【摘要】：目的：1.疏肝祛白方是我科臨床上經(jīng)過(guò)長(zhǎng)期驗(yàn)證治療肝郁氣滯型白癜風(fēng)的經(jīng)驗(yàn)方,本研究旨在觀察疏肝祛白方聯(lián)合窄譜中波紫外線治療肝郁氣滯型面頸部白癜風(fēng)的臨床療效,評(píng)價(jià)此中西醫(yī)結(jié)合方案在臨床具體實(shí)踐中對(duì)面頸部白癜風(fēng)的確切治療效果及其安全性。2.調(diào)查面頸部白癜風(fēng)對(duì)患者的生活質(zhì)量的影響,評(píng)價(jià)治療前后患者生活質(zhì)量的變化情況。方法：選取門(mén)診符合條件的白癜風(fēng)患者共90例,隨機(jī)分為治療組、對(duì)照1組、對(duì)照2組,各組人數(shù)分別為30人。治療組予口服中藥疏肝祛白方(日一劑)、外用消斑酊(外擦于白斑處,早晚各一次)及窄譜中波紫外線照射(起始劑量0.05J/cm2,以后每次遞增0.01 J/cm2,每周2次)。對(duì)照1組予窄譜中波紫外線照射及外用消斑酊治療(方法同治療組)；對(duì)照2組予口服中藥疏肝祛白方及外用消斑酊(方法同治療組)。各組連續(xù)治療12周,分別于治療后4周、8周、12周觀察記錄白斑面積,并分別于治療前及治療后填寫(xiě)“皮膚病生活質(zhì)量指標(biāo)調(diào)查表”。結(jié)果：1.治療4周后,治療組與對(duì)照1組療效差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),與對(duì)照2組差異有統(tǒng)計(jì)學(xué)意義(P0.05),對(duì)照1組與對(duì)照2組療效差異有統(tǒng)計(jì)學(xué)意義(P0.05)；治療8周后,治療組與對(duì)照1組療效差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),與對(duì)照2組差異有統(tǒng)計(jì)學(xué)意義(P0.05),對(duì)照1組與對(duì)照2組療效差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；治療12周后,治療組與對(duì)照1組療效差異有統(tǒng)計(jì)學(xué)意義(P0.05),與對(duì)照2組差異有統(tǒng)計(jì)學(xué)意義(P0.05),對(duì)照1組與對(duì)照2組療效差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。2.83例面頸部白癜風(fēng)患者治療前DLQI評(píng)分平均9.17±3.662分,其中治療組DLQI評(píng)分8.61±3.695分,對(duì)照1組DLQI評(píng)分9.29±4.026分,對(duì)照2組DLQI評(píng)分9.63±3.272分。經(jīng)治療后DLQI評(píng)分均較前下降,治療組DLQI評(píng)分3.61±2.644分,對(duì)照1組DLQI評(píng)分6.89±3.573分,對(duì)照2組DLQI評(píng)分5.26±2.581分,對(duì)每組治療前后評(píng)分進(jìn)行配對(duì)t檢驗(yàn),三組差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。進(jìn)一步對(duì)治療后三組間患者DLQI評(píng)分多重比較(LSD法),三組間均存在顯著差異(P0.05)。結(jié)論：1.治療4周后采用聯(lián)合治療與窄譜中波紫外線治療療效相當(dāng),且療效均優(yōu)于口服中藥組；治療8周后采用聯(lián)合治療療效優(yōu)于口服中藥組,但并不優(yōu)于窄譜中波紫外線照射組；治療12周以后采用聯(lián)合治療法療效優(yōu)于窄譜中波紫外線照射組及口服中藥組,而窄譜中波紫外線照射組及口服中藥組療效相當(dāng)。采用疏肝祛白方結(jié)合窄譜中波紫外線照射的聯(lián)合治療法治療肝郁氣滯型面頸部白癜風(fēng)具有良好療效,且不良反應(yīng)少,值得臨床推廣。2.面頸部白癜風(fēng)對(duì)患者生活質(zhì)量存在相當(dāng)影響,采用聯(lián)合治療法、窄譜中波紫外線照射治療或口服中藥治療均可改善患者生活質(zhì)量,治療組對(duì)生活質(zhì)量的改善情況優(yōu)于對(duì)照1組及對(duì)照2組,對(duì)照2組對(duì)生活質(zhì)量改善優(yōu)于對(duì)照1組。采用疏肝祛白方治療肝郁氣滯型白癜風(fēng)在改善患者生活質(zhì)量方面效果更優(yōu)。
[Abstract]:Purpose 1. The prescription of soothing liver and removing white is an empirical prescription for treating vitiligo with stagnation of liver-qi and qi after long-term verification. The purpose of this study was to observe the clinical effect of soothing the liver and removing white prescription combined with narrow-spectrum ultraviolet B on the treatment of vitiligo on the face and neck of liver-stagnation qi stagnation type. Objective: to evaluate the effect and safety of the treatment of vitiligo on the opposite neck in clinical practice. 2. To investigate the effect of face and neck vitiligo on the quality of life of patients and evaluate the changes of quality of life before and after treatment. Methods: 90 patients with vitiligo were randomly divided into treatment group (n = 30), control group (n = 1) and control group (n = 2). The treatment group was treated with oral Shugan Qubai prescription (one dose per day), external application of Xiaoban tincture (external rubbing on white spot, one time in the morning and evening) and narrow band ultraviolet B radiation (initial dose 0.05J / cm ~ (2), increase by 0.01 J / cm ~ (2), twice a week). Control group 1 was treated with narrow-spectrum ultraviolet B irradiation and external application of Xiaoban tincture (same as treatment group), control group 2 was treated with oral Chinese medicine Shugan Qubai recipe and external application of Xiaoban tincture (same treatment group). The area