影响

Effect of modified Danggui drink combined with mizolastine on hives of blood deficiency and wind dryness type and its influence on quality of life

目的探讨当归饮子加味联合咪唑斯汀治疗血虚风燥型荨麻疹的效果。方法前瞻性选取2020年4月至2023年4月北京中医药大学东直门医院收治的血虚风燥型荨麻疹患者102例作为研究对象,依据随机数字表法分为对照组与研究组,每组各51例。对照组给予咪唑斯汀,研究组给予当归饮子加味联合咪唑斯汀治疗,两组连续治疗8周。比较两组患者的疗效,治疗前、治疗8周后的荨麻疹活动度评分(UAS)、皮肤病生活质量指数(DLQI)评分、炎症因子[白细胞介素-4(IL-4)、干扰素-γ(INF-γ)、超敏C反应蛋白(hs-CRP)]、血常规相关指标[嗜酸性粒细胞(EOS)计数、白细胞计数(WBC)、中性粒细胞(NEU)计数]以及复发情况。结果研究组总有效率为92.16%,高于对照组(76.47%),差异有统计学意义(P<0.05)。治疗8周后,两组的UAS评分、DLQI评分均低于治疗前,且研究组UAS评分、DLQI评分分别为(1.72±0.54)、(6.38±2.04)分,均低于对照组[(2.43±0.63)、(8.86±2.78)分],差异均有统计学意义(P<0.05)。治疗8周后,两组的IL-4、hs-CRP水平均低于治疗前,INF-γ均高于治疗前,且研究组的IL-4、hs-CRP水平分别为(21.25±3.36)pg/mL、(12.52±4.11)mg/L,均低于对照组[(32.34±4.19)pg/mL、(18.53±6.14)mg/L],研究组INF-γ水平为(15.46±3.34)pg/mL,高于对照组[(11.14±3.68)pg/mL],差异均有统计学意义(P<0.05)。治疗8周后,两组的EOS计数、WBC、NEU计数均低于治疗前,且研究组EOS计数、WBC、NEU计数分别为(0.34±0.11)×10^(9)/L、(6.15±1.68)×10^(9)/L、(3.96±1.28)×10^(9)/L,均低于对照组[(0.43±0.13)×10^(9)/L、(7.03±1.92)×10^(9)/L、(4.74±1.56)×10^(9)/L],差异均有统计学意义(P<0.05)。随访12周,研究组复发率为11.11%,低于对照组(50.00%),差异有统计学意义(P<0.05)。结论当归饮子加味联合咪唑斯汀治疗血虚风燥型荨麻疹疗效肯定,能减轻荨麻疹活动度,改善患者生活质量,调节炎症因子、血常规相关指标,且复发率低。

Objective To explore the effect of modified Danggui drink combined with mizolastine for hives of blood deficiency and wind dryness type.Methods A total of 102 patients with hives of blood deficiency and wind dryness type admitted to Dongzhimen Hospital,Beijing University of Traditional Chinese Medicine from April 2020 to April 2023 were prospectively selected as the study subjects.They were divided into the control group and the study group according to the random number table method,with 51 cases in each group.The control group were given mizolastine,the study group were given modified Danggui drink combined with mizolastine,two groups of continuous treatment for 8 weeks.The efficacy,hives activity score(UAS),skin disease quality of life index(DLQI),inflammatory factors [interleukin-4(IL-4),interferon-γ(INF-γ),high-sensitivity C-reactive protein(hs-CRP)],blood routine indicators [eosinophil(EOS) count,white blood cell(WBC) count,neutrophil(NEU) count] before treatment,after 8 weeks of treatment,and recurrence rate were compared between the two groups.Results The total effective rate of the research group was 92.16%,which was higher than that of the control group(76.47%),and the difference was statistically significant(P<0.05).After 8 weeks of treatment,the UAS score and DLQI score of two groups were lower than those before treatment,and the UAS score and DLQI score of the study group were(1.72±0.54) and(6.38±2.04) points,respectively,which were lower than those of the control group [(2.43±0.63) and(8.86±2.78) points],the differences were statistically significant(P<0.05).After 8 weeks of treatment,the levels of IL-4 and hs-CRP in two groups were lower than those before treatment,and the levels of INF-γ were higher than those before treatment,the levels of IL-4 and hs-CRP in the study group were(21.25±3.36) pg/mL and(12.52±4.11) mg/L,respectively,which were lower than those in the control group [(32.34±4.19) pg/mL and(18.53±6.14) mg/L],and the level of INF-γ was(15.46±3.34) pg/mL,which was higher than that in the control group [(11.14±3.68) pg/mL],the differences were statistically significant(P<0.05).After 8 weeks of treatment,the EOS count,WBC and NEU count of the two groups were lower than those before treatment,and the EOS count,WBC and NEU count of the study group were(0.34±0.11)×10^(9)/L,(6.15±1.68)×10^(9)/L,(3.96±1.28)×10^(9)/L,respectively,which were lower than those of the control group [(0.43±0.13)×10^(9)/L,(7.03±1.92)×10^(9)/L,(4.74±1.56)×10^(9)/L],the differences were statistically significant(P<0.05).After 12 weeks of follow-up,the recurrence rate in the study group was 11.11%,which was lower than that in the control group(50.00%),the difference was statistically significant(P<0.05).Conclusion The modified Danggui drink combined with mizolastine has a positive effect on hives of blood deficiency and wind dryness type,which can reduce the activity of hives,improve the quality of life of patients,regulate the levels of inflammatory factors and blood routine indicators,and have a low recurrence rate.