消疹托透饮协定方联合左西替利嗪片治疗慢性荨麻疹临床研究
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摘要
目的观察消疹托透饮协定方联合左西替利嗪片治疗慢性荨麻疹的临床疗效,及对患者血清白细胞介素-25(IL-25)、转化生子因子-β1(TGF-β1)水平的影响。方法采用随机数字表法将80例慢性荨麻疹患者分为对照组和观察组各40例。对照组予左西替利嗪片,5mg/次,1次/d,口服;观察组在对照组基础上予消疹托透饮协定方,每日1剂,水煎,每日2次口服。2组均连续治疗4周。比较2组临床疗效,观察2组治疗前后风团最大直径、风团数目、风团持续时间、发作频率评分,皮肤病生活质量指数(DLQI)量表评分,血清IL-25、TGF-β1水平,记录不良反应及随访6个月的复发情况。结果观察组总有效率为92.50%(37/40),对照组为72.50%(29/40),2组比较差异有统计学意义(P<0.05)。与本组治疗前比较,2组治疗后风团最大直径、风团数目、风团持续时间、发作频率评分及DLQI评分明显下降,血清IL-25、TGF-β1水平明显下降(P<0.05);2组治疗后比较,观察组治疗后风团最大直径、风团数目、风团持续时间、发作频率评分,DLQI评分,及血清IL-25、TGF-β1水平明显低于对照组(P<0.05)。观察组不良反应率为7.50%(3/40),对照组为27.50%(11/40),观察组明显低于对照组(P<0.05)。随访6个月,观察组复发率为11.54%(3/26),对照组为29.41%(5/17),观察组明显低于对照组(P<0.05)。结论消疹托透饮协定方联合左西替利嗪片可有效减轻患者风团发作程度,改善生活质量,其机制可能是通过降低血清IL-25、TGF-β1水平以纠正Th1/Th2细胞失衡、调节免疫应答,从而减轻机体致敏状态。
Objective To investigate the clinical efficacy of Xiaozhen Tuotou Decoction combined with leotirizine tablets for the treatment of chronic urticaria; To explore its influence on serum IL-25 and TGF-β1 levels of patients. Methods Totally 80 patients with chronic urticaria were divided into the control group and the observation group by the random number table method, with 40 cases in each group. The control group was given leotirizine tablets, 5 mg per time, once a day, orally; Patients in the observation group were treated with Xiaozhen Tuotou Decoction on the basis of the control group, one dosage per day, decoction, twice a day, orally. The treatment for both groups lasted for 4 weeks. Clinical efficacy of the two groups was compared. The scores of maximum diameter of wheal, wheal number, wheal duration and seizure frequency, dermatological quality of life index(DLQI) scale, serum IL-25 and TGF-β1 levels were observed before and after treatment. Adverse reactions were recorded and recurrence was followed up for 6 months. Results The total effective rate was 92.50%(37/40) in the observation group and 72.50%(29/40) in the control group, with statistical significance(P<0.05). Compared with before treatment, the score of maximum diameter of wheal, wheal number, wheal duration, seizure frequency and DLQI score of the two groups significantly decreased after treatment, and serum IL-25 and TGF-β1 levels significantly decreased(P<0.05); After treatment, the score of maximum diameter of wheal, wheal number, wheal duration, seizure frequency, DLQI score, IL-25 and TGF-β1 levels in the observation group were significantly lower than those in the control group(P<0.05). The adverse reaction rate of the observation group was 7.50%(3/40), and that of the control group was 27.50%(11/40). The observation group was significantly lower than the control group(P<0.05). After 6 months of follow-up, the recurrence rate was 11.54%(3/26) in the observation group and 29.41%(5/17) in the control group. The observation group was significantly lower than the control group(P<0.05). Conclusion Xiaozhen Tuotou Decoction combined with leotirizine tablets can effectively alleviate the degree of wheal attack in patients and significantly improve their life quality. The mechanism may reduce the imbalance of IL-25 and TGF-β1 to correct the imbalance of Th1/Th2 cells and regulate the immune response, thus reducing the sensitization state of the body.
