本文選題：石藍(lán)草煎劑 + 白芍總苷膠囊��； 參考：《遼寧中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:掌跖膿皰病是臨床上難治性皮膚病之一,皮損侵害患者手掌和足跖部位,影響患者的日常勞作和行走,且病勢(shì)纏綿難愈,常反復(fù)發(fā)作,對(duì)患者的身心造成嚴(yán)重困擾,降低患者的生活質(zhì)量。本次研究通過(guò)對(duì)石藍(lán)草煎劑加減治療掌跖膿皰病的療效觀察,比較分析中藥湯劑與白芍總苷膠囊治療療效結(jié)果的差異,并作出客觀評(píng)價(jià),探究一種新的治療方案,為掌跖膿皰病的治療和預(yù)防提供參考依據(jù)。材料與方法:病例選自2014年3月至2015年3月就診于遼寧中醫(yī)藥大學(xué)附屬醫(yī)院皮膚科門診的72位掌跖膿皰病患者,采用隨機(jī)化分組方法,將患者分為中藥湯劑組(中藥組)和白芍總苷組(白芍組)兩組,各36例。中藥組予中藥湯劑(石藍(lán)草煎劑加減:生石膏30g,龍膽草10g,黃芩10g,金銀花20g,板藍(lán)根30g,馬齒莧30g,車前子30g,苦參10g,滑石粉30g,生地30g,丹皮15g,赤芍15g,白術(shù)20g,茯苓20g,砂仁5g,甘草6g)口服,白芍組予白芍總苷膠囊口服,兩組均予外用藥物輔助治療,6周一個(gè)療程,共治療兩個(gè)療程。對(duì)兩個(gè)療程結(jié)束時(shí)的患者病情狀態(tài)進(jìn)行觀察并記錄評(píng)分,治療結(jié)束后隨訪2次,觀察疾病復(fù)發(fā)情況。結(jié)果:1.第一療程結(jié)束時(shí),兩組患者皮損表現(xiàn)m-PPPASI評(píng)分差異無(wú)統(tǒng)計(jì)學(xué)意義(t=-0.035,P=0.9720.05),中藥組總有效率為34.29%,白芍組總有效率為41.67%,表明在用藥6周后,石藍(lán)草煎劑加減治療掌跖膿皰病同白芍總苷膠囊治療效果相當(dāng)。2.第二療程結(jié)束時(shí),兩組患者皮損表現(xiàn)m-PPPASI評(píng)分呈現(xiàn)出顯著差異(t=-3.855,P=0.0000.05),中藥組總有效率為91.18%,白芍組總有效率為64.51%,表明在用藥12周后,石藍(lán)草煎劑加減治療掌跖膿皰病具有較好療效。3.治療結(jié)束后,兩組患者的瘙癢癥狀均有所緩解(P=0.0000.05),中藥組止癢效果的總有效率為70.59%,白芍組止癢效果的總有效率為45.16%,表明中藥湯劑的止癢效果顯著優(yōu)于白芍組。4.兩次隨訪,兩組患者的皮損表現(xiàn)評(píng)分同治療結(jié)束時(shí)相比均有不同程度的升高,但總體分析中藥組患者皮損表現(xiàn)評(píng)分仍低于白芍組,第二次隨訪時(shí),中藥組復(fù)發(fā)率為32.14%,白芍組為78.95%,表明中藥組的治療效果優(yōu)于白芍組。結(jié)論:1.石藍(lán)草煎劑加減能夠有效改善掌跖膿皰病患者的皮損表現(xiàn)和伴隨癥狀。2.石藍(lán)草煎劑加減治療掌跖膿皰病效果優(yōu)于白芍總苷膠囊治療的療效,且遠(yuǎn)期復(fù)發(fā)率低于白芍組,值得臨床推廣運(yùn)用。
[Abstract]:Objective: palmoplantar pustulosis is one of the clinical refractory dermatoses. Skin lesions encroach on the palms and plantar of the patients and affect their daily work and walking. Reduce the quality of life of patients. In this study, we observed the curative effect of the addition and subtraction of Ishizao decoction on palmoplantar pustular disease, compared and analyzed the difference between traditional Chinese medicine decoction and total paeony glucoside capsule, and made an objective evaluation to explore a new treatment scheme. To provide reference for the treatment and prevention of palmoplantar pustulosis. Materials and methods: from March 2014 to March 2015, 72 patients with palmoplantar pustulosis were selected from the dermatology department of affiliated Hospital of Liaoning University of traditional Chinese Medicine. The patients were divided into traditional Chinese medicine decoction group (traditional Chinese medicine group) and total glucoside of paeony group (paeony group) with 36 cases each. The traditional Chinese medicine group was given traditional Chinese medicine decoction (Chinese medicine decoction: raw gypsum 30g, gentian 10g, baicalin 10g, honeysuckle 20g, Isatidis root 30g, purslane 30g, plantain 30g, Sophora flavescens 10g, talcum powder 30g, raw land 30g, danpi 15g, Radix Paeoniae rubra 15g, Atractylodes macrocephalae 20g, Poria Ling 20g, Amomum kernel 5g, licorice 6g). Total glucoside of paeony was given orally in the paeony group and the two groups were treated with external drug adjuvant therapy for 6 weeks and two courses of treatment. The patients were observed and scored at the end of two courses of treatment. The patients were followed up for 2 times to observe the recurrence of the disease. The result is 1: 1. At the end of the first course of treatment, there was no significant difference between the two groups in the m-PPPASI score of skin lesions. The total effective rate in the traditional Chinese medicine group was 34.29 and the total effective rate in the paeoniae peony group was 41.67, indicating that after 6 weeks of treatment, the total effective rate was 34.29 and 41.67 respectively. The curative effect of Shizhicao decoction on palmoplantar pustulosis was equal to that of total paeony glucoside capsule. At the end of the second course of treatment, the m-PPPASI score of skin lesions in the two groups showed significant difference. The total effective rate of the traditional Chinese medicine group was 91.18 and the total effective rate of the white peony root group was 64.51. The results showed that after 12 weeks of treatment, the addition and subtraction of Herba chinensis decoction had a better curative effect on paw and metatarsal pustular pustule. After treatment, the symptoms of pruritus in both groups were alleviated, the total effective rate of antipruritic effect was 70.59 in the Chinese medicine group and 45.16 in the white peony group, indicating that the antipruritus effect of the traditional Chinese medicine decoction was significantly better than that of the paeoniae group. After two follow-up, the scores of skin lesions in both groups were higher than those at the end of treatment, but the scores of skin lesions in the Chinese medicine group were still lower than those in the paeoniae Alba group, and at the second follow-up, the patients in the traditional Chinese medicine group were still lower than those in the control group. The recurrence rate of Chinese medicine group was 32.14 and that of white peony group was 78.95, which indicated that the treatment effect of Chinese medicine group was better than that of white peony root group. Conclusion 1. The addition and subtraction of Herba chinensis decoction can effectively improve the palmoplantar pustulosis patients' skin lesions and accompanying symptoms. 2. 2. The addition and subtraction of Shi Lan Cao decoction in the treatment of palmoplantar pustular disease was better than that of total paeony glucoside capsule, and the long term recurrence rate was lower than that in Paeoniae Alba group, so it was worth popularizing in clinic.
【學(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R275.9
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本文編號(hào)：1887795