【摘要】：痤瘡是一種常見(jiàn)的發(fā)生于毛囊皮脂腺的慢性炎癥性皮膚病,好發(fā)于青春期男性和女性,且男性略高于女性。在北方某城市調(diào)查了955例受訪者,總患病率為59.6%,男性患病率為64.7%,女性為54.8%,呈現(xiàn)出痤瘡發(fā)病率高,男性較女性稍高的特點(diǎn)。有研究者對(duì)大學(xué)生進(jìn)行UPI問(wèn)卷調(diào)查,結(jié)果顯示痤瘡對(duì)生活質(zhì)量的影響,表現(xiàn)在多個(gè)方面,例如自信、情緒、社交等,且痤瘡對(duì)生活的影響程度與其嚴(yán)重程度呈正相關(guān)。因此,可以說(shuō)痤瘡不但是患病率高的一種皮膚病,而且其對(duì)人的心理和生活質(zhì)量的影響更是不容小覷,應(yīng)引起醫(yī)務(wù)工作者的廣泛關(guān)注。但是,目前痤瘡治療方法種類(lèi)繁多,療效不一,化瘀解毒散結(jié)飲是臨床應(yīng)用有良好療效的經(jīng)驗(yàn)方,通過(guò)前期研究,臨床已證實(shí)化瘀解毒散結(jié)飲治療痤瘡安全有效,但是其結(jié)合刺絡(luò)拔罐作為一個(gè)整體療法的作用及優(yōu)勢(shì)尚缺少實(shí)驗(yàn)研究支持。目的:本研究通過(guò)觀察化瘀解毒散結(jié)飲聯(lián)合刺絡(luò)拔罐法治療脾胃積熱型尋常痤瘡的臨床療效及對(duì)痤瘡患者生活質(zhì)量的影響,探討本聯(lián)合療法治療痤瘡的優(yōu)勢(shì)。方法:將2016年4月至2016年12月于我院皮膚科門(mén)診就診的患者進(jìn)行篩選,從中挑選出與本課題納入標(biāo)準(zhǔn)相符合的尋常型痤瘡患者60例,將60例受試者隨機(jī)分為對(duì)照組和治療組,各30例。治療組予化瘀解毒散結(jié)飲聯(lián)合刺絡(luò)拔罐法治療,對(duì)照組予化瘀解毒散結(jié)飲口服治療,化瘀解毒散結(jié)飲每日1劑,分早晚飯后溫服,刺絡(luò)拔罐法每周治療—次,兩組均治療4周,觀察治療前后患者的癥狀、皮損改善情況及DLQI量表評(píng)分的變化,將治療前后皮損積分、癥狀積分、DLQI量表評(píng)分作為觀察指標(biāo)進(jìn)行對(duì)照分析,以此來(lái)評(píng)價(jià)本研究方法對(duì)脾胃積熱型痤瘡的的治療效果。結(jié)果:通過(guò)觀察4周治療后的效果,經(jīng)統(tǒng)計(jì)結(jié)果,兩組患者癥狀改善總有效率對(duì)比,治療組化瘀解毒散結(jié)飲聯(lián)合刺絡(luò)拔罐法為86.7%,對(duì)照組單服化疲解毒散結(jié)飲為73.3%,兩組治療有統(tǒng)計(jì)學(xué)意義(P0.05),聯(lián)合療法優(yōu)于對(duì)照組;兩組患者皮損消退率對(duì)比,治療組有效率為83.3%,對(duì)照組有效率為73.3%,兩組治療對(duì)皮損消退改善有效,但兩組差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);兩組患者治療前后皮損個(gè)數(shù)減少情況比較,治療組皮損減少率為56.37±11.10,對(duì)照組皮損減少率為50.81±8.53,兩組治療均有效,治療組對(duì)皮損減少情況優(yōu)于對(duì)照組(P0.05);兩組治療前后皮損積分比較,治療組皮損積分改善率為58.97± 11.607,對(duì)照組皮損積分改善率為52.68±8.46,兩組治療均有效,治療組對(duì)皮損積分改善情況優(yōu)于對(duì)照組(P0.05);兩組患者治療前后癥候總積分改善情況比較,治療組總積分改善率為61.72±10.46,對(duì)照組改善率為56.00±7.26,兩組治療均有效,治療組優(yōu)于對(duì)照組(P0.05);兩組患者治療前后DLQI量表評(píng)分改善情況比較,治療組DLQI改善率為81.10±8.3,對(duì)照組為73.87±11.37,可以認(rèn)為治療組對(duì)痤瘡患者DLQI影響程度高于對(duì)照組(P0.05)。結(jié)論:通過(guò)臨床試驗(yàn)觀察表明,化瘀解毒散結(jié)飲聯(lián)合刺絡(luò)拔罐法治療脾胃積熱型痤瘡安全有效,可以改善患者癥狀,減少皮損,能改善痤瘡對(duì)患者生活質(zhì)量的影響,且聯(lián)合療法優(yōu)于單用化瘀解毒散結(jié)飲,值得臨床推廣。
[Abstract]:Aphtha is a common chronic inflammatory skin disease that occurs in the sebaceous glands of the hair follicle, which is good for adolescent males and females, and is slightly higher in males than in females. A total of 955 respondents were investigated in a city in the north, with a total prevalence of 59.6%, a male prevalence of 65.7% and a female of 54. 8%, showing a high incidence of aphtha and a slightly higher number of men. The results showed that the effect of aphtha on the quality of life, such as self-confidence, emotion, social, etc., was positively related to the degree of life. Therefore, it can be said that the skin-sore is not only a kind of skin disease with high prevalence, but also its influence on the psychological and quality of life of the person is not allowed to be small, it should cause the medical worker's extensive attention. However, the present invention has a wide variety of treatment methods, the curative effect is not one, the blood stasis removing and detoxication and the accumulation of the hard mass are the experience of the clinical application of good curative effect, However, it is still lack of experimental research and support for the effect and advantage of the combination of the acupuncture and cupping as a whole therapy. Objective: To study the clinical effect and the effect of the combination therapy on the quality of life of the patients with heat of the spleen and the stomach by observing the effect of the combination of the blood-stasis removing and the mass-clearing and mass-clearing and the combination of the acupuncture and cupping on the quality of the life of the patients with the heat of the spleen and stomach, and to discuss the advantages