中药联合刺络拔罐法治疗寻常性银屑病“血热证”的临床研究
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摘要
目的:客观评价中药联合刺络拔罐法治疗寻常性银屑病(血热证)的临床疗效,为其临床治疗寻常性银屑病提供客观临床依据。方法:84例寻常性银屑病血热证患者被随机分成两组,临床路径组(路径组) 41例,采用口服中药芩珠凉血方,静滴丹参注射液,中药蒸气浴疗。刺络拔罐联合临床路径组(路刺组) 43例,在常规临床路径治疗基础上加用刺络拔罐治疗,每周3次,共计治疗2周。7 d为1个疗程,观察2个疗程。以临床疗效、银屑病面积和严重性指数(PASI)为观察指标,系统评价中药联合刺络拔罐法治疗寻常性银屑病的临床疗效。结果:路刺组愈显率为11. 63%,总有效率95. 35%;路径组愈显率为7. 32%,总有效率为82. 93%。两组的愈显率及总有效率无明显统计学差异(P> 0. 05)。治疗后两组均能明显降低PASI评分,且路刺组优于路径组,具有统计学差异(P <0. 05)。结论:刺络拔罐法联合中药治疗银屑病可显著改善寻常性银屑病患者的临床症状。
Objective: This study was an objective evaluation of the clinical efficacy of the treatment of psoriasis vulgaris( blood-heat syndrome) by using traditional Chinese medicine combined with acupuncture and cupping,providing clinical evidence for traditional Chinese medicine combined with acupuncture and cupping treatment of psoriasis vulgaris(blood heat syndrome). Methods:Eighty-four cases of psoriasis vulgaris patients of blood-heat syndrome were randomly divided into two groups. Forty-one cases were as the clinical pathway group( CP Group),using traditional Chinese medicine Qinzhu Liangxue Decoction,intravenous infusion of Danshen injection and traditional Chinese medicine vapor bath. Another 43 cases as acupuncture and cupping group( AC Group) were treated by acupuncture and cupping treatment combined with clinical pathway group. They were given the acupuncture and cupping treatment three times a week,for a total of 2 weeks. Seven days was for a course of treatment,lasting for 2 courses. The clinical efficacy of the two groups was evaluated by the clinical efficacy,psoriasis area and severity index( PASI). Results: AC group's markedly effective rate was 11. 63% and the total efficiency was 95. 35%. CP group's markedly effective rate was 7. 32% and the total effective rate was 82. 93%. There were no obviously statistic differences between the two groups( P > 0. 05). After treatment,the two groups can significantly reduce the PASI scores,and the AC group's was better than that of the PC group with statistical difference( P < 0. 05). Conclusion: Traditional Chinese medicine combined with acupuncture and cupping therapy can significantly improve the clinical efficacy in patients with psoriasis vulgaris.
Objective: This study was an objective evaluation of the clinical efficacy of the treatment of psoriasis vulgaris( blood-heat syndrome) by using traditional Chinese medicine combined with acupuncture and cupping,providing clinical evidence for traditional Chinese medicine combined with acupuncture and cupping treatment of psoriasis vulgaris(blood heat syndrome). Methods:Eighty-four cases of psoriasis vulgaris patients of blood-heat syndrome were randomly divided into two groups. Forty-one cases were as the clinical pathway group( CP Group),using traditional Chinese medicine Qinzhu Liangxue Decoction,intravenous infusion of Danshen injection and traditional Chinese medicine vapor bath. Another 43 cases as acupuncture and cupping group( AC Group) were treated by acupuncture and cupping treatment combined with clinical pathway group. They were given the acupuncture and cupping treatment three times a week,for a total of 2 weeks. Seven days was for a course of treatment,lasting for 2 courses. The clinical efficacy of the two groups was evaluated by the clinical efficacy,psoriasis area and severity index( PASI). Results: AC group's markedly effective rate was 11. 63% and the total efficiency was 95. 35%. CP group's markedly effective rate was 7. 32% and the total effective rate was 82. 93%. There were no obviously statistic differences between the two groups( P > 0. 05). After treatment,the two groups can significantly reduce the PASI scores,and the AC group's was better than that of the PC group with statistical difference( P < 0. 05). Conclusion: Traditional Chinese medicine combined with acupuncture and cupping therapy can significantly improve the clinical efficacy in patients with psoriasis vulgaris.
引文
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[9]李磊,李新芳.磷酸二酯酶抑制剂apremilast治疗银屑病的研究进展[J].中国医药科学,2017,7(14):25-28.
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[13]向延卫,范斌,徐蓉,等.芩珠凉血方对银屑病血热证患者血清IL-17、IL-23及皮损中相关转录因子的影响[J].南京中医药大学学报,2016,32(4):326-329.
[14]田红霞,张虹亚.中药蒸汽浴治疗血虚风燥型慢性湿疹32例[J].中医外治杂志,2014,23(1):20-21.
