基于集对分析成果的寻常型银屑病血热证诊疗方案的临床研究
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摘要
目的评价既往集对分析得出的诊疗方案治疗银屑病血热证临床疗效。方法将寻常型银屑病血热证患者180例分为3组,其中传统组60例,用犀角地黄汤加减治疗,每日1剂;集对分析组60例,用课题组前期通过集对分析方法得到的诊疗方案治疗,每日1剂;西药组60例,使用阿维A胶囊每次30 mg,每日1次口服治疗,3组共治疗4周,治疗前后观察银屑病皮损面积和严重程度评分(PASI评分),并于治疗后判定疗效。结果集对分析组总有效率为88. 14%,愈显率为61. 02%。传统组总有效率为82. 76%,愈显率为50. 00%。西药组总有效率为67. 24%,愈显率为17. 24%。集对分析组和传统组的总有效率及愈显率相当,差异无统计学意义(P> 0. 05),且均优于西药组(P <0. 05)。集对分析组降低PASI评分优于传统组和西药组(P <0. 01)。胃肠不适反应西药组13例,传统组8例,集对分析组6例,均未影响生活。结论基于集对分析成果的方案是临床治疗寻常型银屑病血热证的安全有效方案,可显著改善患者临床PASI评分。
Objective To evaluate the clinical efficacy of the diagnostic and treatment project of blood-heat syndrome in psoriasis vulgaris based on the results by Set Pair analysis. Methods A total of 180 patients with psoriasis vulgaris were randomly divided into 3 groups. 60 patients in the traditional scheme group were treated with modified Xijiao Dihuang Decoction( 犀角地黄汤),one dose per day; 60 patients in the set pair analysis group were treated with the result of set pair analysis method,one dose per day; 60 patients in the western medicine group were treated with Abamectin A,30 mg each time,once a day for oral administration. The 3 groups were treated for 4 weeks. The psoriasis lesion area and psoriasis area and severity index( PASI) before and after treatment were observed,and the curative effects were determined after treatment. Results The total effective rate was 88. 14% and the obviously effective rate was 61. 02% in the set pair analysis group. The total effective rate was 82. 75% and the obviously effective rate was 50. 00% in the traditional scheme group. The total effective rate of western medicine group was 67. 24%,and the obviously effective rate was 17. 24%. The set pair analysis group was similar to the traditional scheme group,and there was no significant difference between the 2 groups( P > 0. 05),but both groups were superior to the western medicine group( P < 0. 05). Set pair analysis group was better than traditional scheme group and western medicine group in reducing PASI scores( P < 0. 01). There were 13 cases of gastrointestinal discomfort in the western medicine group,8 cases in the traditional scheme group,6 cases in the set pair analysis group,which did not affect daily life. Conclusion The treatment scheme based on set pair analysis is a safe and effective method for the treatment of psoriasis vulgaris with blood-heat syndrome,which can significantly improve the PASI scores of patients.
Objective To evaluate the clinical efficacy of the diagnostic and treatment project of blood-heat syndrome in psoriasis vulgaris based on the results by Set Pair analysis. Methods A total of 180 patients with psoriasis vulgaris were randomly divided into 3 groups. 60 patients in the traditional scheme group were treated with modified Xijiao Dihuang Decoction( 犀角地黄汤),one dose per day; 60 patients in the set pair analysis group were treated with the result of set pair analysis method,one dose per day; 60 patients in the western medicine group were treated with Abamectin A,30 mg each time,once a day for oral administration. The 3 groups were treated for 4 weeks. The psoriasis lesion area and psoriasis area and severity index( PASI) before and after treatment were observed,and the curative effects were determined after treatment. Results The total effective rate was 88. 14% and the obviously effective rate was 61. 02% in the set pair analysis group. The total effective rate was 82. 75% and the obviously effective rate was 50. 00% in the traditional scheme group. The total effective rate of western medicine group was 67. 24%,and the obviously effective rate was 17. 24%. The set pair analysis group was similar to the traditional scheme group,and there was no significant difference between the 2 groups( P > 0. 05),but both groups were superior to the western medicine group( P < 0. 05). Set pair analysis group was better than traditional scheme group and western medicine group in reducing PASI scores( P < 0. 01). There were 13 cases of gastrointestinal discomfort in the western medicine group,8 cases in the traditional scheme group,6 cases in the set pair analysis group,which did not affect daily life. Conclusion The treatment scheme based on set pair analysis is a safe and effective method for the treatment of psoriasis vulgaris with blood-heat syndrome,which can significantly improve the PASI scores of patients.
