足三里自血穴位注射聯(lián)合藥物治療慢性蕁麻疹的臨床觀察
發(fā)布時間：2018-12-26 08:54
【摘要】：研究目的：近年來,較多的學者采用自血、卡介菌多糖核酸注射療法治療慢性蕁麻疹并取得較好的療效。但鮮有二者療效比較的臨床研究。本實驗分別將其聯(lián)合以中藥配合依巴斯汀為基礎的治療,對比自血和卡介菌多糖核酸治療慢性蕁麻疹的臨床療效,探討兩種療法治療慢性蕁麻疹的可行性及安全性,為慢性蕁麻疹的聯(lián)合治療提供參考依據(jù)。研究方法：選擇符合標準的慢性蕁麻疹患者68例,隨機分為治療組34例、對照組34例,治療組給予中藥聯(lián)合依巴斯汀及自血足三里穴位注射治療,對照組給予中藥聯(lián)合依巴斯汀及卡介菌多糖核酸注射液足三里穴位注射治療。觀察記錄患者治療前、治療期間、治療結(jié)束后的癥狀、體征及不良反應,分別在治療后的第7、14、28天對療效和安全性進行評價。療程結(jié)束后,對痊愈患者隨訪1個月。采用SPSS20.0統(tǒng)計軟件進行數(shù)據(jù)分析。統(tǒng)計學方法采用t檢驗、秩和檢驗或卡方檢驗等。研究結(jié)果：共入選病例68例,治療組和對照組可評價療效和安全性的病例分別為32、33例。治療組和對照組治療前性別、年齡、病程、病情嚴重程度比較,差異均無統(tǒng)計學意義(P0.05),兩組均衡性良好,具有可比性。治療組在治療后第7天、第14天、第28天總有效率(痊愈+顯效)分別為43.75%、53.13%、84.38%,對照組在治療后第7天、第14天、第28天分別為39.39%、48.48%、81.82%,治療組略優(yōu)于對照組。組間同期比較經(jīng)卡方檢驗,χ2值分別為0.022、0.015、0.076,P值分別為0.883、0.903、0.783,差異沒有顯著性。治療組治療后第7、14、28天總有效率分別與治療前比較,差異具有顯著性(均P0.05)。治療后第7、14天組內(nèi)比較差異無顯著性,第14、28天比較差異具有顯著性(χ2=0.567,P=0.451和χ2=8.576,P=0.003)。對照組治療后第7、14、28天總有效率分別與治療前比較,差異具有顯著性(均P0.05)。治療后第7、14天組內(nèi)比較差異無顯著性,第14、28天比較差異具有顯著性(χ2=0.547,P=0.459和χ2=10.882,P=0.001)。治療組治療后第7、14、28天與治療前比較,各觀察指標與總積分均有顯著差異(均P0.05)；第7、14天比較,各項指標與總積分均無顯著差異(均P0.05)；第14、28天比較,各項指標與總積分均有顯著差異(均P0.05)。對照組組內(nèi)前后比較結(jié)果與治療組相似。組間治療前后同期比較均無顯著差異(均P0.05)。療程結(jié)束1月內(nèi)隨訪,治療組復發(fā)2例,對照組復發(fā)2例,復發(fā)率分別為20%、18.18%。經(jīng)卡方檢驗,差異無統(tǒng)計學意義(P0.05)。治療組與對照組與藥物相關的不良反應發(fā)生率分別為6.25%、3.03%,兩組不良反應發(fā)生率的差異無統(tǒng)計學意義(P0.05)。結(jié)論：實驗證明所采用的兩種治療方案都能有效控制慢性蕁麻疹,且不良反應及復發(fā)率低,但兩種方案的療效和安全性不具有顯著差異。治療組和對照組均在第7、28天體現(xiàn)出顯著的治療作用,在第14天治療效果則不明顯。表明依巴斯汀對使用該藥敏感的患者見效快,中藥和穴位注射在治療慢性蕁麻疹時發(fā)揮作用相對較慢。由此可見：1、自血和卡介菌多糖核酸穴位注射療效相近,臨床可以根據(jù)實際情況進行選擇；2、在臨床工作中,對經(jīng)依巴斯汀治療1-2周效果不明顯的患者,可變更抗組胺藥的劑量、種類或聯(lián)用其他抗組胺藥；3、中藥和穴位注射應當堅持較長時間的療程,不少于28天。
[Abstract]:Objective: In recent years, more and more scholars have used the self-blood, the BCG polysaccharide nucleic acid injection therapy to treat chronic urticaria and get better curative effect. But there are few clinical studies on the curative effect of the two. This experiment is based on the combination of the traditional Chinese medicine and the bastine, and compared the clinical curative effect of the self-blood and the BCG-polysaccharide nucleic acid in the treatment of chronic urticaria. The feasibility and the safety of the two treatments for the treatment of chronic urticaria are discussed, and the reference basis for the combination therapy of chronic urticaria is provided. Methods: 68 patients with chronic urticaria were randomly divided into treatment group (34 cases) and control group (34 cases). The control group was given a combination of the traditional Chinese medicine and the injection of the polysaccharide nucleic acid injection of ebastine and the BCG. The efficacy and safety were evaluated on the 7th, 14th and 28th day after treatment, before and after the treatment, and the symptoms, signs and adverse reactions after treatment. The patient was followed up for 1 month after the course of treatment. Data analysis was performed using the SPSS10.0 statistical software. The statistical method is t-test, rank sum test or card-side test. The results of the study were as follows: 68 cases were selected, and 32 and 33 cases were evaluated in the treatment group and the control group. The difference of sex, age, course and severity of the treatment group and the control group was not significant (P0.05), and the two groups were well-balanced and comparable. The total effective rate (cure + effect) of the treatment group was 43. 