解毒除湿颗粒治疗大疱性类天疱疮湿热毒蕴证的临床观察
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摘要
目的评价解毒除湿颗粒治疗湿热毒蕴型大疱性类天疱疮(bullous pemphigoid,BP)的临床疗效,为BP提供一种新的、安全有效的治疗方法。方法将60例BP患者随机分为治疗组与对照组各30例,治疗组予以解毒除湿颗粒联合醋酸泼尼松治疗,对照组予以醋酸泼尼松治疗,2个疗程(8周)结束后,比较两组患者治疗前后大疱性类天疱疮疾病面积指数评分(bullous pemphigoid disease area index, BPDAI)、各单项指标评分等改善情况及不良反应,以判定临床疗效及安全性。结果治疗组总有效率82.76%,对照组总有效率58.62%,治疗组的疗效优于对照组(P<0.05)。治疗后治疗组及对照组皮肤评分、瘙痒程度、BPDAI及激素用量均较治疗前下降(P<0.05),且治疗组下降更显著(P<0.05);但两组皮肤损害评分差异无统计学意义(P>0.05)。结论解毒除湿颗粒联合醋酸泼尼松治疗湿热毒蕴型BP,能改善BPDAI,其中对于皮肤评分、瘙痒程度改善较明显,且激素减量优于单用醋酸泼尼松,未见明显毒副作用,安全可靠。
Objective To evaluate the clinical efficacy of Jiedu Chushi Granule in the treatment of bullous pemphigoid(BP)with dampness-heat toxin amassment, and to establish a new safe and effective treatment for BP. Methods Sixty patients with BP were randomly divided into treatment group and control group, with 30 cases in each group. The treatment group received Jiedu Chushi Granule combined with prednisone acetate, and the control group was treated with prednisone acetate alone. After two courses of treatment(8 weeks), the improvements in Bullous Pemphigoid Disease Area Index(BPDAI) score and each index score as well as adverse reactions were compared between the two groups to assess the clinical efficacy and safety of the treatment.Results After treatment, the treatment group had a significantly higher overall response rate than the control group(82.76% vs58.62%, P<0.05). Both groups showed significant reductions in skin score, pruritus score, BPDAI score, and dose of glucocorticoid after treatment(P <0.05), and the treatment group had significantly greater reductions(P <0.05). However, there was no significant difference in skin lesion score between the two groups(P >0.05). Conclusion Jiedu Chushi Granule combined with prednisone acetate can improve BPDAI score, as well as skin score and pruritus score in particular, in the treatment of BP with dampness-heat toxin amassment, and the combination therapy has a reduced dose of glucocorticoid compared with prednisone acetate alone. It is safe and reliable with no obvious toxic and side effects.
Objective To evaluate the clinical efficacy of Jiedu Chushi Granule in the treatment of bullous pemphigoid(BP)with dampness-heat toxin amassment, and to establish a new safe and effective treatment for BP. Methods Sixty patients with BP were randomly divided into treatment group and control group, with 30 cases in each group. The treatment group received Jiedu Chushi Granule combined with prednisone acetate, and the control group was treated with prednisone acetate alone. After two courses of treatment(8 weeks), the improvements in Bullous Pemphigoid Disease Area Index(BPDAI) score and each index score as well as adverse reactions were compared between the two groups to assess the clinical efficacy and safety of the treatment.Results After treatment, the treatment group had a significantly higher overall response rate than the control group(82.76% vs58.62%, P<0.05). Both groups showed significant reductions in skin score, pruritus score, BPDAI score, and dose of glucocorticoid after treatment(P <0.05), and the treatment group had significantly greater reductions(P <0.05). However, there was no significant difference in skin lesion score between the two groups(P >0.05). Conclusion Jiedu Chushi Granule combined with prednisone acetate can improve BPDAI score, as well as skin score and pruritus score in particular, in the treatment of BP with dampness-heat toxin amassment, and the combination therapy has a reduced dose of glucocorticoid compared with prednisone acetate alone. It is safe and reliable with no obvious toxic and side effects.
引文
[1]赵辨.中国临床皮肤病学[M].南京:江苏科学技术出版社,2010:844.
[2]李莉,崔红宙,崔楠,等.新型支被架在大疱性类天疱疮病人外用糖皮质激素治疗中的应用[J].护理研究,2016,30(12):4341-4343.
[3]瞿幸.中医皮肤性病学[M].北京:中国中医药出版社,2009:216-221.
