【摘要】：目的:觀察溫陽(yáng)除濕湯治療寒濕蘊(yùn)脾型慢性濕疹的臨床療效,同時(shí)檢測(cè)慢性濕疹患者治療前后血清中免疫細(xì)胞因子的表達(dá),比較分析治療前后的變化,以期闡述溫陽(yáng)除濕湯治療寒濕蘊(yùn)脾型慢性濕疹的臨床療效及作用機(jī)制,為臨床治療慢性濕疹提供一種新的藥物和思路。方法:在廣西中醫(yī)藥大學(xué)第一附屬醫(yī)院皮膚科門(mén)診招募60名寒濕蘊(yùn)脾型慢性濕疹患者,隨機(jī)分為治療組和對(duì)照組。治療組予以溫陽(yáng)除濕湯,每日一劑,免煎顆粒(江陰天江藥業(yè)有限公司生產(chǎn))溫水沖400ml分早、晚兩次內(nèi)服。對(duì)照組予以鹽酸左西替利嗪膠囊(規(guī)格為5mg/片,由湖南九典制藥有限公司生產(chǎn),國(guó)藥準(zhǔn)字H20060183)溫水內(nèi)服,每次一片,一日一次。治療28天為一個(gè)療程,共治療一個(gè)療程。在治療前、治療第4周進(jìn)行EASI、VAS、生活質(zhì)量評(píng)價(jià)、慢性濕疹生存質(zhì)量量表以及中醫(yī)全身證候積分評(píng)分,在治療結(jié)束后第3個(gè)月末進(jìn)行復(fù)發(fā)情況判定。并觀察患者治療前后外周血IL-4、IFN-γ水平,評(píng)價(jià)臨床療效。結(jié)果:治療組與對(duì)照組治療前后EASI積分比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。治療組與對(duì)照組治療前后中醫(yī)全身證候積分比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。治療4周后,治療組總有效率為86.66%,對(duì)照組為70%,治療組與對(duì)照組總有效率比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。隨訪(fǎng)3個(gè)月,治療組復(fù)發(fā)率明顯低于對(duì)照組復(fù)發(fā)率,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組患者治療后外周血清IL-4水平均降低,IFN-γ水平均升高,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);兩組治療后比較,治療組外周血清IL-4低于對(duì)照組,IFN-γ水平高于對(duì)照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:(1)溫陽(yáng)除濕湯治療寒濕蘊(yùn)脾證慢性濕疹療效確切,顯著優(yōu)于鹽酸左西替利嗪對(duì)照組,在改善患者皮損體征,緩解患者臨床癥狀,提高患者生活質(zhì)量等方面,效果顯著。(2)溫陽(yáng)除濕湯可調(diào)節(jié)外周血IL-4、IFN-γ水平。
[Abstract]:Objective: to observe the clinical effect of Wenyang dehumidification decoction on chronic eczema with cold dampness and spleen accumulation, and to detect the expression of immunocyte cytokines in serum of patients with chronic eczema before and after treatment, and to compare and analyze the changes before and after treatment. The aim is to expound the clinical effect and mechanism of Wenyang dehumidification decoction in treating chronic eczema of the type of cold and dampness retention of spleen, and provide a new medicine and thought for clinical treatment of chronic eczema. Methods: sixty patients with chronic eczema with cold and dampness and spleen were recruited in the dermatology department of the first affiliated Hospital of Guangxi University of traditional Chinese Medicine and randomly divided into treatment group and control group. The treatment group was treated with Wenyang dehumidification decoction, one dose per day, free decoction granule (Jiangyin Tianjiang Pharmaceutical Co., Ltd.) warm water flushing 400ml early and twice later. The control group was treated with levcetirizine hydrochloride capsules (5mg/ tablets, produced by Hunan Jiupin Pharmaceutical Co., Ltd.) and warm water administration of H20060183, one tablet at a time, once a day. Treatment for 28 days as a course of treatment, a total of a course of treatment. Before treatment, EASI VAS4 weeks, quality of life evaluation, chronic eczema quality of life scale and TCM syndromes score, at the end of the third month after treatment to determine the recurrence situation. The levels of IL-4 and IFN- 緯 in peripheral blood were observed before and after treatment to evaluate the clinical efficacy. Results: there were significant differences in EASI scores between the treatment group and the control group before and after treatment (P0.05). Treatment group and control group before and after treatment of TCM systemic syndrome scores, the differences were statistically significant (P0.05). After 4 weeks of treatment, the total effective rate of the treatment group was 86.66, and that of the control group was 70. The total effective rate of the treatment group and the control group were significantly different (P0.05). After 3 months follow-up, the recurrence rate in the treatment group was significantly lower than that in the control group, and the difference was statistically significant (P0.05). After treatment, the levels of IL-4 in peripheral blood of the two groups were significantly lower than those in the control group (P0.05), and the levels of serum IL-4 in the treatment group were significantly lower than those in the control group (P0.05). Conclusion: (1) Wenyang dehumidification decoction is effective in treating chronic eczema with cold dampness and spleen retention syndrome, which is superior to levo-cetirizine hydrochloride control group in improving the signs of skin lesions, relieving the clinical symptoms and improving the quality of life of the patients. (2) Wenyang dehumidification decoction could regulate the level of IFN- 緯 in peripheral blood.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R275.9

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