75%, 53. 13%, 84. 38%, respectively, and the control group was 39. 39%, 48. 48%, 81.82%, respectively, and the treatment group was slightly superior to the control group at the 7th day, the 14th day and the 28th day after the treatment. The results showed that the two values were 0.022, 0.015, 0.076 and 0.883, 0.903, and 0.783, respectively, and there was no significant difference between the two groups. The total effective rate of the 7th, 14th and 28th day after treatment in the treatment group was significantly higher than that of the pre-treatment group (P <0.05). There was no significant difference in group 7 and 14 after treatment, and the difference between day 14 and day 28 was significant (Sup2 = 0.567, P = 0.451 and Sup2 = 8.576, P = 0.003). The total effective rate of 7, 14 and 28 days after treatment in the control group was significantly higher than that before treatment (P0.05). There was no significant difference in group 7 and 14 after treatment, and the difference was significant in the 14th and 28th days (Sup2 = 0.547, P = 0.459 and Sup2 = 10.882, P = 0.001). The 7, 14 and 28 days after the treatment group were compared with the pre-treatment, and there was a significant difference between the observation index and the total score (P <0.05). There was no significant difference between the indexes and the total score on the 7th and 14th day (P <0.05), and there was a significant difference between the indexes and the total scores on the 14th and 28th day (all P0.05). The results of the comparison between the control group and the control group were similar to those in the treatment group. There was no significant difference in the group-to-group treatment before and after treatment (P0.05). The recurrence rate of the treatment group was 20% and 18. 18%, respectively. The difference between the two groups was not significant (P0.05). The incidence of adverse reactions in the treatment group and the control group was 6.25% and 3.03%, respectively, and there was no significant difference in the incidence of adverse reactions between the two groups (P0.05). Conclusion: The experimental results show that both treatment regimens can effectively control the chronic urticaria, and the adverse reaction and the recurrence rate are low, but the curative effect and the safety of the two schemes do not have significant difference. The treatment group and the control group showed significant treatment effect on the 7th and 28th objects, and the treatment effect was not obvious on the 14th day. It is shown that the effect of ebastine on the use of the drug is relatively slow in the treatment of chronic urticaria. it can be seen that 1, the curative effect of the self-blood and the BCG polysaccharide nucleic acid acupuncture point injection is similar, the clinic can be selected according to the actual situation, and in the clinical work, the dosage of the antihistamine can be changed for patients with the effect of 1-2 weeks after the ebastine is treated, the type or combination with other antihistamines; and 3, the traditional Chinese medicine and the acupuncture point injection should stick to a long period of treatment, not less than 28 days.