Objective To investigate the clinical efficacy of Xiaozhen Tuotou Decoction combined with leotirizine tablets for the treatment of chronic urticaria; To explore its influence on serum IL-25 and TGF-β1 levels of patients. Methods Totally 80 patients with chronic urticaria were divided into the control group and the observation group by the random number table method, with 40 cases in each group. The control group was given leotirizine tablets, 5 mg per time, once a day, orally; Patients in the observation group were treated with Xiaozhen Tuotou Decoction on the basis of the control group, one dosage per day, decoction, twice a day, orally. The treatment for both groups lasted for 4 weeks. Clinical efficacy of the two groups was compared. The scores of maximum diameter of wheal, wheal number, wheal duration and seizure frequency, dermatological quality of life index(DLQI) scale, serum IL-25 and TGF-β1 levels were observed before and after treatment. Adverse reactions were recorded and recurrence was followed up for 6 months. Results The total effective rate was 92.50%(37/40) in the observation group and 72.50%(29/40) in the control group, with statistical significance(P<0.05). Compared with before treatment, the score of maximum diameter of wheal, wheal number, wheal duration, seizure frequency and DLQI score of the two groups significantly decreased after treatment, and serum IL-25 and TGF-β1 levels significantly decreased(P<0.05); After treatment, the score of maximum diameter of wheal, wheal number, wheal duration, seizure frequency, DLQI score, IL-25 and TGF-β1 levels in the observation group were significantly lower than those in the control group(P<0.05). The adverse reaction rate of the observation group was 7.50%(3/40), and that of the control group was 27.50%(11/40). The observation group was significantly lower than the control group(P<0.05). After 6 months of follow-up, the recurrence rate was 11.54%(3/26) in the observation group and 29.41%(5/17) in the control group. The observation group was significantly lower than the control group(P<0.05). Conclusion Xiaozhen Tuotou Decoction combined with leotirizine tablets can effectively alleviate the degree of wheal attack in patients and significantly improve their life quality. The mechanism may reduce the imbalance of IL-25 and TGF-β1 to correct the imbalance of Th1/Th2 cells and regulate the immune response, thus reducing the sensitization state of the body.
引文
[1] REE E, ABD-ELMAGED W M, AHMED D A, et al. Pattern of chronic urticaria and value of autologous serum skin test in Sohag Province, Upper Egypt[J]. Electron Physician,2018,10(5):6781-6788.
[2]张涛,余瑶.复方甘草酸苷片联合左西替利嗪对慢性荨麻疹患者血清学指标及免疫功能的影响[J].标记免疫分析与临床,2018,25(6):871-874,906.
[3]唐诗韵,彭丽,宋宗诌,等.通络法在慢性荨麻疹诊治中的运用研究[J].辽宁中医杂志,2017,44(12):2521-2523.
[4]中华医学会皮肤性病学分会免疫学组.中国荨麻疹诊疗指南(2014版)[J].中国实用乡村医生杂志,2015,49(17):45-47.
[5]中华人民共和国卫生部.中药新药临床研究指导原则:第三辑[M].北京,1997:86-89.
[6] FINLAY A Y, KHAN G K. Dermatology Life Quality Index(DLQI)-a simple practical measure for routine clinical use[J]. Clin Exp Dermatol,1994,19(3):210-216.
[7]李国灿.祛风养血润燥汤联合针刺拔罐治疗血虚风燥型慢性荨麻疹30例[J].中国中医药科技,2018,25(1):139-141.
[8]马友谊.疏风消疹饮治疗荨麻疹的临床疗效观察[J].中国中医药科技,2018,25(1):101-102.
[9] KOLKHIR P, POGORELOV D, DARLENSKI R, et al. Management of chronic spontaneous urticaria:a worldwide perspective[J]. World Allergy Organ J,2018,11(1):14.
[10]韩钰,王娟,张亚丽,等.慢性自发性荨麻疹患者血清25-(OH)-D和IL-25水平检测[J].中国麻风皮肤病杂志,2018,34(5):287-289.
[11]朱莲花,南美兰,金哲虎.慢性荨麻疹患者血清IL-25及IL-31水平的检测[J].中国皮肤性病学杂志,2017,31(1):43-44.
