当归饮子联合依巴斯汀片治疗血虚风燥型老年性皮肤瘙痒症患者临床评价
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摘要
目的探究血虚风燥型老年性皮肤瘙痒症行当归饮子联合依巴斯汀片治疗的临床效果及对血清炎症介质、补体C_3、C_4水平的影响。方法选取2015年6月-2017年6月本院收治的血虚风燥型老年性皮肤瘙痒症患者92例为研究对象。按随机数字表法将患者分为两组,对照组(n=46)给予依巴斯汀片治疗,研究组(n=46)加用当归饮子治疗。观察两组临床疗效及治疗前后各项症状评分、血清炎症介质(TNF-α)、血清嗜酸性粒细胞阳离子蛋白(EC_P)、血清免疫球蛋白E(IgE)、补体C_3、C_4水平。结果研究组有效率(82. 61%)高于对照组(63. 04%),差异有统计学意义(P <0. 05)。治疗前两组各症状评分、血清炎症介质及补体C_3、C_4水平比较差异均无统计学意义(P> 0. 05)。治疗后两组各症状评分、血清炎症介质水平均降低,补体C_3、C_4水平均升高,其中研究组瘙痒面积、瘙痒程度、继发性皮损评分及血清TNF-α、EC_P、IgE水平均低于对照组,差异有统计学意义(P均<0. 05),血清补体C_3、C_4水平高于对照组,差异有统计学意义(P均<0. 05)。结论当归饮子联合依巴斯汀片治疗血虚风燥型老年性皮肤瘙痒症可明显上调患者血清补体C_3、C_4水平,抑制血清炎症介质释放,改善患者症状,临床效果理想。
Objective To investigate the efficacy of Angelica sinensis drink combined with ebastine tablet in treating senile pruritus of blood vacuity and wind dryness,and its effect on serum inflammatory mediators,complement C_3 and C_4. Methods Ninety-two patients with senile pruritus of blood deficiency and wind dryness treated in our hospital from June 2015 to June 2017 were enrolled. The patients were divided into two groups according to the random number table. The control group( n = 46) was treated with ebastine tablet,the study group( n = 46) was given both ebastine tablet and Angelica root. The clinical efficacy,symptom scores,levels of serum inflammatory mediators,including tumor necrosis factor-α( TNF-α),serum eosinophil cationic protein( ECP),serum IgE,and complement C_3,C_4 levels were measured before and aftertreatments. Results The total effective rate in study group was higher than that in the controls( 82. 61% vs. 63. 04%,P < 0. 05). Before the treatment,there were no significant differences in symptom scores,levels of serum inflammatory mediators,complement C_3 and C_4 levels between the two groups( P > 0. 05). After treatment,the symptom scores and levels of serum inflammatory mediators decreased,but levels of complement C_3 and C_4 increased in both groups; Area and extent of pruritus,scores of secondary lesions and serum TNF-α,ECP and IgE levels were lower in the treated group than in the controls( all P < 0. 05); In contrast,levels of serum C_3 and C_4 were higher in the treated group than in the controls( P < 0. 05). Conclusion Angelica root drink combined with ebastine tablet can increase serum levels of complement C_3 and C_4,and inhibit the release of serum inflammatory mediators. It is effective for senile pruritus of blood vacuity and wind dryness.
Objective To investigate the efficacy of Angelica sinensis drink combined with ebastine tablet in treating senile pruritus of blood vacuity and wind dryness,and its effect on serum inflammatory mediators,complement C_3 and C_4. Methods Ninety-two patients with senile pruritus of blood deficiency and wind dryness treated in our hospital from June 2015 to June 2017 were enrolled. The patients were divided into two groups according to the random number table. The control group( n = 46) was treated with ebastine tablet,the study group( n = 46) was given both ebastine tablet and Angelica root. The clinical efficacy,symptom scores,levels of serum inflammatory mediators,including tumor necrosis factor-α( TNF-α),serum eosinophil cationic protein( ECP),serum IgE,and complement C_3,C_4 levels were measured before and aftertreatments. Results The total effective rate in study group was higher than that in the controls( 82. 61% vs. 63. 04%,P < 0. 05). Before the treatment,there were no significant differences in symptom scores,levels of serum inflammatory mediators,complement C_3 and C_4 levels between the two groups( P > 0. 05). After treatment,the symptom scores and levels of serum inflammatory mediators decreased,but levels of complement C_3 and C_4 increased in both groups; Area and extent of pruritus,scores of secondary lesions and serum TNF-α,ECP and IgE levels were lower in the treated group than in the controls( all P < 0. 05); In contrast,levels of serum C_3 and C_4 were higher in the treated group than in the controls( P < 0. 05). Conclusion Angelica root drink combined with ebastine tablet can increase serum levels of complement C_3 and C_4,and inhibit the release of serum inflammatory mediators. It is effective for senile pruritus of blood vacuity and wind dryness.
