本文選題：白塞病 + 濕熱毒蘊(yùn)　； 參考：《中國中醫(yī)科學(xué)院》2016年碩士論文

【摘要】：目的：觀察加味四妙勇安湯治療濕熱毒蘊(yùn)型白塞病的有效性和安全性。方法：于2015年3月至2016年3月期間中國中醫(yī)科學(xué)院西苑醫(yī)院風(fēng)濕科門診及病房就診的白塞病患者,選取其中符合納入標(biāo)準(zhǔn)的50例,根據(jù)有無服用西藥分為中西藥組和中藥組,中藥組予加味四妙勇安湯顆粒劑口服,中西藥組在原有西藥的基礎(chǔ)上加用加味四妙勇安湯,療程為4周,觀察治療前后癥狀體征積分變化,記錄實(shí)驗室療效指標(biāo)、安全性指標(biāo)及不良反應(yīng),對結(jié)果進(jìn)行統(tǒng)計分析。結(jié)果：組內(nèi)治療前后自身癥狀體征積分比較,發(fā)現(xiàn)兩組在總積分、口腔潰瘍、皮膚病變、關(guān)節(jié)腫痛、煩躁及乏力方面差異均具有統(tǒng)計學(xué)意義；此外,中藥組在口苦、大便干結(jié)、大便稀溏方面差異具有統(tǒng)計學(xué)意義,中西藥組在外陰潰瘍、神疲、口干及失眠多夢方面差異具有統(tǒng)計學(xué)意義,其治療后積分要顯著低于治療前,說明兩組在改善患者癥狀體征方面均有效果,且有所側(cè)重。組內(nèi)治療前后實(shí)驗室療效指標(biāo)比較,中西藥組的血沉改變有統(tǒng)計學(xué)差異,說明中西藥組可使患者血沉下降。中藥組的血沉改變,以及兩組的C-反應(yīng)蛋白改變均無統(tǒng)計學(xué)差異。中藥組總有效率82.60%,中西藥組總有效率88.50%,兩組治療均有效,總有效率差異無顯著統(tǒng)計學(xué)意義。組間癥狀體征積分差值比較發(fā)現(xiàn),兩組總積分改善情況無顯著差異。中藥組大便稀溏積分增加多于中西藥組,說明中藥組能促使患者排便。其余各癥狀體征積分的差值比較無顯著差異。兩組病例治療前后血沉及C-反應(yīng)蛋白差值比較均無顯著差異,兩組對ESR及CRP的影響相當(dāng)。在安全性方面,中西藥組存在肝損害、白細(xì)胞升高的可能,中藥組安全性較高。結(jié)論：加味四妙勇安湯治療白塞病療效確切,安全性好。
[Abstract]:Objective: to observe the efficacy and safety of modified Simiao Yong an decoction in the treatment of damp-heat toxin accumulated Behcet's disease. Methods: from March 2015 to March 2016, 50 patients with Behcet's disease were selected from the Department of Rheumatology, Xiyuan Hospital, Chinese Academy of traditional Chinese Medicine. The traditional Chinese medicine group was treated with modified Simiao Yong an decoction orally, and the Chinese and western medicine group was treated with modified Simiao Yong an decoction on the basis of the original western medicine. The course of treatment was 4 weeks. The changes of symptoms and signs were observed before and after treatment, and the laboratory curative effect indexes were recorded. Safety indexes and adverse reactions were analyzed statistically. Results: there were significant differences in total score, oral ulcer, skin lesion, joint swelling and pain, irritability and fatigue between the two groups before and after treatment. There were significant differences in loose stools between Chinese and western medicine groups in vulvar ulcers, fatigue, dry mouth and insomnia, and the scores after treatment were significantly lower than those before treatment. The results showed that the two groups were effective in improving the symptoms and signs of the patients. The changes of ESR in Chinese and western medicine group were significantly different before and after treatment, indicating that the ESR of patients in TCM group could be decreased. There was no significant difference in ESR and C-reactive protein between the two groups. The total effective rate of traditional Chinese medicine group was 82.60 and that of Chinese and western medicine group was 88.50. The two groups were all effective, and the total effective rate had no significant difference. There was no significant difference in the improvement of the total score between the two groups. The scores of loose stool in TCM group increased more than those in TCM group, indicating that TCM group can promote defecation. There was no significant difference in the scores of other symptoms and signs. There was no significant difference in ESR and C-reactive protein difference between the two groups before and after treatment. The effects on ESR and CRP were similar between the two groups. In terms of safety, liver damage and leukocytosis may occur in Chinese and western medicine group, and higher safety in traditional Chinese medicine group. Conclusion: modified Simiao Yong an decoction is effective and safe in the treatment of Behcet's disease.
【學(xué)位授予單位】：中國中醫(yī)科學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259

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