[15]杨洪浦,吕兵波,蒋俊青,等.中药熏蒸治疗银屑病[J].中国麻风皮肤病杂志,2006,22(1):41-42.
[16]孙健,王国贤.丹参注射液对小鼠鼠尾表皮细胞分化的影响及其作用机制研究[J].中国皮肤性病学杂志,2009,23(1):16-19.
[17]孙健,李东宁,阎铁夫,等.丹参注射液对小鼠鼠尾表皮细胞分化及Th1/Th2细胞因子的影响[J].中国皮肤性病学杂志,2013,27(8):775-777.
[18]张爱珍,张强.电针五脏俞穴配合刺络拔罐治疗寻常型银屑病临床研究[J].新中医,2011,43(12):95-98.
[19]蓝宏荣,连婉仪,吴允波.中医外治寻常型银屑病研究进展[J].江西中医药,2015,46(10):77-80.
[20]植翠崧,李燕红,谭剑萍.刺络拔罐与消银汤联合护理干预银屑病随机平行对照研究[J].实用中医内科杂志,2014,28(11):156-158.
[21]陈文雯,张秋婷.刺血拔罐法治疗寻常型银屑病[J].内蒙古中医药,2017,36(12):124.
[2]刘鹏月,韩秀萍.银屑病生物制剂治疗方法进展[J].临床皮肤科杂志,2017,46(11):820-823.
[3]王凯,曾嘉琦,王笑然,等.银屑病的临床治疗进展[J].医学综述,2017,23(23):4659-4664,4670.
[4]Rungapiromnan W,Yiu Z Z,Warren R B,et al.Impact of Biologic Therapies on Risk of Major Adverse Cardiovascular Events in Patients with Psoriasis:Systematic Review and Meta-analysis of Randomised Controlled Trials[J].Br J Dermatol,2017,176(4):890-901.
[5]Yiu Z Z N,Exton L S,Jabbar-Lopez Z,et al.Risk of Serious Infections in Patients with Psoriasis on Biologic Therapies:ASystematic Review and Meta-Analysis[J].Journal of Investigative Dermatology,2016,136(8):1584-1591.
[6]赵冰洁,张江安,于建斌,等.阿维A对银屑病患者血脂影响的回顾性分析[J].临床皮肤科杂志,2017,46(6):406-408.
[7]周郅轲.复方甘草酸苷联合阿维A胶囊治疗银屑病临床疗效观察[J].临床合理用药杂志,2017,49(13):88-89.
[8]金婷婷,陈喜雪,赵邑,等.托法替布治疗的中、重度银屑病患者血清细胞因子及人β-防御素-2的水平[J].中国皮肤性病学杂志,2017,31(8):838-841.
[9]李磊,李新芳.磷酸二酯酶抑制剂apremilast治疗银屑病的研究进展[J].中国医药科学,2017,7(14):25-28.
[10]赵辨.中国临床皮肤病学[M].2版.南京:江苏科学技术出版社,2009:1011-1012.
[11]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:276-277.
[12]徐蓉,王洁,李福伦,等.加味芩珠凉血方及辨证加减治疗寻常性银屑病(血热证)的临床疗效观察[J].时珍国医国药,2012,23(2):424-426.
[13]向延卫,范斌,徐蓉,等.芩珠凉血方对银屑病血热证患者血清IL-17、IL-23及皮损中相关转录因子的影响[J].南京中医药大学学报,2016,32(4):326-329.
[14]田红霞,张虹亚.中药蒸汽浴治疗血虚风燥型慢性湿疹32例[J].中医外治杂志,2014,23(1):20-21.
[15]杨洪浦,吕兵波,蒋俊青,等.中药熏蒸治疗银屑病[J].中国麻风皮肤病杂志,2006,22(1):41-42.
[16]孙健,王国贤.丹参注射液对小鼠鼠尾表皮细胞分化的影响及其作用机制研究[J].中国皮肤性病学杂志,2009,23(1):16-19.
[17]孙健,李东宁,阎铁夫,等.丹参注射液对小鼠鼠尾表皮细胞分化及Th1/Th2细胞因子的影响[J].中国皮肤性病学杂志,2013,27(8):775-777.
[18]张爱珍,张强.电针五脏俞穴配合刺络拔罐治疗寻常型银屑病临床研究[J].新中医,2011,43(12):95-98.
[19]蓝宏荣,连婉仪,吴允波.中医外治寻常型银屑病研究进展[J].江西中医药,2015,46(10):77-80.
[20]植翠崧,李燕红,谭剑萍.刺络拔罐与消银汤联合护理干预银屑病随机平行对照研究[J].实用中医内科杂志,2014,28(11):156-158.
[21]陈文雯,张秋婷.刺血拔罐法治疗寻常型银屑病[J].内蒙古中医药,2017,36(12):124.