健脾祛湿法在银屑病湿疹样变中的临床应用研究
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摘要
【目的】研究健脾祛湿法在治疗银屑病湿疹样变中的治疗效果。【方法】将60例患者随机分为试验组和对照组,每组各30例。2组患者均给予外涂达力士软膏治疗,在此基础上,试验组给予口服健脾祛湿颗粒治疗,对照组给予口服雷公藤多苷片和开瑞坦治疗,疗程1个月。观察2组患者治疗前后银屑病面积与严重性指数评分(PASI)、瘙痒程度视觉模拟评分(VAS)及皮肤病生活质量指标调查表评分(DLQI)的变化情况,评价2组的疗效、安全性及复发情况。【结果】(1)经1个月治疗后,试验组总有效率为93.3%,对照组为73.3%,组间比较,试验组疗效优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者PASI、VAS和DLQI评分均较治疗前明显降低(P<0.05),且试验组对各项评分的降低作用均明显优于对照组,差异均有统计学意义(P<0.05)。(3)在整个治疗过程中,2组患者均未发生严重不良反应事件。(4)停药1周后,2组患者均没有出现病情复发的情况。【结论】以健脾祛湿法治疗脾虚湿热型银屑病湿疹样变患者疗效显著,在改善瘙痒程度、减少皮损面积及提高患者生活质量方面均优于口服雷公藤多苷片和开瑞坦治疗的对照组,且无毒副作用,安全有效。
Objective To study the therapeutic effect of therapy for invigorating spleen and dispelling dampness in treating psoriasis eczematoid changes.Methods A total of 60 patients were randomly divided into trial group and control group,30 cases in each group.The patients in the two groups were given external application of Calcipotriol Ointment,and additionally,the trial group was given oral use of Jianpi Qushi Granules for invigorating spleen and dispelling dampness,and the control group was given oral use of Tripterygium Wilfordii Glycosides Tablets and Loratadine Tablets for one month.Before and after treatment,the scores of psoriasis area and severity index(PASI),pruritus scores evaluated with Visual Analogue Scale(VAS),and the scores of Dermatology Life Quality Index(DLQI)were observed.And the clinical efficacy,safety and recurrence in the two groups were also evaluated.Results(1)After treatment for one month,the trial group achieved a total effective rate of 93.3%,and had stronger effect than the control group(73.3%),the difference being significant(P<0.05).(2)After treatment,the PASI scores,psoriasis VAS scores and DLQI scores in the two groups were much decreased(P<0.05 compared with those before treatment),and the decrease in the trial group was superior to that in the control group(P<0.05).(3)During the treatment,no severe adverse reaction was found in the two groups.(4)After suspension of the medication for one week,no recurrence was found in the two groups.Conclusion The therapy for invigorating spleen and dispelling dampness exerts certain effect in treating psoriasis eczematoid changes with the syndrome of spleen deficiency and damp-heat by relieving psoriasis,reducing skin lesion area,and improving the quality of life of the patients.And it is more effective and safer than oral use of Tripterygium Wilfordii Glycosides Tablets and Loratadine Tablets.
Objective To study the therapeutic effect of therapy for invigorating spleen and dispelling dampness in treating psoriasis eczematoid changes.Methods A total of 60 patients were randomly divided into trial group and control group,30 cases in each group.The patients in the two groups were given external application of Calcipotriol Ointment,and additionally,the trial group was given oral use of Jianpi Qushi Granules for invigorating spleen and dispelling dampness,and the control group was given oral use of Tripterygium Wilfordii Glycosides Tablets and Loratadine Tablets for one month.Before and after treatment,the scores of psoriasis area and severity index(PASI),pruritus scores evaluated with Visual Analogue Scale(VAS),and the scores of Dermatology Life Quality Index(DLQI)were observed.And the clinical efficacy,safety and recurrence in the two groups were also evaluated.Results(1)After treatment for one month,the trial group achieved a total effective rate of 93.3%,and had stronger effect than the control group(73.3%),the difference being significant(P<0.05).(2)After treatment,the PASI scores,psoriasis VAS scores and DLQI scores in the two groups were much decreased(P<0.05 compared with those before treatment),and the decrease in the trial group was superior to that in the control group(P<0.05).(3)During the treatment,no severe adverse reaction was found in the two groups.(4)After suspension of the medication for one week,no recurrence was found in the two groups.Conclusion The therapy for invigorating spleen and dispelling dampness exerts certain effect in treating psoriasis eczematoid changes with the syndrome of spleen deficiency and damp-heat by relieving psoriasis,reducing skin lesion area,and improving the quality of life of the patients.And it is more effective and safer than oral use of Tripterygium Wilfordii Glycosides Tablets and Loratadine Tablets.
引文
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[12]王蕾,黄咏菁,王敏华.银屑灵片治疗寻常型银屑病的临床观察[J].广州中医药大学学报,2009,26(6):520.
[2]范瑞强,邓丙戍,杨志波.中医皮肤性病学[M].北京:科学技术文献出版社,2010:474.
[3]中华医学会皮肤性病学分会银屑病学组.中国银屑病治疗指南(2008版)[J].中华皮肤科杂志,2009,42(3):213.
[4]卫星,张志云.继发于湿疹及传染性软疣的寻常性银屑病各1例[J].中国皮肤性病学杂志,1997,11(2):60.
[5]李瑾,张媛.湿疹合并银屑病1例[J].人民军医,2014,57(2):150.
[6]杨国亮,王侠生.现代皮肤病学[M].上海:上海医科大学出版社,1998:516.
[7]陆明敏.寻常型银屑病皮肤屏障功能检测及湿疹样变相关因素临床探讨[D].合肥:安徽医科大学,2015.
[8]瞿幸,屈双擎.寻常型银屑病的中医辨证治疗[J].中国临床医生杂志,2009,37(8):2.
[9]董亦秋,瞿幸.中药治疗18例湿疹样银屑病临床观察[J].四川中医,2013,31(7):106.
[10]钟金宝,殷新,卢传坚.禤国维教授治疗银屑病经验介绍[J].新中医,2004,36(9):11.
[11]欧阳卫权,范瑞强,李红毅.禤国维教授运用皮肤解毒汤治疗银屑病经验[J].新中医,2014,46(6):28.
[12]王蕾,黄咏菁,王敏华.银屑灵片治疗寻常型银屑病的临床观察[J].广州中医药大学学报,2009,26(6):520.