穴位贴敷后出现的水疱与接触性皮炎相关性分析
|
摘要
目的:观察穴位贴敷后患者贴敷处出现的水疱特点,探讨水疱与接触性皮炎的相关性。方法:选取接受穴位贴敷治疗后出现水疱并同意行皮损处皮肤活检的15例患者,观察其贴敷处水疱的临床表现及皮肤病理学特点。结果:贴敷处水疱的临床表现为:接触药贴局部皮肤感觉以瘙痒为主,或伴刺痛感;可见单个大水疱或成簇小水疱,基底部可见红斑、丘疹。水疱内液体光镜下可见大量白细胞,水疱液瑞氏染色后在光镜下可见中性粒细胞(NEU)、嗜酸性粒细胞以及单核、淋巴细胞等。水疱处皮肤病理学特点为:表皮层缺失,部分组织细胞变性坏死,表皮层及真皮层可见NEU浸润;真皮层小血管周围可见单核、淋巴细胞浸润。结论:穴位贴敷后患者贴敷处出现的水疱为接触性皮炎。
Objective: To observe the relationship between the blister and contact dermatitis after acupoint paste. Methods: Fifteen cases of patients who accepted acupoint paste therapy and consented to skin biopsy were selected. The clinical and skin pathological features of these patients were observed after acupoint paste. Results: The clinical features of the blister after acupoint paste were as follows: there was itching or accompanied by tingling sensation in the local skin that contacted the Chinese herbs.Single big blister or a cluster of small blisters could be visible,with erythema and papule in the basal skin. A mass of white blood cell in the blister content. Neutrophils(NEU),eosinophils,monocytes and lymphocytes could be seen in the blister fluid after Wright's staining under the light microscope. The pathological features of the local skin were as follows: deletion of epidermis,degeneration or necrosis of skin tissue cells. Neutrophils infiltration could be found in the epidermis and dermis. At the same time,monocytes and lymphocytes infiltration could be found around the blood vessels in the dermis. Conclusion: The blisters after acupoint paste were a kind of contact dermatitis.
Objective: To observe the relationship between the blister and contact dermatitis after acupoint paste. Methods: Fifteen cases of patients who accepted acupoint paste therapy and consented to skin biopsy were selected. The clinical and skin pathological features of these patients were observed after acupoint paste. Results: The clinical features of the blister after acupoint paste were as follows: there was itching or accompanied by tingling sensation in the local skin that contacted the Chinese herbs.Single big blister or a cluster of small blisters could be visible,with erythema and papule in the basal skin. A mass of white blood cell in the blister content. Neutrophils(NEU),eosinophils,monocytes and lymphocytes could be seen in the blister fluid after Wright's staining under the light microscope. The pathological features of the local skin were as follows: deletion of epidermis,degeneration or necrosis of skin tissue cells. Neutrophils infiltration could be found in the epidermis and dermis. At the same time,monocytes and lymphocytes infiltration could be found around the blood vessels in the dermis. Conclusion: The blisters after acupoint paste were a kind of contact dermatitis.
引文
[1]谢洋,余学庆.冬病夏治穴位贴敷治疗呼吸系统疾病的作用机制探讨[J].世界科学技术-中医药现代化,2013,15(6):1473-1476.
[2]张巧红.热毒宁联合穴位贴敷对毛细支气管炎儿童肺功能及免疫功能的影响[J].世界科学技术-中医药现代化,2015,17(10):2099-2103.
[3]吴倩扉,陆庆荣,张毅明,等.穴位敷贴治疗支气管哮喘疗效观察[J].上海针灸杂志,2009,28(11):626-628.
[4]李春雨,任传云,龚容,等.穴位贴敷治疗哮喘的皮肤反应与临床疗效关系的研究[J].北京中医药大学学报,2012,35(6):430-432.
[5]美国食品药品监督管理局.FDA警告氯巴占能引起严重皮肤反应[J].世界临床药物,2014,35(1):64.
[6]崇桂琴,林宁.发泡灸源流探析[J].山东中医杂志,2000,19(10):581-582.
[7]王钰珏,钟兰,丰芬.三伏天灸疗法研究概述[J].实用中医药杂志,2013,29(4):319-322.
[8]陈秋帆.天灸疗法的临床应用概况[J].中医外治志,2007,16(2):56-57.
[9]崔淑华,李娜,邢燕军,等.穴位贴敷不同皮肤反应对防治支气管哮喘发作的影响[J].针刺研究,2014,39(3):222-227.
[10]邓声华.接触性皮炎与药物性皮炎[J].人人健康,1997(9):12-13.
[11]赵辨.临床皮肤病学[M].2版.南京:江苏科学技术出版社,1996:2.
[12]方丽.苦肤洗剂配合红光治疗小鼠变应性接触性皮炎的机理研究[J].世界科学技术-中医药现代化,2016,18(4):653-658.
[13]Storan ER,Nolan U,Kirby B.Allergic contact dermatitis caused by the tea tree oil-containing hydrogel Burnshield?[J].Contact Derm,2016,74(5):309-310.
[14]Ngarmjiratam N,Wattanakrai P.Photoallergic contact dermatitis caused by Quisqualis indica(Combretum indicum)[J].Contact Derm,2016,74(5):313-314.
[15]王晓萌,张理涛.中药三伏贴所致痒疹样接触性皮炎1例[J].中国中西医结合皮肤性病学杂志,2014,13(1):17-19.