【學位授予單位】：成都中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R246.7
本文編號：2391849
[Abstract]:Objective: In recent years, more and more scholars have used the self-blood, the BCG polysaccharide nucleic acid injection therapy to treat chronic urticaria and get better curative effect. But there are few clinical studies on the curative effect of the two. This experiment is based on the combination of the traditional Chinese medicine and the bastine, and compared the clinical curative effect of the self-blood and the BCG-polysaccharide nucleic acid in the treatment of chronic urticaria. The feasibility and the safety of the two treatments for the treatment of chronic urticaria are discussed, and the reference basis for the combination therapy of chronic urticaria is provided. Methods: 68 patients with chronic urticaria were randomly divided into treatment group (34 cases) and control group (34 cases). The control group was given a combination of the traditional Chinese medicine and the injection of the polysaccharide nucleic acid injection of ebastine and the BCG. The efficacy and safety were evaluated on the 7th, 14th and 28th day after treatment, before and after the treatment, and the symptoms, signs and adverse reactions after treatment. The patient was followed up for 1 month after the course of treatment. Data analysis was performed using the SPSS10.0 statistical software. The statistical method is t-test, rank sum test or card-side test. The results of the study were as follows: 68 cases were selected, and 32 and 33 cases were evaluated in the treatment group and the control group. The difference of sex, age, course and severity of the treatment group and the control group was not significant (P0.05), and the two groups were well-balanced and comparable. The total effective rate (cure + effect) of the treatment group was 43. 75%, 53. 13%, 84. 38%, respectively, and the control group was 39. 39%, 48. 48%, 81.82%, respectively, and the treatment group was slightly superior to the control group at the 7th day, the 14th day and the 28th day after the treatment. The results showed that the two values were 0.022, 0.015, 0.076 and 0.883, 0.903, and 0.783, respectively, and there was no significant difference between the two groups. The total effective rate of the 7th, 14th and 28th day after treatment in the treatment group was significantly higher than that of the pre-treatment group (P <0.05). There was no significant difference in group 7 and 14 after treatment, and the difference between day 14 and day 28 was significant (Sup2 = 0.567, P = 0.451 and Sup2 = 8.576, P = 0.003). The total effective rate of 7, 14 and 28 days after treatment in the control group was significantly higher than that before treatment (P0.05). There was no significant difference in group 7 and 14 after treatment, and the difference was significant in the 14th and 28th days (Sup2 = 0.547, P = 0.459 and Sup2 = 10.882, P = 0.001). The 7, 14 and 28 days after the treatment group were compared with the pre-treatment, and there was a significant difference between the observation index and the total score (P <0.05). There was no significant difference between the indexes and the total score on the 7th and 14th day (P <0.05), and there was a significant difference between the indexes and the total scores on the 14th and 28th day (all P0.05). The results of the comparison between the control group and the control group were similar to those in the treatment group. There was no significant difference in the group-to-group treatment before and after treatment (P0.05). The recurrence rate of the treatment group was 20% and 18. 18%, respectively. The difference between the two groups was not significant (P0.05). The incidence of adverse reactions in the treatment group and the control group was 6.25% and 3.03%, respectively, and there was no significant difference in the incidence of adverse reactions between the two groups (P0.05). Conclusion: The experimental results show that both treatment regimens can effectively control the chronic urticaria, and the adverse reaction and the recurrence rate are low, but the curative effect and the safety of the two schemes do not have significant difference. The treatment group and the control group showed significant treatment effect on the 7th and 28th objects, and the treatment effect was not obvious on the 14th day. It is shown that the effect of ebastine on the use of the drug is relatively slow in the treatment of chronic urticaria. it can be seen that 1, the curative effect of the self-blood and the BCG polysaccharide nucleic acid acupuncture point injection is similar, the clinic can be selected according to the actual situation, and in the clinical work, the dosage of the antihistamine can be changed for patients with the effect of 1-2 weeks after the ebastine is treated, the type or combination with other antihistamines; and 3, the traditional Chinese medicine and the acupuncture point injection should stick to a long period of treatment, not less than 28 days.
【學位授予單位】：成都中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R246.7
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，本文編號：2391849
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