陈氏黑药膏联合五神汤治疗急性期下肢丹毒的临床观察及对炎症因子的影响

Clinical observation of Chen’s Black ointment combined with Wushen Decoction in treatment of erysipelas of lower extremity in acute stage and its influence on inflammatory factors

目的:观察陈氏黑药膏联合五神汤治疗急性期下肢丹毒的临床观察及对炎症因子的影响。方法:选择2021年2月~2023年2月在上海市中医医院治未病科接受治疗的85例丹毒患者,采用随机数表法分为试验组(n=43)和对照组(n=42)。两组均基础给予阿莫西林胶囊及五神汤口服,对照组给予金黄膏治疗,试验组给予陈氏黑药膏治疗。1周为1疗程,比较两组临床疗效、白细胞计数(WBC)、中性粒细胞百分比(N%)、C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、下肢外周径差、红肿范围、中医证候积分。结果:试验组治愈7例,显效23例,有效11例,无效2例,痊愈率16.28%,痊愈显效率69.77%,总有效率95.34%;对照组治愈3例,显效11例,有效21例,无效7例,痊愈率7.14%,痊愈显效率33.33%,总有效率83.33%。两组比较,试验组痊愈显效率明显优于对照组(P<0.01),试验组与对照组总有效率无明显差异(P>0.05);治疗后,两组白细胞计数、CRP、IL-6、TNF-α均下降,试验组降低效果显著优于对照组(P<0.01);治疗后,两组中性粒细胞百分比均下降,试验组降低效果优于对照组(P<0.05);治疗后,两组下肢外周径差差异无统计学意义(P>0.05),但试验组下降趋势较对照组明显;试验组与对照组均能缩小患者红斑面积,试验组疗效显著优于对照组(P<0.01);两组均能改善中医证候积分,试验组疗效显著优于对照组(P<0.01);治疗期间,对照组不良反应主要有皮疹瘙痒、恶心呕吐、胃肠道不适;试验组不良反应主要有恶心呕吐、胃肠道不适,两组不良反应发生情况比较有统计学意义(P<0.05),试验组不良反应明显少于对照组。结论:在丹毒中应用陈氏黑药膏联合五神汤治疗效果显著,可能与其可有效改善CRP、IL-6及TNF-α水平有关。

Objective To study Clinical observation of Chen's Black ointment combined with Wushen Decoction in treatment of erysipelas of lower extremity in acute stage and its influence on inflammatory factors.Method 85patients with erysipelas who received treatment in the Department of Treatment and Treatment of Shanghai Hospital of Traditional Chinese Medicine from February 2021to February 2023experimental group(n=43)and control group(n=42).Both groups were given amoxicillin capsules and Wushen decoction orally,the control group was given golden paste treatment,and the experimental group was given Chen's black ointment treatment.The clinical efficacy,white blood cell count(WBC),neutrophil percentage(N%),C-reactive protein(CRP),interleukin 6(IL-6),tumor necrosis factorα(TNF-α),peripheral diameter difference of lower extremities,range of redness and swelling,and TCM symptom score.Results In the experimental group,7people were cured,23people were significantly effective,11people were effectively and 2people were ineffective,with a recovery rate of 16.28%,a significant recovery efficiency of 69.77%,and a total effective rate of 95.34%.In the control group,3patients were cured,11were effective,21were effective,and 7were ineffective.The recovery rate was 7.14%,the recovery efficiency was 33.33%,and the total effective rate was 83.33%.Compared with.After treatment,white blood cell count,CRP,IL-6and TNF-α were decreased in both groups,After treatment,the percentage of neutrophil decreased in both groups,During the treatment period,the main adverse reactions in the control group were rash,pruritus,nausea,vomiting and gastrointestinal discomfort.The adverse reactions of the experimental group mainly included nausea,vomiting and gastrointestinal discomfort,and there was statistical significance.Conclusion The application of Chen's black ointment combined with Wushen Decoction in the treatment of erysipelas has remarkable effect,which may be related to the effective improvement of CRP,IL-6and TNF-α levels.