[16]陆东庆,王晓鸿,高兴华,等.镍接触性皮炎的斑贴试验及其组织病理学特征[J].中国工业医学杂志,2015,18(1):11-13.
[17]Thyssen JP,Linneberg A,Ross-Hansen K,et al.Filaggrin mutations are strongly associated with contact sensitization in individuals with dermatitis[J].Contact Dermatitis,2013,68(5):273-376.
[18]Wood LC,Jackson SM,Elias PM,et al.Cutaneous barrier perturbation stimulates cytokine production in the epidermis of mice[J].J Clin Invest,1992,90(2):482-487.
[19]Meller S,Lauerma AI,Kopp FM,et al.Chemokine responses distinguish chemical-induced allergic from irritant skin inflammation:memory T cells make the difference[J].J Allergy Clin Immunol,2007,119(6):1470-1480.
[20]Ale IS,Maibacht HA.Diagnostic approach in allergic and irritant contact dermatitis[J].Expert Rew Clin Immunol,2010,6(2):291-310.
[21]张璐.张氏医通[M].北京:中国中医药出版社,1995:85.
[22]Sollmann T.A Mannal of Pharmacology[M].Philadelphia:WB Saunders Co,1957:167.
[23]刁义平.生甘遂和醋甘遂提取物急性毒性和刺激性实验研[J].药物不良反应杂志,2007,9(4):243-246.
[24]Li J,Jin HZ.Allergic contact dermatitis caused by Chinese herbal medicine,white mustard seed[J].J Dermatol,2013,40(1):69-70.
[2]张巧红.热毒宁联合穴位贴敷对毛细支气管炎儿童肺功能及免疫功能的影响[J].世界科学技术-中医药现代化,2015,17(10):2099-2103.
[3]吴倩扉,陆庆荣,张毅明,等.穴位敷贴治疗支气管哮喘疗效观察[J].上海针灸杂志,2009,28(11):626-628.
[4]李春雨,任传云,龚容,等.穴位贴敷治疗哮喘的皮肤反应与临床疗效关系的研究[J].北京中医药大学学报,2012,35(6):430-432.
[5]美国食品药品监督管理局.FDA警告氯巴占能引起严重皮肤反应[J].世界临床药物,2014,35(1):64.
[6]崇桂琴,林宁.发泡灸源流探析[J].山东中医杂志,2000,19(10):581-582.
[7]王钰珏,钟兰,丰芬.三伏天灸疗法研究概述[J].实用中医药杂志,2013,29(4):319-322.
[8]陈秋帆.天灸疗法的临床应用概况[J].中医外治志,2007,16(2):56-57.
[9]崔淑华,李娜,邢燕军,等.穴位贴敷不同皮肤反应对防治支气管哮喘发作的影响[J].针刺研究,2014,39(3):222-227.
[10]邓声华.接触性皮炎与药物性皮炎[J].人人健康,1997(9):12-13.
[11]赵辨.临床皮肤病学[M].2版.南京:江苏科学技术出版社,1996:2.
[12]方丽.苦肤洗剂配合红光治疗小鼠变应性接触性皮炎的机理研究[J].世界科学技术-中医药现代化,2016,18(4):653-658.
[13]Storan ER,Nolan U,Kirby B.Allergic contact dermatitis caused by the tea tree oil-containing hydrogel Burnshield?[J].Contact Derm,2016,74(5):309-310.
[14]Ngarmjiratam N,Wattanakrai P.Photoallergic contact dermatitis caused by Quisqualis indica(Combretum indicum)[J].Contact Derm,2016,74(5):313-314.
[15]王晓萌,张理涛.中药三伏贴所致痒疹样接触性皮炎1例[J].中国中西医结合皮肤性病学杂志,2014,13(1):17-19.
[16]陆东庆,王晓鸿,高兴华,等.镍接触性皮炎的斑贴试验及其组织病理学特征[J].中国工业医学杂志,2015,18(1):11-13.
[17]Thyssen JP,Linneberg A,Ross-Hansen K,et al.Filaggrin mutations are strongly associated with contact sensitization in individuals with dermatitis[J].Contact Dermatitis,2013,68(5):273-376.
[18]Wood LC,Jackson SM,Elias PM,et al.Cutaneous barrier perturbation stimulates cytokine production in the epidermis of mice[J].J Clin Invest,1992,90(2):482-487.
[19]Meller S,Lauerma AI,Kopp FM,et al.Chemokine responses distinguish chemical-induced allergic from irritant skin inflammation:memory T cells make the difference[J].J Allergy Clin Immunol,2007,119(6):1470-1480.
[20]Ale IS,Maibacht HA.Diagnostic approach in allergic and irritant contact dermatitis[J].Expert Rew Clin Immunol,2010,6(2):291-310.
[21]张璐.张氏医通[M].北京:中国中医药出版社,1995:85.
[22]Sollmann T.A Mannal of Pharmacology[M].Philadelphia:WB Saunders Co,1957:167.
[23]刁义平.生甘遂和醋甘遂提取物急性毒性和刺激性实验研[J].药物不良反应杂志,2007,9(4):243-246.
[24]Li J,Jin HZ.Allergic contact dermatitis caused by Chinese herbal medicine,white mustard seed[J].J Dermatol,2013,40(1):69-70.