清热除湿方治疗急性湿疹(湿热蕴结证)的疗效观察

Efficacy Observation on Qingre Chushi Decoction in Treating Acute Eczema(Syndrome of Accumulated Dampness-heat)

目的观察清热除湿方治疗急性湿疹(湿热蕴结证)的效果,初步探寻其作用机制。方法选择急性湿疹患者96例,按照随机数字表法分为观察组与对照组各48例。对照组予以3%硼酸洗液外用联合可氯雷他定胶囊口服,观察组以3%硼酸洗液外用联合清热除湿方口服,两组疗程均为2周。比较两组治疗前后症状评分(湿疹面积、瘙痒程度、湿疹形态、皮疹颜色)、湿疹面积和严重指数(EASI)评分、瘙痒视觉模拟量表(VAS)评分,并比较两组外周血嗜酸粒细胞(EOS)、白细胞介素-4(IL-4)、免疫球蛋白E(IgE)含量和白细胞介素-22(IL-22)mRNA、芳香烃受体(AhR)m RNA相对表达量,并比较两组治疗总有效率。结果治疗后观察组症状评分、EASI评分、瘙痒VAS评分均低于对照组(P<0.05),外周血EOS、IL-4、IgE含量及IL-22 m RNA、AhR m RNA相对表达量均低于对照组(P<0.05);观察组总有效率为93.75%,显著高于对照组的77.08%(P<0.05)。结论清热除湿方可有效缓解病情,减轻临床治疗症状,降低治疗外周血EOS、IL-4、IgE含量,治疗急性湿疹(湿热蕴结证)效果显著,其机制可能与降低IL-22 m RNA、AhR m RNA表达有关。

Objective:To observe the efficacy of Qingre Chushi Decoction in treating Acute eczema(syndrome of accumulated dampness-heat)and to preliminarily analysis the related mechanism.Methods:Totally 96 patients with acute eczema were selected and divided into an observation group and a control group according to random number table method,with 48 patients in each group.The control group were treated with 3%boric acid lotion for external use and cloloratadine capsules orally,while the observation group were treated with traditional Chinese medicine Qingre Chushi Decoction orally on this basis.The treatment courses for both groups were 2 weeks.The symptom scores(eczema area,itching degree,eczema morphology,rash color),eczema area and severity index(EASI score),itching visual analogue scale(VAS)score before and after treatment,and the content of peripheral blood eosinophils(EOS),interleukin-4(IL-4),immunoglobulin E(IgE),and the relative expression of interleukin-22(IL-22)mRNA and aromatic hydrocarbon receptor(AhR)mRNA,and the total effective rate of the two groups were compared.Results:After treatment,the symptom score,EASI score,and itching VAS of the observation group were lower than those of the control group(P<0.05).The levels of EOS,IL-4,IgE in peripheral blood,as well as the relative expression of IL-22 m RNA and AhR mRNA were lower than those of the control group(P<0.05).The total effective rate of the observation group was higher than that of the control group(P<0.05).Conclusion:Qingre Chushi Decoction can effectively alleviate the condition,alleviate clinical symptoms,reduce the levels of EOS,IL-4,and IgE in the peripheral blood,and has a significant effect on the treatment of acute eczema with syndrome of accumulated dampness-heat.Its mechanism may be related to the reduction of IL-22 mRNA and AhR mRNA levels.