引文
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[11]李欣,蒯仂,许逊哲,等.基于集对分析的疗效曲线在银屑病血热证药物选优中的应用[J].新中医,2017,49(10):107-111.
[12]吴苗,马丽俐,徐唯,等.犀角地黄汤加减对血热型寻常型银屑病的疗效观察[J].浙江医学,2018,40(9):998-999.
[13]郑虎占,董泽宏,余靖.中药现代研究与应用[M].北京:学苑出版社,1999:307.
[14]王玉英,熊小利,龙剑文.白芍总苷对静止期银屑病患者血清TNF-α及IL-8的影响[J].现代中西医结合杂志,2009,18(18):2111-2112.
[15]韩明权,刘嘉湘,高虹,等.24味中药对人肺腺癌细胞核酸和蛋白质及细胞周期的影响观察[J].中国中西医结合杂志,1995,15(3):147-149.
[16]任文华,张双全,宋大祥,等.少棘蜈蚣水提取物的抗菌活性[J].中药材,2007,30(1):10-14.
[17]褚婕,张金芝,沈大跃,等.蜈蚣对小鼠免疫功能的影响[J].天津药学,1994,6(2):23-25.
[18]韩雪飞,王永奎,陈华艳,等.蝎毒抗癌多肽纯化组分对小鼠肝癌的生长抑制作用及带瘤小鼠胸腺重量的影响[J].河南医科大学学报,2000,35(4):288-290.
[19]王会贤,章灵华,黄艺,等.氧化苦参碱对LAK细胞活性的影响[J].免疫学杂志,1994,10(1):17-19.
[20]王云,龙发.苦参抗肿瘤机制的研究进展[J].现代肿瘤医学,2005,13(2):280-282.
[2]周国容,刘兵.中西医结合治疗寻常型银屑病疗效的Meta分析[J].中医临床研究,2015,7(4):12-15,18.
[3]赵克勤.试论集对分析与模糊数学的关系[C]//中南模糊数学与系统理论成果会论文集.大庸:湖南科学技术出版社,1991:310-311.
[4]李峰,李欣,迮侃,等.寻常型银屑病血热证的辨证因子初探[J].新中医,2012,44(10):57-60.
[5]李欣,徐蓉,周敏,等.基于集对分析的寻常型银屑病方证相关性研究[J].辽宁中医杂志,2012,39(6):974-978.
[6]孙传兴.临床疾病诊断依据治愈好转标准[M].北京:人民军医出版社,2002:294.
[7]国家中医药管理局.中医病证诊断疗效标准[S].北京:中国医药科技出版社,2012:276-277.
[8]FREDRIKSSON T,PETTERSSON U.Severe psoriasis:oral therapy with a new retinoid[J].Dermatologica,1978,157(4):238-244.
[9]郑筱萸.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:299-301.
[10]李欣,蒯仂,许逊哲,等.基于集对分析的疗效曲线在银屑病血热证药物选优中的应用[J].新中医,2017,49(10):107-111.
[11]李欣,蒯仂,许逊哲,等.基于集对分析的疗效曲线在银屑病血热证药物选优中的应用[J].新中医,2017,49(10):107-111.
[12]吴苗,马丽俐,徐唯,等.犀角地黄汤加减对血热型寻常型银屑病的疗效观察[J].浙江医学,2018,40(9):998-999.
[13]郑虎占,董泽宏,余靖.中药现代研究与应用[M].北京:学苑出版社,1999:307.
[14]王玉英,熊小利,龙剑文.白芍总苷对静止期银屑病患者血清TNF-α及IL-8的影响[J].现代中西医结合杂志,2009,18(18):2111-2112.
[15]韩明权,刘嘉湘,高虹,等.24味中药对人肺腺癌细胞核酸和蛋白质及细胞周期的影响观察[J].中国中西医结合杂志,1995,15(3):147-149.
[16]任文华,张双全,宋大祥,等.少棘蜈蚣水提取物的抗菌活性[J].中药材,2007,30(1):10-14.
[17]褚婕,张金芝,沈大跃,等.蜈蚣对小鼠免疫功能的影响[J].天津药学,1994,6(2):23-25.
[18]韩雪飞,王永奎,陈华艳,等.蝎毒抗癌多肽纯化组分对小鼠肝癌的生长抑制作用及带瘤小鼠胸腺重量的影响[J].河南医科大学学报,2000,35(4):288-290.
[19]王会贤,章灵华,黄艺,等.氧化苦参碱对LAK细胞活性的影响[J].免疫学杂志,1994,10(1):17-19.
[20]王云,龙发.苦参抗肿瘤机制的研究进展[J].现代肿瘤医学,2005,13(2):280-282.
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