本文關(guān)鍵詞：止癢顆粒治療糖尿病皮膚瘙癢癥血虛風(fēng)燥證的臨床療效觀察　出處：《北京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 臨床療效觀察 糖尿病皮膚瘙癢癥 血虛風(fēng)燥證 止癢顆粒

【摘要】：糖尿病是臨床高發(fā)疾病,皮膚瘙癢癥是其主要并發(fā)癥之一,主要表現(xiàn)為全身或局部皮膚瘙癢,呈游走性、陣發(fā)性,以夜間發(fā)作為重,嚴(yán)重影響患者的生活質(zhì)量。西醫(yī)學(xué)研究認(rèn)為其發(fā)病原因主要與皮膚干燥,血糖異常,皮膚感染,神經(jīng)損傷,藥物過敏等密切相關(guān)。在治療上以抗組胺H1受體拮抗劑、糖皮質(zhì)激素、免疫調(diào)節(jié)及局部UV照射治療為主,但常因出現(xiàn)不良反應(yīng)無法長期應(yīng)用,治療間斷后,瘙癢迅速復(fù)發(fā),為治療帶來了極大的困難。中醫(yī)認(rèn)為該病的病因病機(jī)與氣陰兩虛、血熱、血瘀、血虛風(fēng)燥有關(guān),故在治療上多以養(yǎng)血活血、滋陰涼血、祛風(fēng)潤燥為法,取得良好的療效,有效的規(guī)避了西醫(yī)的缺陷。止癢顆粒是我院皮膚科的常用方,在治療皮膚瘙癢癥方面收效頗著,其滋陰養(yǎng)血、祛風(fēng)潤燥的功效符合糖尿病皮膚瘙癢癥血虛風(fēng)燥證的中醫(yī)病機(jī),因此會取得令人滿意的療效。本課題通過進(jìn)一步的臨床實踐研究以期為止癢顆粒的臨床應(yīng)用奠定理論基礎(chǔ)及拓展思路,在治療糖尿病皮膚瘙癢癥方面展現(xiàn)中醫(yī)臨床特色,闊寬其應(yīng)用前景。研究目的:采用臨床觀察研究方法,觀察止癢顆粒方治療血虛風(fēng)燥型糖尿病皮膚瘙癢癥的臨床療效及對其安全性進(jìn)行評估。研究方法:采用隨機(jī)、對照的臨床觀察方法,病例均來源于2016年9月一 2017年2月北京中醫(yī)藥大學(xué)第三附屬醫(yī)院皮膚科門診及內(nèi)分泌科門診和病房的患者,符合糖尿病皮膚瘙癢癥血虛風(fēng)燥證的納入標(biāo)準(zhǔn),通過填寫《止癢顆粒治療糖尿病皮膚瘙癢癥血虛風(fēng)燥證臨床觀察表》,采集證候癥狀、舌脈等相關(guān)信息,納入符合研究條件的患者。將符合納入的糖尿病皮膚瘙癢癥血虛風(fēng)燥證患者60例隨機(jī)分為兩組:治療組、對照組各30例,分別予止癢顆粒方和依巴斯汀片治療,2周為一個療程,分別在治療前、治療中(用藥1周)、治療后進(jìn)行瘙癢、干燥等指標(biāo)比較和療效評價,并于結(jié)束治療2周后進(jìn)行隨訪,記錄相關(guān)指標(biāo)變化。研究結(jié)果:本臨床觀察研究共納入60例患者,治療組和對照組各30例,兩組患者在性別、年齡、病程治療前癥狀積分方面比較無顯著性差異(p0.05),具有可比性。兩組療效比較,治療組總有效率90.0%,對照組總有效率50.0%,差異有統(tǒng)計學(xué)意義(p0.05);治療組用藥1周、2周后,瘙癢總評分、皮損總評分均比治療前降低,且在瘙癢程度、瘙癢面積、瘙癢頻率、持續(xù)時間方面分值低于對照組,差異有統(tǒng)計學(xué)意義(p0.05)。停藥2周后隨訪,瘙癢癥狀和皮損癥狀積分仍比治療前降低(p0.05)。在治療過程中,患者依從性良好,無中途退出患者,且血常規(guī)、尿常規(guī)、肝腎功能檢測結(jié)果均基本在臨床正常范圍內(nèi),治療前后無明顯較大差異。結(jié)論:止癢顆粒方能有效改善患者瘙癢癥狀積分和皮膚干燥、鱗屑、抓痕血痂等皮損癥狀積分,是治療血虛風(fēng)燥型糖尿病皮膚瘙癢癥的有效方劑。且該方法安全可靠,復(fù)發(fā)率小,值得臨床推廣應(yīng)用。
[Abstract]:Diabetes is a clinical common disease, skin pruritus is one of the main complications, mainly for systemic or local skin itching, a walk, paroxysmal, at night as heavy, serious impact on quality of life of patients. Western medicine research believes that the cause of the disease is mainly related to skin drying, abnormal blood sugar, skin infection, nerve injury, drug allergy and so on. In terms of treatment, anti histamine H1 receptor antagonist, glucocorticoid, immunomodulation and local UV irradiation are the main treatments, but they often fail to be applied for a long time because of adverse reactions. After treatment, pruritus rapidly recurrences, which brings great difficulties for treatment. Chinese medicine believes that the disease pathogenesis and syndrome of Qi Yin deficiency, blood stasis, blood heat, blood deficiency and wind dryness, so in most of the treatment of nourishing and activating blood, nourishing yin and moistening method for dispelling wind, cooling blood, has a good curative effect, effectively avoid the defects of Western medicine. Zhiyang granule is commonly used in our hospital department of Dermatology, in the treatment of skin pruritus effect has its pathogenesis, nourishing Yin, expelling Runzao effect with diabetic skin pruritus of blood deficiency and wind dryness, thus satisfying curative effect. This topic through further clinical practice in order to study the clinical application of Qufengzhiyang particles theory foundation and develop ideas, to show