of the combination therapy in the treatment of the sore. Methods: From April 2016 to December 2016, the patients who were treated in the Department of Dermatology of our hospital were selected to select 60 cases of the patients with common aphtha according to the standard of the subject, and 60 subjects were randomly divided into the control group and the treatment group, and 30 cases were randomly divided into the control group and the treatment group. The treatment group is used for treating blood stasis, removing toxic substance and resolving hard mass, and is used for the treatment of acupuncture and cupping. The control group is used for the treatment of blood stasis, detoxication, hard mass, oral treatment, blood stasis removing, detoxication, hard mass, and the like, and the two groups are treated once a week for four weeks, and the symptoms of the patients before and after the treatment are observed. The improvement of the lesions and the change of the DLQI scale score were used to compare the scores of skin lesion, symptom and DLQI as the observation index to evaluate the therapeutic effect of this study on the heat type of the spleen and stomach. Results: Through observation of the effect of 4-week treatment, the results showed that the total effective rate of the two groups of patients improved the total effective rate, and the combination of the treatment group with the stasis-removing and detoxication and the mass-clearing and the combination of the two groups was 86.7%. The effective rate of the treatment group was 83.3%, the effective rate of the control group was 73.3%, and the response rate of the two groups was 73.3%. The difference of the two groups was not significant (P0.05), and the number of lesions before and after the treatment of the two groups was less than that of the control group (P0.05). The reduction rate of the skin lesions in the treatment group was 56. 37 to 11. 10, and the reduction rate of the skin lesions in the control group was 50. 81 to 8.53, and the treatment group was more effective in the treatment of the lesions than in the control group (P0.05). The score of the skin lesions in the treatment group was compared with that of the control group (P0.05). The improvement rate of the score of the skin lesions in the treatment group was 58. 97-11.607, In the control group, the improvement rate of the skin lesions was 52. 68 to 8.46, and the two groups were effective. The improvement of the score of the treatment group was better than that of the control group (P0.05). The improvement rate of the total score of the treatment group was 61.72 and 10.46, and the improvement rate of the control group was 6.00, 7.26, respectively. The treatment group was superior to the control group (P0.05). The improvement rate of DLQI in the treatment group was 81.10% and 80.3, and the control group was 73.87-11.37, and it was considered that the effect of the treatment group on the DLQI of the patients with ulcers was higher than that in the control group (P0.05). Conclusion: Through the observation of clinical trials, it is shown that the combination of the combination of the stasis-removing and detoxication, and the combination of the acupuncture and cupping to treat the heat type of the spleen and the stomach is safe and effective, can improve the symptoms of the patients, reduce the skin lesions, can improve the quality of the patients' living, and the combination therapy is superior to that of the single-purpose blood-removing and toxin-removing and hard-resolving hard drink, and is worthy of clinical popularization.
【學(xué)位授予單位】：北京中醫(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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