四逆散合桂枝茯苓丸口服配合中药面膜、阿达帕林凝胶外敷治疗寻常性痤疮湿热蕴结证临床观察

Clinical Curative Effect of Sini Powder(四逆散)Combined with Guizhi Fulling Pill(桂枝茯苓丸),Chinese Herbal Mask and Adapalene Gel for External Application on Acne Vulgaris of Dampness-Heat Accumulation Syndrome

目的探究四逆散合桂枝茯苓丸口服配合中药面膜、阿达帕林凝胶外敷治疗寻常性痤疮(acne vulgaris,AV)湿热蕴结证的临床效果观察。方法选择2020年8月—2022年8月来河南科技大学第一附属医院就诊的AV湿热蕴结证患者60例,按照随机数表法,分成观察组(30例)和对照组(30例)。对照组采用丹参酮胶囊口服+中药面膜+阿达帕林凝聚外用,观察组采用四逆散合桂枝茯苓丸口服+中药面膜+阿达帕林凝胶外敷治疗。比较两组的临床疗效。比较治疗前、后两组的中医证候积分、炎性因子水平,记录两组不良反应情况。结果治疗后,观察组的总有效率为93.33%(28/30),高于对照组的73.33%(22/30)(P<0.05)。治疗后,两组的中医证候积分均低于治疗前,且观察组的口臭、尿黄、颜面油腻、皮疹脓疱的评分分别为(2.12±0.61)分、(1.34±0.36)分、(1.32±0.28)分、(1.56±0.41)分,低于对照组的(2.87±0.54)分、(1.95±0.51)分、(2.09±0.53)分、(2.17±0.69)分(P<0.05);治疗后,两组的白细胞介素(interleukin,IL)-6、IL-8及IL-17均低于治疗前,且观察组的水平分别为(53.16±7.25)pg/mL、(20.41±3.15)pg/mL、(15.31±2.43)pg/mL,均低于对照组的(72.45±7.18)pg/mL、(30.54±3.26)pg/mL、(21.58±2.95)pg/mL(P<0.05)。两组的不良反应发生率分别为6.67%(2/30)、3.33%(1/30),差异无统计学意义(P>0.05)。结论四逆散合桂枝茯苓丸口服配合中药面膜、阿达帕林凝胶外敷治疗AV湿热蕴结证患者具有良好疗效,能有效改善患者临床症状,降低机体的炎症因子水平,且具有一定安全性。

Objective To explore the clinical curative effect of Sini Powder(四逆散)combined with Guizhi Fulling(桂枝茯苓丸),Chinese herbal mask and adapalene gel for external application on acne vulgaris(AV)of dampness-heat accumulation syndrome.Methods A total of 60 patients with AV of dampness-heat accumulation syndrome treated in the hospital were enrolled between August 2020 and August 2022.According to random number table method,they were divided into observation group(30 cases)and control group(30 cases).On basis of Chinese herbal masks and adapalene gel for external application,the control group was given tanshinone capsules,while the observation group was given Sini Powder combined with Guizhi Fulling Pill.The clinical curative effect,scores of TCM syndromes and levels of inflammatory factors in the two groups were compared before and after treatment.The adverse reactions in both groups were recorded.Results After treatment,total response rate of the observation group was higher than that of the control group[93.33%(28/30)vs 73.33%(22/30),P<0.05].After treatment,the scores of TCM syndromes in both groups were decreased.The scores of halitosis,yellow urine,greasy face and rash pustules in the observation group were(2.12±0.61)points,(1.34±0.36)points,(1.32±0.28)points and(1.56±0.41)points,lower than those in the control group[(2.87±0.54)points,(1.95±0.51)points,(2.09±0.53)points,(2.17±0.69)points,P<0.05].After treatment,the levels of interleukin(IL)-6,IL-8 and IL-17 in both groups were decreased,which were lower in the observation group than those in the control group[(53.16±7.25)pg/mL,(20.41±3.15)pg/mL,(15.31±2.43)pg/mL vs(72.45±7.18)pg/mL,(30.54±3.26)pg/mL,(21.58±2.95)pg/mL,P<0.05].The difference in incidence of adverse reactions between the two groups was not statistically significant[6.67%(2/30)vs 3.33%(1/30),P>0.05].Conclusion The treatment of Sini Powder combined with Guizhi Fulling Pill,Chinese herbal mask and adapalene gel for external application is good on patients with AV of dampness-heat accumulation syndrome,which can effectively improve the clinical symptoms and reduce the levels of inflammatory factors,with certain safety.