茵陈蒿汤加减治疗湿热阻络型变应性皮肤血管炎溃疡的临床观察

Clinical observation of modified Yinchenhao Decoction in treating patients of allergic cutaneous vasculitis ulcer with syndrome of dampness-heat blocking collaterals

目的:观察茵陈蒿汤加减治疗湿热阻络型变应性皮肤血管炎溃疡的临床疗效。方法:纳入湿热阻络型变应性皮肤血管炎溃疡患者60例,随机分为治疗组和对照组,每组各30例。所有患者均给予基础治疗,包括抗凝、抗感染、创面换药等,对照组患者在基础治疗的同时给予甲泼尼龙片口服,治疗组患者在基础治疗的同时给予茵陈蒿汤加减口服。两组均以10 d为1个疗程,共观察6个疗程。治疗结束后,评价两组患者的临床疗效;于治疗前及治疗10 d、20 d、30 d、40 d、50 d、60 d后,采用视觉模拟评分法(VAS)评估患者的创面疼痛程度;于治疗10 d、20 d、30 d、40 d、50 d、60 d后,比较两组的痊愈率;治疗全程记录两组患者的不良反应发生情况,比较两组患者的不良反应发生率。结果:治疗后,治疗组的临床总有效率为96.67%,对照组为86.67%,两组临床疗效比较差异有统计学意义(P<0.05),治疗组的疗效优于对照组。治疗10 d、20 d、30 d、40 d、50 d、60 d后,两组患者的疼痛VAS评分较治疗前均降低(P<0.05);且治疗30 d、40 d、50 d、60 d后,治疗组患者的VAS评分均低于对照组(P<0.05)。治疗30 d、40 d、50 d、60 d后,治疗组患者的创面痊愈率均明显高于对照组(P<0.05)。在治疗过程中,治疗组的不良反应发生率为6.67%,对照组为26.67%,治疗组的不良反应发生率明显低于对照组(P<0.05)。结论:在基础治疗的同时联合应用茵陈蒿汤加减治疗湿热阻络型变应性皮肤血管炎溃疡,具有较好的临床疗效和安全性,可明显减轻患者的疼痛症状,促进创面愈合。

Objective:To observe the clinical efficacy of modified Yinchenhao Decoction in treating patients of allergic cutaneous vasculitis ulcer with syndrome of dampness-heat blocking collaterals.Methods:Sixty patients of allergic cutaneous vasculitis ulcer with syndrome of dampness-heat blocking collaterals were included and randomly divided into the treatment group and control group,30 cases in each group.All the patients were treated with basic treatments,including anti-coagulation,anti-infection,wound dressing and so on.Meanwhile,the patients in the control group were orally treated with methylprednisolone tablets and the patients in the treatment group were orally treated with modified Yinchenhao Decoction.Ten days were taken as one treatment course and 6 courses were observed.After treatment,the clinical efficacy of the two groups was evaluated.Before treatment and 10,20,30,40,50 and 60 days after treatment,the wound pain was assessed by visual analogue scale(VAS)score;10,20,30,40,50 and 60 days after treatment,the recovery rate was compared between the two groups.During the treatment course,the occurrence of adverse reactions in the two groups was recorded,and the incidence of adverse reactions was compared between the two groups.Results:After treatment,the total clinical effective rate was 96.67%in the treatment group and 86.67%in the control group.There was statistically significant difference on the clinical efficacy between the two groups(P<0.05),and the efficacy of the treatment group was better than that of the control group.After treatment for 10,20,30,40,50 and 60 days,the VAS scores for pain were decreased in both groups compared with before treatment(P<0.05);and after treatment for 30,40,50 and 60 days,the VAS scores of the treatment group were lower than those of the control group(P<0.05).After treatment for 30,40,50 and 60 days,the wound healing rates of the treatment group were significantly higher than those of the control group(P<0.05).In the course of treatment,the incidence rates of adverse reactions were 6.67%in the treatment group and 26.67%in the control group,respectively,and the incidence of adverse reactions in the treatment group was obviously lower than that in the control group(P<0.05).Conclusion:The basic treatments combined with modified Yinchenhao Decoction shows good clinical efficacy and safety in the treatment of allergic cutaneous vasculitis ulcer with syndrome of dampness-heat blocking collaterals,which can significantly alleviate the pain and promote the wound healing.