引文
[1]李牧,王红梅.归血颗粒联合复方维E膏治疗老年瘙痒症疗效观察[J].中国麻风皮肤病杂志,2014,30(7):444-445.
[2]钱轶雯,郭敏骅,蔡茂庆.止痒外洗方联合当归饮子治疗血虚风燥型老年性皮肤瘙痒症疗效观察[J].现代中西医结合杂志,2017,26(24):2685-2687.
[3]胡伟才,黄玲,陈卫丰.养血祛风汤联合西替利嗪滴剂治疗老年性皮肤瘙痒症(血虚风燥证)的疗效观察[J].中医药导报,2016,22(7):77-79.
[4]汪海珍,黄盼,杨志波.当归饮子配方颗粒对血虚风燥型银屑病患者皮肤屏障功能的影响[J].湖南中医药大学学报,2015,35(4):41-43.
[5]王康生.依巴斯汀片联合皮敏消胶囊治疗玫瑰糠疹的疗效观察[J].吉林医学,2014,35(10):2068-2069.
[6]中华人民共和国卫生部.中药新药临床研究指导原则(第3辑)[M].北京:中国医药科技出版社,1997:99-100.
[7]王萍,张菊美.老年皮肤瘙痒的辨证施治[J].中医学报,2013,28(1):133-134.
[8]郭静,杜艾嫒,左小红,等.当归饮子治疗皮肤病的溯源及现代研究进展[J].辽宁中医杂志,2016,43(5):1097-1100.
[9]黄丽晖,于叶.裸花紫珠胶囊联合依巴斯汀片治疗玫瑰糠疹血热证35例[J].河南中医,2016,36(11):1957-1959.
[10]张学军.皮肤性病学[M]. 8版.北京:人民卫生出版社,2013:1359.
[11]Lan D,Zhang HY,Pang BS. Effect of guishen zhiyang recipe for treatment of patients with senile pruritus of blooddeficiency and Gan-hyperactive syndrome type and its impact on stem cell factor and dynorphin[J]. Chinese Journal of Integrated Traditional and Western Medicine,2009,29(7):611-613.
[12]石海云,庄严,王学艳.舌下含服粉尘螨滴剂治疗尘螨Ig E阳性的特应性皮炎47例临床观察[J].中国皮肤性病学杂志,2014,28(6):658-660.
[13]胡月,赵海春,安国芝,等.慢性自发性荨麻疹血清脱氢表雄酮硫酸酯与总Ig E,IL-2,IL-4,IFN-γ的相关性[J].中国皮肤性病学杂志,2016,30(10):1007-1009,1013.
[14]宋业专,卢润超,卢华昌,等.润燥止痒胶囊联合依匹斯汀治疗慢性湿疹疗效及对外周血EOS、血清Ig E水平的影响[J].现代中西医结合杂志,2016,25(30):3390-3392.
[15]孙丽伟,康尔恂,李杰,等.慢性特发性荨麻疹免疫机制研究进展[J].国际皮肤性病学杂志,2012,38(5):301-303.
[16] Kikuchi Y,Kaplan A. A role for C5a in augmenting Ig G dependent histamine release from basophils in chronic urticaria[J]. J Allergy Clin Immunol,2002,109(1):114-118.
[17]程靖.当归饮子联合西药治疗慢性荨麻疹血虚风燥证临床研究[J].新中医,2016,48(4):184-186.
[18]郭静,杨瑞,李向花,等.补体C3、C4及C反应蛋白与系统性红斑狼疮疾病活动度的关系[J].宁夏医科大学学报,2016,38(5):554-555.
