【摘要】： 目的：通過(guò)臨床觀察和動(dòng)物實(shí)驗(yàn),觀察0.5%冰醋酸聯(lián)合清熱利濕中藥方劑(以茵陳蒿湯為基礎(chǔ)方劑)治療腸胃濕熱型痤瘡的臨床療效及0.5%冰醋酸聯(lián)合清熱利濕中藥外用對(duì)動(dòng)物皮脂腺斑的作用,探究0.5%冰醋酸聯(lián)合清熱利濕中藥外用對(duì)腸胃濕熱型痤瘡的治療機(jī)理。 方法：臨床觀察：62例臨床確定為腸胃濕熱型痤瘡患者,隨機(jī)分為試驗(yàn)組與對(duì)照組,試驗(yàn)組給予清熱利濕中藥方劑口服,同時(shí)隔日給予0.5%冰醋酸聯(lián)合清熱利濕中藥外敷痤瘡皮疹,每次30分鐘；對(duì)照組給予單純口服上述中藥湯劑,連續(xù)觀察4周,判定用藥后皮膚情況,評(píng)價(jià)療效。 實(shí)驗(yàn)研究：選用金黃地鼠背部皮脂腺斑作為痤瘡模型,將30只金黃地鼠隨機(jī)分為5組,每組6只,分別為0.5%冰醋酸組、中藥組、0.1%冰醋酸聯(lián)合中藥組、0.5%冰醋酸聯(lián)合中藥組、正常對(duì)照組,通過(guò)在金黃地鼠背部皮脂腺斑處分別外敷0.5%冰醋酸、蒸餾水聯(lián)合中藥、0.1%冰醋酸聯(lián)合中藥、0.5%冰醋酸聯(lián)合中藥以及蒸餾水,隔日一次,每次30分鐘,4周后取金黃地鼠背部皮脂腺斑,經(jīng)過(guò)固定、染色、切片,制成病理圖片,借助于圖像分析系統(tǒng),觀察皮脂腺斑的微觀結(jié)構(gòu)變化。 結(jié)論：臨床試驗(yàn)：試驗(yàn)組明顯優(yōu)于對(duì)照組(P0.05),說(shuō)明對(duì)于腸胃濕熱型痤瘡患者在口服中藥湯劑基礎(chǔ)上增加0.5%冰醋酸聯(lián)合清熱利濕中藥外用有利于痤瘡治療,優(yōu)于單純口服清熱利濕中藥湯劑者。 動(dòng)物試驗(yàn)：0.5%冰醋酸聯(lián)合清熱利濕中藥外用能夠使金黃地鼠背部皮脂腺斑角質(zhì)層厚度變薄,毛囊皮脂腺漏斗部角質(zhì)細(xì)胞堆積減少,脫離,毛囊內(nèi)的角化物質(zhì)明顯減少,皮脂腺細(xì)胞縮小,明顯優(yōu)于其它組,其次為0.1%冰醋酸聯(lián)合中藥組和純中藥組亦有明顯療效,兩組之間比較無(wú)明顯差異,0.5%冰醋酸單純外用僅僅能夠使角質(zhì)細(xì)胞層細(xì)胞粘合作用減弱,角質(zhì)細(xì)胞層疏松,蒸餾水組對(duì)皮脂腺斑無(wú)作用。
[Abstract]:Objective: to observe the clinical effect of 0.5% acetic acid combined with traditional Chinese medicine for clearing heat and dampness (based on Yinchenhao decoction) in the treatment of acne due to gastrointestinal dampness and heat and dampness, and to explore the therapeutic mechanism of 0.5% acetic acid combined with traditional Chinese medicine for clearing away heat and dampness on acne due to dampness and dampness of intestines and stomach, and to explore the therapeutic mechanism of 0.5% acetic acid combined with traditional Chinese medicine for clearing heat and dampness on acne due to dampness and heat in intestines and stomach. Methods: clinical observation: 62 patients with acne of gastrointestinal dampness and heat were randomly divided into experimental group and control group. The experimental group was given Qingre and dampness prescription, and 0.5% acetic acid combined with clearing heat and dampness traditional Chinese medicine was given to acne rash every other day for 30 minutes. The control group was treated with the above traditional Chinese medicine decoction for 4 weeks, the skin condition after treatment was judged and the curative effect was evaluated. Experimental study: 30 golden hamsters were randomly divided into 5 groups with 0.5% acetic acid group, traditional Chinese medicine group, 0.1% acetic acid combined with traditional Chinese medicine group, 0.5% glacial acetic acid combined with traditional Chinese medicine group and normal control group by external application of 0.5% glacial acetic acid and distilled water to the back sebaceous gland spot of golden hamster, and 30 golden hamsters were randomly divided into 5 groups with 0.5% glacial acetic acid, distilled water and traditional Chinese medicine, respectively, and the other 30 golden hamsters were randomly divided into 5 groups with 0.5% glycolic acid group, 0.1% acetic acid combined with traditional Chinese medicine group, 0.5% acetic acid combined with traditional Chinese medicine group and normal control group. 0.1% acetic acid combined with traditional Chinese medicine, 0.5% acetic acid combined with traditional Chinese medicine and distilled water, once every other day for 30 minutes, 4 weeks later, the back sebaceous gland spot of golden hamster was taken and fixed, stained and sliced to make pathological pictures. With the help of image analysis system, the microstructure of sebaceous gland spot was observed. Conclusion: the clinical trial: the experimental group is obviously superior to the control group (P 0.05), indicating that the addition of 0.5% acetic acid combined with Qingre and dampness Chinese medicine is beneficial to the treatment of acne on the basis of oral traditional Chinese medicine decoction, and is superior to the simple oral Qingre and dampness traditional Chinese medicine decoction. Animal experiment: 0.5% acetic acid combined with traditional Chinese medicine for clearing heat and dampness could make the thickness of keratin layer of sebaceous gland on the back of golden hamster thinner, the accumulation of keratinocytes in funnel part of hair follicles decreased, detachment, the keratinizing substance in hair follicles decreased obviously, the sebaceous gland cells decreased obviously, which was obviously better than that in other groups, followed by 0.1% acetic acid combined with traditional Chinese medicine group and pure traditional Chinese medicine group, and there was no significant difference between the two groups. 0.5% acetic acid alone could only weaken the adhesion of keratinocyte layer and loose keratinocyte layer. Distilled water group had no effect on sebaceous gland spot.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類號(hào)】：R758.733

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