of leukoplakia was observed at 4 weeks, 8 weeks and 12 weeks after treatment in each group for 12 weeks, and the quality of life index questionnaire for skin diseases was completed before and after treatment. The result is 1: 1. After 4 weeks of treatment, there was no significant difference between the treatment group and the control group (P0.05), but there was a significant difference between the treatment group and the control group (P0.05), the difference between the control group 1 and the control group 2 was statistically significant (P0.05); after 8 weeks of treatment, there was a significant difference in the curative effect between the control group and the control group (P0.05). There was no significant difference between the treatment group and the control group (P0.05), but there was no significant difference between the control group (P0.05) and the control group (P0.05), but there was no significant difference between the control group (P0.05) and the control group (P0.05). There was significant difference between treatment group and control group (P0.05), but there was no significant difference between control group 1 (P0.05) and control group 2 (P0.05). 2.83 patients with face and neck vitiligo had an average DLQI score of 9.17 鹵3.662 before treatment. The DLQI score of the treatment group was 8.61 鹵3.695, the DLQI score of the control group was 9.29 鹵4.026, and the DLQI score of the control group was 9.63 鹵3.272. After treatment, the DLQI scores were all decreased. The DLQI score of the treatment group was 3.61 鹵2.644, the DLQI score of the control group was 6.89 鹵3.573, and the DLQI score of the two control groups was 5.26 鹵2.581.The scores of each group were matched t test before and after treatment, and there were significant differences among the three groups (P0.05). Further more, there were significant differences among the three groups in DLQI scores after treatment (LSD method) (P0.05). Conclusion 1. After 4 weeks of treatment, the therapeutic effect of combined treatment was similar to that of narrow band ultraviolet B, and the curative effect was better than that of oral Chinese medicine group after 8 weeks, but not better than that of narrow band ultraviolet B irradiation group. After 12 weeks of treatment, the therapeutic effect of combined therapy was better than that of narrow band ultraviolet B irradiation group and oral Chinese medicine group, but the narrow band ultraviolet B radiation group and oral Chinese medicine group had the same curative effect. The combination therapy of soothing liver and removing white prescription combined with narrow spectrum ultraviolet B irradiation has good curative effect and few adverse reactions in treating face and neck vitiligo of liver stagnation and qi stagnation type, which is worth popularizing in clinic. 2. The quality of life of patients with vitiligo on the face and neck was significantly affected, and the quality of life could be improved by combined therapy, narrow band ultraviolet B irradiation or oral Chinese medicine. The improvement of quality of life in treatment group was better than that in control group 1 and control group 2, and the improvement of quality of life in control group 2 was better than that in control group 1. Treating vitiligo with stagnation of liver and qi with the prescription of soothing the liver and removing the white is better in improving the quality of life of the patients.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R758.41

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