[19]何泽生,安国芝,赵海春.外周血C3,C4与慢性荨麻疹患者病情的相关性[J].中国皮肤性病学杂志,2013,27(1):26-28.
[20]喻国华.当归饮子加减治疗老年性皮肤瘙痒症58例疗效观察[J].中药药理与临床,2015,31(4):211-212.
[21]张建,赵静.当归饮子加味治疗糖尿病皮肤瘙痒症临床观察[J].内蒙古中医药,2013,32(36):45-46.
[2]钱轶雯,郭敏骅,蔡茂庆.止痒外洗方联合当归饮子治疗血虚风燥型老年性皮肤瘙痒症疗效观察[J].现代中西医结合杂志,2017,26(24):2685-2687.
[3]胡伟才,黄玲,陈卫丰.养血祛风汤联合西替利嗪滴剂治疗老年性皮肤瘙痒症(血虚风燥证)的疗效观察[J].中医药导报,2016,22(7):77-79.
[4]汪海珍,黄盼,杨志波.当归饮子配方颗粒对血虚风燥型银屑病患者皮肤屏障功能的影响[J].湖南中医药大学学报,2015,35(4):41-43.
[5]王康生.依巴斯汀片联合皮敏消胶囊治疗玫瑰糠疹的疗效观察[J].吉林医学,2014,35(10):2068-2069.
[6]中华人民共和国卫生部.中药新药临床研究指导原则(第3辑)[M].北京:中国医药科技出版社,1997:99-100.
[7]王萍,张菊美.老年皮肤瘙痒的辨证施治[J].中医学报,2013,28(1):133-134.
[8]郭静,杜艾嫒,左小红,等.当归饮子治疗皮肤病的溯源及现代研究进展[J].辽宁中医杂志,2016,43(5):1097-1100.
[9]黄丽晖,于叶.裸花紫珠胶囊联合依巴斯汀片治疗玫瑰糠疹血热证35例[J].河南中医,2016,36(11):1957-1959.
[10]张学军.皮肤性病学[M]. 8版.北京:人民卫生出版社,2013:1359.
[11]Lan D,Zhang HY,Pang BS. Effect of guishen zhiyang recipe for treatment of patients with senile pruritus of blooddeficiency and Gan-hyperactive syndrome type and its impact on stem cell factor and dynorphin[J]. Chinese Journal of Integrated Traditional and Western Medicine,2009,29(7):611-613.
[12]石海云,庄严,王学艳.舌下含服粉尘螨滴剂治疗尘螨Ig E阳性的特应性皮炎47例临床观察[J].中国皮肤性病学杂志,2014,28(6):658-660.
[13]胡月,赵海春,安国芝,等.慢性自发性荨麻疹血清脱氢表雄酮硫酸酯与总Ig E,IL-2,IL-4,IFN-γ的相关性[J].中国皮肤性病学杂志,2016,30(10):1007-1009,1013.
[14]宋业专,卢润超,卢华昌,等.润燥止痒胶囊联合依匹斯汀治疗慢性湿疹疗效及对外周血EOS、血清Ig E水平的影响[J].现代中西医结合杂志,2016,25(30):3390-3392.
[15]孙丽伟,康尔恂,李杰,等.慢性特发性荨麻疹免疫机制研究进展[J].国际皮肤性病学杂志,2012,38(5):301-303.
[16] Kikuchi Y,Kaplan A. A role for C5a in augmenting Ig G dependent histamine release from basophils in chronic urticaria[J]. J Allergy Clin Immunol,2002,109(1):114-118.
[17]程靖.当归饮子联合西药治疗慢性荨麻疹血虚风燥证临床研究[J].新中医,2016,48(4):184-186.
[18]郭静,杨瑞,李向花,等.补体C3、C4及C反应蛋白与系统性红斑狼疮疾病活动度的关系[J].宁夏医科大学学报,2016,38(5):554-555.
[19]何泽生,安国芝,赵海春.外周血C3,C4与慢性荨麻疹患者病情的相关性[J].中国皮肤性病学杂志,2013,27(1):26-28.
[20]喻国华.当归饮子加减治疗老年性皮肤瘙痒症58例疗效观察[J].中药药理与临床,2015,31(4):211-212.
[21]张建,赵静.当归饮子加味治疗糖尿病皮肤瘙痒症临床观察[J].内蒙古中医药,2013,32(36):45-46.