本文選題：山海棠合劑 + 血熱型��； 參考：《云南中醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:觀察山海棠合劑治療血熱型尋常型銀屑病的療效及安全性,并從微觀角度探討藥物作用機理,為山海棠合劑治療尋常型銀屑病的臨床應(yīng)用提供科學(xué)依據(jù)。方法:采用隨機對照試驗,把66例血熱型尋常型銀屑病患者隨機分為試驗組和對照組,每組33例,詳細記錄患者相關(guān)資料并檢測血清IL-12和IL-23水平;同時選取30例健康志愿者檢測血清IL-12和IL-23水平進行比較。試驗組口服山海棠合劑,對照組口服阿維A膠囊;兩組均外用丹皮酚軟膏。每周復(fù)診1次,連續(xù)用藥8周后進行療效判定并復(fù)查血清IL-12和IL-23水平。運用SPSS22.0軟件對數(shù)據(jù)資料進行統(tǒng)計分析。結(jié)果:1.受試66例患者中,試驗組脫落1例,對照組脫落3例,共收集有效病例62例。兩組性別、年齡、病程、病情、血清IL-12和IL-23水平等基線資料具有可比性(P0.05)。2.療程結(jié)束,試驗組和對照組中醫(yī)證候評分均較治療前顯著降低(P0.05),試驗組優(yōu)于對照組(P0.05)。3.療程結(jié)束,試驗組和對照組PASI評分均較治療前顯著降低(P0.05),兩組比較差異無統(tǒng)計學(xué)意義(P0.05)。4.試驗組和對照組治療前血清IL-12和IL-23水平均顯著高于健康志愿者(P0.05),療程結(jié)束后均較治療前顯著降低(P0.05);療程結(jié)束兩組血清IL-12水平、試驗組血清IL-23水平與健康志愿者比較差異無統(tǒng)計學(xué)意義(P0.05),對照組血清IL-23水平與健康志愿者比較差異仍有統(tǒng)計學(xué)意義(P0.05)。5.治療7天后,試驗組總有效率優(yōu)于對照組(P0.05),治療14天、21天、28天,兩組總有效率比較差異無統(tǒng)計學(xué)意義(P0.05);療程結(jié)束,試驗組總有效率90.63%,愈顯率71.88%;對照組總有效率83.33%,愈顯率60.33%。試驗組高于對照組,但兩組比較差異無統(tǒng)計學(xué)意義(P0.05)。6.試驗組和對照組均無嚴重不良反應(yīng)發(fā)生,試驗組有3例發(fā)生輕度腹痛、腹脹,減少服藥次數(shù)后癥狀消失;對照組有6例服藥后出現(xiàn)皮膚干燥、口腔黏膜干燥,未經(jīng)處理,隨用藥時間推移自行緩解,3例服藥期間出現(xiàn)轉(zhuǎn)氨酶輕度升高,停藥2個月后復(fù)查恢復(fù)至正常。7.療程結(jié)束后隨訪3個月,試驗組復(fù)發(fā)4例,對照組復(fù)發(fā)9例,兩組比較差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:山海棠合劑治療血熱型尋常型銀屑病療效確切,無明顯不良反應(yīng),與西藥阿維A膠囊相比具有起效較快、復(fù)發(fā)率低、不良反應(yīng)較輕等優(yōu)勢。
[Abstract]:Objective: to observe the efficacy and safety of Shanhaitang mixture in treating psoriasis vulgaris with blood heat, and to explore the mechanism of drug action from microscopic point of view, and to provide scientific basis for clinical application of Shanhaitang mixture in the treatment of psoriasis vulgaris. Methods: 66 patients with psoriasis vulgaris of blood fever type were randomly divided into trial group and control group with 33 cases in each group. The relevant data and serum IL-12 and IL-23 levels were recorded in detail. Serum IL-12 and IL-23 levels were measured in 30 healthy volunteers. The experimental group was treated with Shanhaitang mixture and the control group with Avera capsule, and both groups were treated with paeonol ointment. The curative effect was evaluated and the serum IL-12 and IL-23 levels were reviewed after 8 weeks of continuous treatment. Use SPSS22.0 software to carry on the statistical analysis to the data. The result is 1: 1. Among 66 patients, 1 case in the test group and 3 cases in the control group. 62 effective cases were collected. The baseline data of sex, age, course of disease, condition, serum IL-12 and IL-23 levels were comparable between the two groups. At the end of the course of treatment, the scores of TCM syndromes in the test group and the control group were significantly lower than those before treatment, and the test group was superior to the control group. At the end of the course of treatment, the PASI scores of the test group and the control group were significantly lower than those of the control group before treatment. The difference between the two groups was not statistically significant. The levels of serum IL-12 and IL-23 in the experimental group and the control group were significantly higher than those in the healthy volunteers before treatment, and the levels of serum IL-12 in the two groups were significantly lower after the end of the course of treatment than before the treatment, and at the end of the course of treatment, the levels of serum IL-12 in the two groups were significantly decreased. There was no significant difference in serum IL-23 level between the experimental group and the healthy volunteers, but there was still significant difference in the serum IL-23 level between the control group and the healthy volunteers. After 7 days of treatment, the total effective rate in the experimental group was better than that in the control group (P 0.05), the total effective rate in the two groups was not significantly different from that in the control group (P 0.05), the total effective rate in the test group was 90.63 and 71.888.The total effective rate in the control group was 83.33 and the effective rate was 60.33. The experimental group was higher than the control group, but there was no significant difference between the two groups. There were 3 cases of mild abdominal pain and abdominal distention in the test group, and 6 cases of the control group had dry skin, dry oral mucosa and untreated skin after reducing the number of times of taking the medicine, and no serious adverse reactions occurred in the test group and control group, while in the control group, there were 3 cases with mild abdominal pain and abdominal distension. The level of transaminase increased slightly in 3 patients with spontaneous remission during medication, and returned to normal at 2 months after withdrawal. Three months after the end of the course of treatment, 4 cases of recurrence were found in the trial group and 9 cases in the control group. The difference between the two groups was statistically significant (P 0.05). Conclusion: Shanhaitang mixture is effective in treating psoriasis vulgaris of blood fever type and has no obvious adverse reaction. Compared with Avea capsule, it has the advantages of quick onset, low recurrence rate and mild adverse reaction.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R275.9

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