本文選題：毫火針　切入點：中藥方　出處：《廣州中醫(yī)藥大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:通過觀察毫火針配合中藥與單純中藥療法治療脾虛濕蘊型慢性濕疹的臨床療效,對比兩種療法并探討毫火針配合中藥治療脾虛濕蘊型慢性濕疹的作用,尋求治療慢性濕疹快捷有效的方法,并為之后慢性濕疹中醫(yī)內(nèi)外結(jié)合療法的應(yīng)用提供可靠的臨床資料。方法:收集病例66例,通過SPSS 19.0得出隨機數(shù)字,制成隨機分配卡共66張,分別裝入66個不透明信封內(nèi),信封號同卡片序號,按1:1比例分成治療組(毫火針配合中藥組)和對照組(單純中藥組),隨后根據(jù)納入病例前來就診的順序進行分配,按信封內(nèi)卡片規(guī)定的分組進行對應(yīng)治療,治療組和對照組各33例。對照組予以中藥方(蒼術(shù)10g,白術(shù)15g,陳皮6g,炒麥芽30g,茯苓15g,苡仁30g,滑石18g,澤瀉15g,生甘草10g,黃柏10g,白芷10g,蟬衣10g,苦參10g,白鮮皮15g,地膚子12g)加減治療,每日1劑,水煎分2次早晚服用,連服5周。治療組在對照組治療的基礎(chǔ)上加用毫火針治療,主要點刺皮損局部,每周治療2次,連續(xù)治療5周。治療前后分別記錄患者的濕疹面積及嚴重度指數(shù)評分(EASI評分)和瘙癢評分,用于統(tǒng)計分析及臨床療效評價。結(jié)果:將兩組病例的年齡、性別、病程、治療前EASI評分和瘙癢評分等進行比較,差異無統(tǒng)計學意義(p0.05),提示兩組具有可比性。兩組患者經(jīng)治療后,采用EASI評分和瘙癢評分,得分均較治療前有所降低,治療前后差異有統(tǒng)計學意義(p0.05)。與對照組相比,治療組治療前后瘙癢評分差優(yōu)于對照組,差異有統(tǒng)計學意義(p0.05),而EASI評分差和全身紅斑、丘疹、鱗屑、苔蘚癥狀評分差的差異不具有統(tǒng)計學意義(p0.05)。治療組顯效13例,有效17例,無效0例,總有效率為100%,對照組顯效4例,有效16例,無效11例,總有效率為64.5%,差異具有統(tǒng)計學意義(p0.05),其中治療組顯效率(43.3%)明顯高于對照組(12.9%),可見在5周的治療時間內(nèi)治療組的整體療效比對照組更好,且對瘙癢的改善作用更加顯著。結(jié)論:慢性濕疹是臨床常見的皮膚病,以皮損局部的慢性炎癥為特征,中藥方專為脾虛濕蘊型皮膚病而設(shè),健脾行氣,祛濕利水,內(nèi)調(diào)以改善患者脾虛濕盛的體質(zhì),毫火針速刺局部皮損,通過其溫熱刺激,以達到疏經(jīng)通絡(luò)、祛腐生肌、引邪外出的外治作用,兩者內(nèi)外同治,更好地改善慢性濕疹的皮損,達到治療的目的。毫火針配合中藥和單純中藥療法治療脾虛濕蘊型慢性濕疹均能取得良好的臨床療效,而且相比單純中藥療法,毫火針配合中藥療法療效更好,且兩組在治療過程中均未見不良反應(yīng),值得臨床推廣和應(yīng)用。
[Abstract]:Objective: to observe the clinical curative effect of traditional Chinese medicine and traditional Chinese medicine on chronic eczema with spleen deficiency and dampness accumulation, and to compare the two kinds of therapy and to explore the effect of acupuncture combined with traditional Chinese medicine on chronic eczema with spleen deficiency and dampness accumulation. To seek a quick and effective method for the treatment of chronic eczema, and to provide reliable clinical data for the later application of internal and external therapy of TCM for chronic eczema. Methods: 66 cases of chronic eczema were collected and the random numbers were obtained by SPSS 19.0. A total of 66 random distribution cards were made. In 66 opaque envelopes, the envelope number was the same as the card number. According to 1: 1 ratio, they were divided into two groups: the treatment group and the control group, which were then assigned according to the order in which the patients were included. The corresponding treatment is carried out according to the grouping specified by the card in the envelope, Treatment group and control group (33 cases each). The control group was treated with traditional Chinese medicine prescription (Atractylodes Atractylodes 10g, Atractylodes macrocephala 15g, pericarp 6g, fried malt 30g, Poria cocos 15g, lachryma seed 30g, talc 18g, alisma 15g, licorice 10g, yellow cypress 10g, angelica dahurica 10g, Sophora flavescens 10g, fresh skin 15g, skin 12g). One dose per day, water decoction is taken twice in the morning and evening, even for 5 weeks. The treatment group is treated with acupuncture on the basis of the treatment in the control group, mainly prick local lesions, 2 times a week, The area and severity index scores of eczema (EASI) and pruritus score were recorded before and after treatment for 5 weeks. There was no significant difference between the two groups in EASI score and pruritus score before treatment, indicating that the two groups were comparable. After treatment, the EASI score and the pruritus score in the two groups were lower than those before treatment. Compared with the control group, the difference of pruritus score before and after treatment in the treatment group was better than that in the control group, and the difference was statistically significant (p 0.05), while the EASI score was lower and the systemic erythema, papules, scales were lower than those in the control group. The difference of moss symptom score was not statistically significant (p 0.05). In the treatment group, there were 13 cases of marked effect, 17 cases of effective effect, 0 cases of ineffective, the total effective rate was 100%, while in the control group, there were 4 cases of marked effect, 16 cases of effective and 11 cases of failure. The total effective rate was 64.5, and the difference was statistically significant (P 0.05). The effective rate of treatment group was significantly higher than that of control group (43.3%). It was obvious that the overall effect of treatment group was better than that of control group within 5 weeks of treatment. Conclusion: chronic eczema is a common skin disease, characterized by local chronic inflammation of skin lesions. Chinese medicine prescription is specially designed for skin diseases of spleen deficiency and dampness accumulation. In order to improve the body of spleen deficiency and dampness of patients, acupuncture with fire to prick the local skin lesions, through its warm and heat stimulation, to achieve the external treatment effect of thinning the meridians and clearing the collaterals, dispel the rotten muscles, and induce evil to go out, and treat both inside and outside together, the skin lesions of chronic eczema can be improved better, so as to improve the skin lesions of chronic eczema. To achieve the purpose of the treatment, both Chinese herbal medicine and traditional Chinese medicine alone can achieve good clinical efficacy in treating chronic eczema with spleen deficiency and dampness accumulation, and compared with traditional Chinese medicine alone, the curative effect of Chinese herbal medicine therapy is better than that of point fire acupuncture combined with traditional Chinese medicine. There was no adverse reaction in both groups, which was worth popularizing and applying.
【學位授予單位】：廣州中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R246.7

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