clinical characteristics in the field of Chinese medicine treatment of diabetic skin pruritus, broad application prospect. Objective: using the research methods of clinical observation, to observe the clinical curative effect of Zhiyang granule Decoction in the treatment of blood deficiency and wind dryness skin pruritus and diabetes and to evaluate its safety. Methods: the clinical observation of the randomized and controlled method, the patients from outpatient and inpatient outpatient department of Dermatology and Department of Endocrinology Affiliated Hospital of Beijing University of Chinese Medicine in September 2016 February 2017 third patients with diabetic skin pruritus of blood deficiency and wind dryness of the inclusion criteria, by completing the "Zhiyang granule in the treatment of diabetic skin pruritus of blood deficiency and wind dryness syndrome clinical observation table", acquisition the syndrome symptoms, tongue and pulse and other related information, the conditions of the patients included in the study. Will meet the inclusion of the diabetic skin pruritus of blood deficiency and wind dryness, 60 cases of patients were randomly divided into two groups: treatment group and control group with 30 cases in each group, were treated with Qufengzhiyang particles and Ebastine Tablets for 2 weeks for a course of treatment, respectively, before treatment, treatment (1 weeks), after treatment for pruritus, dry indicators and evaluation of curative effect, treatment and follow-up after 2 weeks on end, record the related index changes. Results: a total of 60 patients were included in the study. There were 30 cases in the treatment group and the control group. There was no significant difference in the symptom score between the two groups in terms of gender, age and course of treatment (P0.05). To compare the effects of two groups, the total effective rate of treatment group 90%, control group total effective rate was 50%, the difference was statistically significant (P0.05); the treatment group for 1 weeks and 2 weeks, the total score, total skin pruritus scores were lower than before treatment, and the degree of itching, itching, itching area frequency, duration the score lower than the control group, the difference was statistically significant (P0.05). After 2 weeks of drug withdrawal, the symptoms of itching and the symptom score of skin lesions were still lower than those before the treatment (P0.05). During the course of treatment, patients had good compliance and no withdrawal from their patients. Blood routine, urine routine and liver and kidney function tests were basically in the normal clinical range. There was no significant difference between before and after treatment. Conclusion: Zhiyang granule can improve the symptoms of itching integral and dry skin, scales, such as scratches blood scab skin symptoms, is an effective prescription for treatment of blood deficiency and wind dryness diabetic skin pruritus. The method is safe and reliable, and the recurrence rate is small. It is worthy of clinical application.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R259

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