【摘要】：目的:觀察補(bǔ)陽(yáng)還五湯加減治療氣虛血瘀型難治性斑禿的臨床療效,并探討皮膚鏡在脫發(fā)類(lèi)疾病中的運(yùn)用前景。方法:將72例氣虛血瘀型難治性斑禿患者,隨機(jī)分為兩組。治療組(36例)口服補(bǔ)陽(yáng)還五湯加減,對(duì)照組(36例)口服復(fù)方甘草酸苷片,兩組在治療期間均聯(lián)合梅花針叩刺。運(yùn)用皮膚鏡對(duì)納入觀察的氣虛血瘀型難治性斑禿患者進(jìn)行臨床療效的微觀觀察。以4周為一個(gè)觀察療程,分別于治療前及治療后第4周、8周、12周末填寫(xiě)療效觀察表,并用SPSS 22.0對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析判定療效。結(jié)果:1皮損積分:治療前治療組與對(duì)照組皮損積分比較差異無(wú)統(tǒng)計(jì)學(xué)意義,具有可比性。經(jīng)3個(gè)療程(12周)治療,治療組治療后皮損積分為6.11±3.503較治療前皮損積分11.08±3.093明顯降低;對(duì)照組治療后積分為8.34±5.218較治療前皮損積分10.94±2.947明顯降低;并對(duì)治療組與對(duì)照組組間比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05),治療組在改善皮損評(píng)分上效果明顯優(yōu)于對(duì)照組。2臨床療效:經(jīng)3個(gè)療程(12周)治療后,治療組痊愈3例,顯效15例,有效13例,無(wú)效5例,總有效率86.11%;對(duì)照組痊愈1例,顯效11例,有效9例,總有效率60.00%。治療組有效率明顯高于對(duì)照組,差異均有統(tǒng)計(jì)學(xué)意義。3皮膚鏡微觀療效觀察:兩組患者經(jīng)皮膚鏡下觀察,治療前終毛數(shù)密度的差異無(wú)統(tǒng)計(jì)學(xué)意義;治療組治療4周、8周及12周后的終毛數(shù)密度均高于對(duì)照組,差異均有統(tǒng)計(jì)學(xué)意義。結(jié)論:1補(bǔ)陽(yáng)還五湯加減聯(lián)合梅花針叩刺對(duì)氣虛血瘀型難治性斑禿有確切的療效,為臨床難治性斑禿的辨證施治提供了新的思路與方法。2補(bǔ)陽(yáng)還五湯加減治療氣虛血瘀型難治性斑禿的療效優(yōu)于復(fù)方甘草酸苷片。3皮膚鏡在脫發(fā)類(lèi)疾病的臨床療效評(píng)估上具有廣闊的應(yīng)用前景。
[Abstract]:Objective: to observe the clinical effect of Buyang Huanwu decoction in treating refractory alopecia areata with Qi deficiency and blood stasis, and to explore the application prospect of dermatoscope in alopecia. Methods: 72 patients with refractory alopecia areata with qi deficiency and blood stasis were randomly divided into two groups. The treatment group (36 cases) was treated with Buyang Huanwu decoction and the control group (36 cases) with compound glycyrrhizin tablets. The clinical efficacy of refractory alopecia areata with deficiency of qi and blood stasis was observed with dermatoscope. After 4 weeks of treatment as a course of treatment, we filled out the observation form before treatment and at the end of 4th, 8th and 12th week after treatment, and evaluated the curative effect by statistical analysis of data with SPSS 22. 0. Results: 1 the score of skin lesion: there was no significant difference between the treatment group and the control group before treatment. After 3 courses of treatment (12 weeks), the score of skin lesion in the treatment group was 6.11 鹵3.503, which was significantly lower than that before treatment (11.08 鹵3.093). In the control group, the score after treatment was 8.34 鹵5.218, which was significantly lower than that before treatment (10.94 鹵2.947). The difference between the treatment group and the control group was statistically significant (P0.05). The effect of the treatment group in improving the score of skin lesions was significantly better than that in the control group. 2 Clinical efficacy: after three courses of treatment (12 weeks), 3 cases in the treatment group were cured. There were 15 cases of remarkable effect, 13 cases of effective and 5 cases of ineffective. The total effective rate was 86.11%. In the control group, 1 case was cured, 11 cases were effective, 9 cases were effective, the total effective rate was 60.00g. The effective rate of the treatment group was significantly higher than that of the control group, and the difference was statistically significant. 3 observation of microscopic curative effect of dermatoscope: there was no significant difference in the number of hair density before treatment between the two groups. After 4 weeks, 8 weeks and 12 weeks of treatment, the end hair density in the treatment group was significantly higher than that in the control group. Conclusion: (1) Buyang Huanwu decoction combined with plum blossom acupuncture has definite curative effect on refractory alopecia areata with deficiency of qi and blood stasis. 2 the curative effect of Buyang Huanwu decoction in treating refractory alopecia areata with Qi deficiency and blood stasis is better than that of compound glycyrrhizin tablet. 3 the clinical effect of dermatoscope in alopecia is better than that of compound glycyrrhizin tablets. The evaluation of curative effect has broad application prospect.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【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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