火针联合中药熏蒸治疗老年性皮肤瘙痒症的疗效观察及对血清炎症因子水平的影响

Therapeutic observation of fire needling combined with Chinese medicine fumigation in treating senile pruritus and the effects on serum inflammatory factor levels

目的观察火针联合中药熏蒸治疗老年性皮肤瘙痒症的临床疗效及其对患者皮损修复、睡眠质量及血清炎症因子水平的影响。方法将100例老年性皮肤瘙痒症患者按随机数字表法分为对照组(50例)和研究组(50例)。对照组予常规西医治疗,研究组在对照组治疗基础上另予火针联合中药熏蒸治疗。比较两组临床疗效,观察两组治疗前、治疗3周后和治疗6周后皮损愈合评分、瘙痒次数、匹兹堡睡眠质量指数(Pittsburghsleep quality index,PSQI)评分和汤氏睡眠状况调查表评分以及血清嗜酸性粒细胞(eosinophils,EOS)计数、白介素-4(interleukin-4,IL-4)和白介素-12(interleukin-12,IL-12)水平的变化。结果研究组总有效率优于对照组(P<0.05)。治疗6周后,两组皮损愈合评分和瘙痒次数均低于治疗3周后(P<0.05),且研究组均优于对照组(P<0.05)。治疗6周后,两组PSQI评分以及血清EOS计数均低于治疗3周后(P<0.05),且研究组均优于对照组(P<0.05)。治疗3周后和治疗6周后,两组血清IL-4和IL-12水平均高于治疗前(P<0.05),组间比较差异无统计学意义(P>0.05)。结论在常规西医治疗基础上,火针联合中药熏蒸治疗老年性皮肤瘙痒症可提高临床疗效,能加快皮损的修复,改善患者睡眠质量,调节血清EOS水平。

Objective To observe the clinical efficacy of fire needling plus Chinese medicine fumigation in treating senile pruritus and the effects on skin lesion repair,sleep quality,and serum inflammatory factor levels.Method One hundred senile pruritus patients were randomized into a control group(50 cases)and a research group(50 cases)using the random number table method.The control group was prescribed conventional Western medicine treatment,and the research group received additional fire needling and Chinese medicine fumigation intervention.The clinical efficacy was compared between the two groups.Before treatment and after 3 and 6 weeks of treatment,the skin lesion repair score,number of itch times,Pittsburgh sleep quality index(PSQI)score,TANG’s sleep status survey score,and serum levels of eosinophils(EOS)count,interleukin(IL)-4,and IL-12 were observed.Result The research group surpassed the control group in comparing the total effective rate(P<0.05).After 6-week treatment,the skin lesion repair score and the number of itch times were lower than those after 3-week treatment in both groups(P<0.05),and the research group was superior to the control group(P<0.05).After 6-week treatment,the PSQI score and serum EOS count were lower than those after 3-week treatment in the two groups (P<0.05), and the research group was superior to the control group (P<0.05). After 3 and 6 weeks of treatment, the serum IL-4 and IL-12 levels were higher than those before treatment in both groups (P<0.05), while the between-group differences were statistically insignificant (P>0.05). Conclusion Based on conventional Western medicine treatment, fire needling plus Chinese medicine fumigation can enhance clinical efficacy, accelerate skin lesion repair, improve sleep quality, and regulate the serum EOS level in treating senile pruritus.