中药外敷联合西药治疗儿童多形性红斑(热毒内蕴型)临床疗效观察
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摘要
目的观察中药外敷联合西药治疗儿童多形性红斑(热毒内蕴型)的临床疗效。方法采用随机数字表法将48例多形性红斑(热毒内蕴型)患儿分为观察组(中药外敷联合常规西医治疗)和对照组(常规西医治疗)各24例,两组均治疗14d后观察其临床疗效、皮疹消退天数及两组患儿的免疫功能。结果观察组和对照组的临床总有效率分别为95.8%和79.2%,两组比较有显著性差异(P<0.05);观察组皮疹消退天数明显短于对照组(P<0.05);观察组治疗前后,CD3+、CD4+、CD8+、及IgA、IgG、IgM水平改善幅度明显优于对照组(P<0.05)。结论中药外敷联合西药治疗儿童多形性红斑(热毒内蕴型)疗效肯定,能缩短患儿患皮疹时间,减轻痛苦,值得推广。
Objective To observe the clinical curative effect of traditional Chinese medicine(TCN) external application combined with western medicine in treatment of thermal intrinsic type of children's erythema multiforme. Methods 48 cases of children with thermal intrinsic type of erythema multiforme were randomly divided into observation group and control group,24 cases in each group. Control group was given the treatment of methylprednisolone, observation group was treated with TCM external application on the basis of control group. The treatment of both groups lasted for 2 weeks. The clinical efficacy,the number of days that the rash subsides, and the immune functions of the two groups were observed after treatment. Results The total effective rate of the observation group was 95.8%, and that of the control group was 79.2%, the difference between the two groups was statistically significant(P<0.05); the number of skin rashes in observation group was significantly shorter than that in control group, the difference between the two groups was statistically significant(P<0.05): the improvement of CD3+, CD4+,CD8+, and IgA, IgG and IgM before and after treatment were significantly better than those in control group, and the difference was statistically significant(P<0.05). Conclusion The efficacy of TCM external application combined with western medicine is certain in treatment of thermal intrinsic type of children's erythema multiforme, it can shorten the time of skin rash, alleviate the pain, and is worthy of promoting.
Objective To observe the clinical curative effect of traditional Chinese medicine(TCN) external application combined with western medicine in treatment of thermal intrinsic type of children's erythema multiforme. Methods 48 cases of children with thermal intrinsic type of erythema multiforme were randomly divided into observation group and control group,24 cases in each group. Control group was given the treatment of methylprednisolone, observation group was treated with TCM external application on the basis of control group. The treatment of both groups lasted for 2 weeks. The clinical efficacy,the number of days that the rash subsides, and the immune functions of the two groups were observed after treatment. Results The total effective rate of the observation group was 95.8%, and that of the control group was 79.2%, the difference between the two groups was statistically significant(P<0.05); the number of skin rashes in observation group was significantly shorter than that in control group, the difference between the two groups was statistically significant(P<0.05): the improvement of CD3+, CD4+,CD8+, and IgA, IgG and IgM before and after treatment were significantly better than those in control group, and the difference was statistically significant(P<0.05). Conclusion The efficacy of TCM external application combined with western medicine is certain in treatment of thermal intrinsic type of children's erythema multiforme, it can shorten the time of skin rash, alleviate the pain, and is worthy of promoting.
引文
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[24]郭齐,李连达,郝伟,等.牡丹皮有效组分重组方对家兔血小板聚集及凝血功能的影响[J].中国现代应用药学,2010,26(11):967-970.
[25] Cheng CY,Ho TY,Lee EJ,et al.Ferulic acid reduces cer-ebral infarct through its antioxidative and anti-inflammatoryeffects following transient focal cerebral ischemia in rats[J].American Journal of Chinese Medicine,2008,36(6):1105-1119.
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[27]田庚元,李寿桐,宋麦丽,等.牛膝多糖硫酸酯的合成及抗病毒活性[J].药学学报,1995,30(2):107.
[28]石婷,黄林林,李莺.儿童渗出性多形性红斑免疫功能状况的研究[J].中国医学创新,2014,11(11):6-8.
[2] Harr T,French LE. Toxic epidermal necrolysis and Stevens-Johnson syndrome[J].Orphanet J Rare Dis,2010,5(2):39-49.
