【摘要】：目的通過桂枝湯治療膽堿能性蕁麻疹(Cholinergic urticaria,Ch U)患者臨床癥狀的療效觀察,同時(shí)檢測Ch U患者自體血清皮膚試驗(yàn)、自體汗液皮膚試驗(yàn)和血清中總Ig E水平的變化,對(duì)桂枝湯治療膽堿能性蕁麻疹的病理機(jī)制進(jìn)行初步探討。方法1.臨床資料本組臨床資料均來自于武漢周邊某部隊(duì)軍人。2016年3月至2017年1月共我們收集膽堿能性蕁麻疹合格調(diào)查問卷836份,其中符合膽堿能性蕁麻疹診斷標(biāo)準(zhǔn)的患者69人,愿意全程參與本次實(shí)驗(yàn)的膽堿能性蕁麻疹患者有20人。2.治療和方法使用中藥(口服桂枝湯每日1劑,每次150ml,早晚各1次)治療膽堿能性蕁麻疹患者30天,觀察自體血清皮膚試驗(yàn)、自體汗液皮膚試驗(yàn)和血清中總Ig E的水平在口服桂枝湯的過程中,其治療前、治療15天、治療30天后的變化。結(jié)果1.臨床研究方面(1)經(jīng)過15天的治療后,觀察臨床療效數(shù)據(jù)顯示:15天治療的總有效率為40%。經(jīng)過30天的治療后,觀察臨床療效數(shù)據(jù)顯示:30天治療的總有效率為90%。治療后15天癥狀積分下降指數(shù)(SSRI)與治療后30天SSRI比較,差異有顯著統(tǒng)計(jì)學(xué)意義(P0.05),治療后30天SSRI較治療后15天SSRI顯著增加。(2)治療后30天癥狀評(píng)分與治療前癥狀評(píng)分相比,結(jié)果有顯著統(tǒng)計(jì)學(xué)差異(P0.01),而治療后15天癥狀評(píng)分與治療前癥狀評(píng)分相比,結(jié)果無明顯統(tǒng)計(jì)學(xué)差異(P0.05)。2.實(shí)驗(yàn)室研究方面(1)桂枝湯治療膽堿能性蕁麻疹患者,治療前與治療30天后,自體汗液皮膚試驗(yàn)結(jié)果有顯著統(tǒng)計(jì)學(xué)差異(P0.01),而自體血清皮膚試驗(yàn)治療前與治療30天后相比,其結(jié)果無明顯統(tǒng)計(jì)學(xué)差異(P0.05)。(2)治療后30天的總Ig E水平與治療前的總Ig E水平相比,結(jié)果有顯著統(tǒng)計(jì)學(xué)差異(P0.05),而治療后15天的總Ig E水平與治療前總Ig E水平相比,結(jié)果無明顯統(tǒng)計(jì)學(xué)差異(P0.05)。結(jié)論桂枝湯治療膽堿能性蕁麻疹有較好的臨床療效,桂枝湯能夠調(diào)節(jié)膽堿能性蕁麻疹患者出汗情況,減少風(fēng)團(tuán)的產(chǎn)生,減輕患者的臨床癥狀,降低患者血清總Ig E水平,調(diào)節(jié)機(jī)體的免疫功能,從而提高膽堿能性蕁麻疹患者的生活質(zhì)量。
[Abstract]:Objective to observe the efficacy of Guizhi decoction in treating cholinergic urticaria (Cholinergic urticaria,Ch U), and to detect the changes of serum autogenous skin test, autologous sweat skin test and serum total Ig E level in patients with Ch U. The pathological mechanism of Guizhi decoction in the treatment of cholinergic urticaria was discussed. Method 1. From March 2016 to January 2017, we collected 836 qualified questionnaires for cholinergic urticaria, 69 of which met the diagnostic criteria of cholinergic urticaria. Twenty patients with cholinergic urticaria were willing to participate in the study. To treat cholinergic urticaria patients with cholinergic urticaria by traditional Chinese medicine (oral Guizhi decoction, 150 ml / day, 1 time in the morning and evening) for 30 days, and observe the skin test of autogenous serum. Autologous perspiration skin test and serum total Ig E levels in the course of oral administration of Guizhi decoction, the changes were observed before, 15 days and 30 days after treatment. Result 1. In clinical studies (1) after 15 days of treatment, the observation of clinical efficacy data showed that the total effective rate of 15 days treatment was 40%. After 30 days of treatment, the clinical efficacy data showed that the total effective rate of 30 days treatment was 90. The decrease index of symptom score (SSRI) on day 15 after treatment was significantly higher than that on day 30 after treatment (P0.05), and SSRI on day 30 after treatment was significantly higher than that on day 15 after treatment. (2) symptom score at day 30 after treatment was significantly higher than that at day 30 after treatment. Results there was significant statistical difference (P0.01), but there was no significant difference between the symptom score of 15 days after treatment and the pre-treatment symptom score (P0.05). 2. In laboratory studies, (1) there was a significant difference in the results of autologous sweat skin test before and after 30 days of treatment in patients with cholinergic urticaria treated with Guizhi decoction (P0.01), but there was a significant difference between before and after 30 days of treatment with the autologous serum skin test. The results showed that there was no significant difference (P0.05). (2) between the total Ig E level 30 days after treatment and the total Ig E level before treatment (P0.05), while the total Ig E level 15 days after treatment was compared with the total Ig E level before treatment. Results there was no significant statistical difference (P0.05). Conclusion Guizhi decoction has a good clinical effect on cholinergic urticaria. Guizhi decoction can regulate the sweating condition of cholinergic urticaria patients, reduce the formation of wind mass, alleviate the clinical symptoms of patients, and reduce the serum total Ig E level of patients with cholinergic urticaria. Adjusts the body's immune function, thus improves the cholinergic urticaria patient's quality of life.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R275.9

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