[4]赵炳南,张志礼.简明中医皮肤病学[M].北京:中国中医药出版社,2014:209-211.
[5]杨志波,范瑞强,邓丙戌.中医皮肤性病学[M].北京:中国中医药出版社,2010:154-158.
[6] MURRELL D F, DANIEL B S, JOLY P, et a1. Definitions and outcomemeasures for bullous pemphigoid:recommendations by an international panel of experts[J]. J Am Acad Dermatol, 2012,66(3):479-485.
[7]唐苏为,谢韶琼.皮肤瘙痒程度评价方法进展[J].中国皮肤性病学杂志,2016,30(1):84-85.
[8]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.
[9] LOO W J, BURROWS N P. Management of autoimmune skin disorders in the elderly[J]. Drugs Aging, 2004, 21(12):767-777.
[10]王亚丹,杨建波,戴忠,等.中药金银花的研究进展[J].药物分析杂志,2014,34(11):1928-1935.
[11]胡静,马琳,张坚,等.连翘的研究进展[J].中南药学,2012,10(10):760-764.
[12]彭腾,李鸿翔,邓赟,等.白术内酯类成分及其药理作用研究进展[J].中国药房,2012,23(39):3732-3734.
[13]云宝仪,周磊,谢鲲鹏等.黄芩素抑菌活性及其机制的初步研究[J].药学学报,2012,47(12):1587-1592.
[14]孟祥乐,李红伟,李颜,等.栀子化学成分及其药理作用研究进展[J].中国新药杂志,2011,20(11):959-967.
[15]王建平,张海燕,傅旭春.土茯苓的化学成分和药理作用研究进展[J].海峡药学,2013,25(1):42-44.
[16]王朴.生地黄的现代药理研究与临床应用[J].中国中医药现代远程教育,2008,6(8):986.
[17]于艳,袁媛,贾天柱,等.苍术炮制前后化学成分及药理作用研究近况[J].时珍国医国药,2016,27(1):189-191.
[18]张蔷,高文远,满淑丽.黄芪中有效成分药理活性的研究进展[J].中国中药杂志,2012,37(21):3203-3207.
[2]李莉,崔红宙,崔楠,等.新型支被架在大疱性类天疱疮病人外用糖皮质激素治疗中的应用[J].护理研究,2016,30(12):4341-4343.
[3]瞿幸.中医皮肤性病学[M].北京:中国中医药出版社,2009:216-221.
[4]赵炳南,张志礼.简明中医皮肤病学[M].北京:中国中医药出版社,2014:209-211.
[5]杨志波,范瑞强,邓丙戌.中医皮肤性病学[M].北京:中国中医药出版社,2010:154-158.
[6] MURRELL D F, DANIEL B S, JOLY P, et a1. Definitions and outcomemeasures for bullous pemphigoid:recommendations by an international panel of experts[J]. J Am Acad Dermatol, 2012,66(3):479-485.
[7]唐苏为,谢韶琼.皮肤瘙痒程度评价方法进展[J].中国皮肤性病学杂志,2016,30(1):84-85.
[8]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.
[9] LOO W J, BURROWS N P. Management of autoimmune skin disorders in the elderly[J]. Drugs Aging, 2004, 21(12):767-777.
[10]王亚丹,杨建波,戴忠,等.中药金银花的研究进展[J].药物分析杂志,2014,34(11):1928-1935.
[11]胡静,马琳,张坚,等.连翘的研究进展[J].中南药学,2012,10(10):760-764.
[12]彭腾,李鸿翔,邓赟,等.白术内酯类成分及其药理作用研究进展[J].中国药房,2012,23(39):3732-3734.
[13]云宝仪,周磊,谢鲲鹏等.黄芩素抑菌活性及其机制的初步研究[J].药学学报,2012,47(12):1587-1592.
[14]孟祥乐,李红伟,李颜,等.栀子化学成分及其药理作用研究进展[J].中国新药杂志,2011,20(11):959-967.
[15]王建平,张海燕,傅旭春.土茯苓的化学成分和药理作用研究进展[J].海峡药学,2013,25(1):42-44.
[16]王朴.生地黄的现代药理研究与临床应用[J].中国中医药现代远程教育,2008,6(8):986.
[17]于艳,袁媛,贾天柱,等.苍术炮制前后化学成分及药理作用研究近况[J].时珍国医国药,2016,27(1):189-191.
[18]张蔷,高文远,满淑丽.黄芪中有效成分药理活性的研究进展[J].中国中药杂志,2012,37(21):3203-3207.