[3]胡亚美,江载芳.诸福棠实用儿科学[M].第8版,北京:人民卫生出版社,2012:794-795.
[4] Harr T,French LE.Toxic epidermal neerolysis and Stevens-Johnson syndrome[J]. Orphanet J Rare Dis,2010,5(2):39-49.
[5]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,1994:12.
[6]张书兰,赵德育,王全,等.儿童渗出性多形性红斑32例临床分析[J].安徽医药.2014:12(3):513-515.
[7] Oranje AP. Stevens Johnson syndrome[J]. Pediatr Dermatol,2008,3(1):304-310.
[8] Samim F,Aluck A,Zed C,et al. Erythema Multiforme A Re-view of Epidemiology,Pathogenesis,Clinical Features. andTreatment[J].Dent Clin N Am,2013,57(4):583-596.
[9] Alberta L. From HSV infection to erythema multiformethrough autoimmune crossreactivity[J]. Autoimmunity Re-views,2018,17(6):1423-1424.
[10]王吉松.中西医结合治疗多形性红斑临床研究[J].中国卫生产业,2013,18(20):17-18.
[11]周宝宽.审证求因治疗多形红斑[J].辽宁中医药大学学报,2011,11(9):20-21.
[12]杨鹏斐,王思农.王文春治疗多形性红斑经验[J].实用中医药杂志,2013,10(4):284-285.
[13]赵文雁,范玲玲.中医塌渍配合凉血活血汤治疗血热型多形性红斑30例[J].中医研究,2011,23(12):40-41.
[14]吴山,杜羽,范永升.范永升教授治疗小儿多形性红斑经验[J].浙江中医药大学学报,2018,14(3):187-189.
[15]郭静,张毅.白鲜皮复方临床应用集萃[J].中医药学刊,2005,12(3):513-514.
[16]周晓鹰,陈洁,金柳,等.白鲜皮的药理作用及抗炎活性成分研究进展[J].常州大学学报:自然科学版,2018,20(1):82-86.
[17]陆朝华,曹劲松,凡华,等.白鲜皮水提物改善迟发型变态反应性肝损伤的作用机理[J].中国药科大学学报,1999,16(3):102-103.
[18]时东方,郑梅竹,赵立春,等.白鲜皮中白鲜碱的分离及抗炎活性[J].中国实验方剂学杂志,2012,20(14):128-131.
[19]张艳华,汪荣斌,王存琴,等.中药地肤的研究进展[J].现代中药研究与实践,2016,6(1):84-86.
[20]赵万红,曹永孝,刘静,等.复方白芷胶囊的长期毒性研究[J].山西医科大学学报,2006,22(2):160-163.
[21]赵万红,曹永孝,刘静,等.复方白芷胶囊的活血化瘀作用[J].中国天然药物,2003,11(3):231-232.
[22]游小琳,李丽,肖永庆.白芷水溶性部分化学成分研究[J].中国中药杂志,2002,30(4):55-56..
[23] Koo YK,Kim JM,Koo JY,et al. Plateletanti-aggregatoryand blood anti-coagulant effects of compounds isolated fromPaeonia lactiflora and Paeonia suffruticosa[J].Pharmazie,2010,65(8):624-628.
[24]郭齐,李连达,郝伟,等.牡丹皮有效组分重组方对家兔血小板聚集及凝血功能的影响[J].中国现代应用药学,2010,26(11):967-970.
[25] Cheng CY,Ho TY,Lee EJ,et al.Ferulic acid reduces cer-ebral infarct through its antioxidative and anti-inflammatoryeffects following transient focal cerebral ischemia in rats[J].American Journal of Chinese Medicine,2008,36(6):1105-1119.
[26]秦建鲜,黄锁义.鸡血藤药理作用的研究进展[J].时珍国医国药,2014,14(1):180-183.
[27]田庚元,李寿桐,宋麦丽,等.牛膝多糖硫酸酯的合成及抗病毒活性[J].药学学报,1995,30(2):107.
[28]石婷,黄林林,李莺.儿童渗出性多形性红斑免疫功能状况的研究[J].中国医学创新,2014,11(11):6-8.