[12] TAVAKOL M, MOVAHEDI M, AMIRZARGAR A A, et al. Association of interleukin 10 and transforming growth factor β gene polymorphisms with chronic idiopathic urticaria[J]. Acta Dermatovenerol Croat,2014,22(4):239-245.
[13]何沅莉,单葵,曹雨微,等.慢性荨麻疹患者血清IL-17、IL-23、TGF-β水平检测分析[J].现代医药卫生,2018,34(3):364-365,368.
[14]张飞娟,白莉.慢性荨麻疹患者外周血中白细胞介素25、17的表达及意义[J].中国中西医结合皮肤性病学杂志,2016,15(1):16-18.
[15]周小强,李高峰,罗玉香,等.盐酸左西替利嗪联合白芍总苷治疗儿童慢性特发性荨麻疹的临床研究[J].世界中西医结合杂志,2017,12(11):1542-1545.
[16]李钦,胡继宏,高博,等.黄芪多糖在免疫调节方面的最新研究进展[J].中国实验方剂学杂志,2017,23(2):199-206.
[17]吴贤波,金沈锐,李世明,等.防风醇提物对肥大细胞PAR-2及相关细胞因子的影响[J].中国实验方剂学杂志,2016,22(5):123-126.
[2]张涛,余瑶.复方甘草酸苷片联合左西替利嗪对慢性荨麻疹患者血清学指标及免疫功能的影响[J].标记免疫分析与临床,2018,25(6):871-874,906.
[3]唐诗韵,彭丽,宋宗诌,等.通络法在慢性荨麻疹诊治中的运用研究[J].辽宁中医杂志,2017,44(12):2521-2523.
[4]中华医学会皮肤性病学分会免疫学组.中国荨麻疹诊疗指南(2014版)[J].中国实用乡村医生杂志,2015,49(17):45-47.
[5]中华人民共和国卫生部.中药新药临床研究指导原则:第三辑[M].北京,1997:86-89.
[6] FINLAY A Y, KHAN G K. Dermatology Life Quality Index(DLQI)-a simple practical measure for routine clinical use[J]. Clin Exp Dermatol,1994,19(3):210-216.
[7]李国灿.祛风养血润燥汤联合针刺拔罐治疗血虚风燥型慢性荨麻疹30例[J].中国中医药科技,2018,25(1):139-141.
[8]马友谊.疏风消疹饮治疗荨麻疹的临床疗效观察[J].中国中医药科技,2018,25(1):101-102.
[9] KOLKHIR P, POGORELOV D, DARLENSKI R, et al. Management of chronic spontaneous urticaria:a worldwide perspective[J]. World Allergy Organ J,2018,11(1):14.
[10]韩钰,王娟,张亚丽,等.慢性自发性荨麻疹患者血清25-(OH)-D和IL-25水平检测[J].中国麻风皮肤病杂志,2018,34(5):287-289.
[11]朱莲花,南美兰,金哲虎.慢性荨麻疹患者血清IL-25及IL-31水平的检测[J].中国皮肤性病学杂志,2017,31(1):43-44.
[12] TAVAKOL M, MOVAHEDI M, AMIRZARGAR A A, et al. Association of interleukin 10 and transforming growth factor β gene polymorphisms with chronic idiopathic urticaria[J]. Acta Dermatovenerol Croat,2014,22(4):239-245.
[13]何沅莉,单葵,曹雨微,等.慢性荨麻疹患者血清IL-17、IL-23、TGF-β水平检测分析[J].现代医药卫生,2018,34(3):364-365,368.
[14]张飞娟,白莉.慢性荨麻疹患者外周血中白细胞介素25、17的表达及意义[J].中国中西医结合皮肤性病学杂志,2016,15(1):16-18.
[15]周小强,李高峰,罗玉香,等.盐酸左西替利嗪联合白芍总苷治疗儿童慢性特发性荨麻疹的临床研究[J].世界中西医结合杂志,2017,12(11):1542-1545.
[16]李钦,胡继宏,高博,等.黄芪多糖在免疫调节方面的最新研究进展[J].中国实验方剂学杂志,2017,23(2):199-206.
[17]吴贤波,金沈锐,李世明,等.防风醇提物对肥大细胞PAR-2及相关细胞因子的影响[J].中国实验方剂学杂志,2016,22(5):123-126.