自拟消白汤治疗稳定期气滞血瘀型白癜风患者对皮肤镜积分、机体免疫和生活质量的影响

Effect of Self-Made Xiaobai Decoction(消白汤)on Dermatoscopy Score,Body Immunity,and Quality of Life of Patients with Vitiligo of Qizhi and Xueyu(气滞血瘀)Syndrome in Stable Stage

目的:分析自拟消白汤治疗稳定期气滞血瘀型白癜风患者对皮肤镜积分、机体免疫和生活质量的影响。方法:选取2022年01月~2023年01月三所医院收治的稳定期气滞血瘀型白癜风患者133例(剔除3例,脱落4例),最终随机分为治疗组(自拟消白汤^(+)常规治疗)、对照组(常规治疗)各63例,对比两组近期疗效、治疗前后中医证候积分、皮肤镜积分、抑郁自评量表(SAS)、焦虑自评量表(SDS)、机体免疫相关指标[分化决定簇抗原4(CD4^(+))、CD4^(+)/CD8^(+)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)]、炎性反应指标[肿瘤坏死因子-α(TNF-α)、白介素-33(IL-33)、IL-6]及皮肤病生活质量指数(DLQI)评分,记录不良反应。结果:与治疗前比较,两组治疗后各项中医证候积分均明显降低,皮肤镜积分均增加,两组SAS评分、SDS评分均降低,3个月、6个月DLQI评分均降低,CD4^(+)、CD4^(+)/CD8^(+)及血清IgA、IgM含量升高,血清TNF-α、IL-33、IL-6含量明显降低(P<0.05);治疗后,与对照组比较,治疗组的各项中医证候积分降低,皮肤镜积分升高,而SAS评分、SDS评分降低,3个月、6个月DLQI评分明显降低(P<0.05),CD4^(+)、CD4^(+)/CD8^(+)及血清IgA、IgM含量明显升高,血清TNF-α、IL-33、IL-6含量明显降低(P<0.05);治疗组有效率为84.13%,明显高于对照组的61.90%(P<0.05);两组不良反应发生率为6.35%和4.76%,无明显差异(P>0.05)。结论:自拟消白汤治疗稳定期气滞血瘀型白癜风患者疗效较好,可升高其中医证候与皮肤镜积分、降低焦虑抑郁情绪,调节免疫功能及炎性因子水平,提高生活质量,安全可靠,值得临床推广。

Objective:To analyze the effect of self-made Xiaobai Decoction(消白汤)on dermatoscopy score,body immunity,and quality of life of patients with vitiligo of Qizhi and Xueyu(气滞血瘀)syndrome in the stable stage.Methods:A total of 133 patients(three patients were excluded,and four patients were lost to follow-up)with vitiligo of Qizhi and Xueyu syndrome in stable stage who were admitted to three hospitals from January 2022 to January 2023 were selected,and they were finally randomly divided into treatment group(self-made Xiaobai Decoction+routine treatment)and control group(routine treatment),with 63 cases in each group.The short-term efficacy,TCM syndrome scores,dermatoscopy scores,self-rating anxiety scale(SAS)scores,self-rating depression scale(SDS)scores,immunity-related indicators[cluster of differentiation 4(CD4^(+)),CD4^(+)/CD8^(+),immunoglobulin A(IgA),and immunoglobulin M(IgM)],inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-33(IL-33),and interleukin-6(IL-6)],and dermatology life quality index(DLQI)scores were compared between the groups.Adverse reactions were recorded.Results:After treatment,TCM syndrome scores of both groups were decreased,and dermoscopy scores of both groups were increased.The SAS and SDS scores of both groups were decreased.Three months and six months after treatment,DLQI scores of both groups were decreased(P<0.05).Serum levels of CD4^(+),CD4^(+)/CD8^(+),IgA,and IgM in both groups were increased,while those of TNF-α,IL-33,and IL-6 were decreased(P<0.05).After treatment,compared with the control group,TCM syndrome scores were decreased in the treatment group,and the dermoscopy score was increased.The SAS and SDS scores were decreased,and the DLQI scores after three months and six months were decreased(P<0.05).The serum levels of CD4^(+),CD4^(+)/CD8^(+),IgA,and IgM were increased,while those of TNF-α,IL-33,and IL-6 were significantly decreased(P<0.05).The effective rate of treatment in the treatment group was 84.13%,which was higher than 61.90%in the control group(P<0.05).The adverse reaction rate of each group was 6.35%and 4.76%,respectively,which had no significant difference(P>0.05).Conclusion:Self-made Xiaobai Decoction is effective in the treatment of patients with vitiligo of Qizhi and Xueyu syndrome in the stable stage.It can improve TCM syndrome scores and dermoscopy scores,relieve anxiety and depression,regulate immune function and inflammatory factors,and enhance the quality of life.It is safe and reliable for clinical applications.