健脾祛风汤联合针刺治疗血虚风燥型特应性皮炎疗效及对患者皮肤屏障功能的影响
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摘要
目的探讨血虚风燥型特应性皮炎(atopic dermatitis,AD)应用健脾祛风汤联合针刺治疗的临床效果及对患者皮肤屏障功能的影响。方法选取2015年6月-2017年6月本院收治的120例AD患者,采用随机数字表法均分为两组,每组60例。对照组予以依巴斯汀片治疗,观察组采取健脾祛风汤联合针刺治疗。记录比较两组临床疗效,治疗前后皮损评分、皮肤屏障功能及生活质量变化。结果治疗3个月后,观察组有效率为85.00%,对照组有效率为55.00%,差异有统计学意义(P<0.05)。与治疗前相比,两组治疗后皮损范围、皮损严重程度、瘙痒与睡眠评分及SCORAD总分均显著降低(P<0.05),且观察组下降更显著(P<0.05)。两组治疗后经皮失水率(TEWL)值较治疗前均显著降低(P<0.05),角质层含水量均显著升高(P<0.05);且观察组改善更显著(P<0.05)。两组治疗后日常活动、工作学习、自觉症状、业余休闲、人际关系和治疗评分较治疗前均显著下降(P<0.05);且观察组降低更显著(P<0.05)。结论血虚风燥型AD应用健脾祛风汤联合针刺治疗更能有效缓解患者症状体征,改善皮损状况,促进皮肤屏障功能修复,疗效显著,且安全性高。
Objective To investigate the clinical effect of Jianpiqufeng decoction combined with acupuncture treatment on blood deficiency and wind-dry type atopic dermatitis( AD)and its impact on the skin barrier function of the patients. Methods A total of 120 patients with AD admitted to our hospital from June 2015 to June 2017 were collected and evenly divided into two groups according to random number table,with 60 cases in each group. The control group was treated with ebastine tablets,whereas the observation group were given the combination of Jianpiqufeng decoction and acupuncturetreatment. The clinical efficacy and changes of skin lesion scores,skin barrier function and life quality before and after treatment were recorded and compared between the two groups. Results After 3 months of treatment,the effective rate was 85. 00% in the observation group and 55. 00% in the control group,and the difference was statistically significant( P < 0. 05). The skin lesion area and severity,scores for sleep and pruritus,and SCORAD scores of both groups were decreased remarkably( P < 0. 05).More importantly,the decrease of the observation group was more significant( P <0. 05) as compared with that before treatment. The transepidermal water loss( TEWL)value of the two groups after treatment was significantly lower than that before treatment( P < 0. 05). The water content in the stratum corneum was increased significantly( P < 0. 05),which was more pronounced in the observation group( P < 0. 05). The scores of daily activities,work-learning,subjective symptoms,leisure time,interpersonal relationship,and treatment scores of the two groups after treatment were significantly lower than those before treatment( P < 0. 05),which were more remarkable in the observation group( P < 0. 05). Conclusion Jianpiqufeng decoction combined with acupuncture can effectively relieve the symptoms and signs of patients with deficiency of blood and wind-dry type AD,improve the skin lesions,and promote the repair of skin barrier function. Thus,this strategy has remarkable curative effect and high safety.
Objective To investigate the clinical effect of Jianpiqufeng decoction combined with acupuncture treatment on blood deficiency and wind-dry type atopic dermatitis( AD)and its impact on the skin barrier function of the patients. Methods A total of 120 patients with AD admitted to our hospital from June 2015 to June 2017 were collected and evenly divided into two groups according to random number table,with 60 cases in each group. The control group was treated with ebastine tablets,whereas the observation group were given the combination of Jianpiqufeng decoction and acupuncturetreatment. The clinical efficacy and changes of skin lesion scores,skin barrier function and life quality before and after treatment were recorded and compared between the two groups. Results After 3 months of treatment,the effective rate was 85. 00% in the observation group and 55. 00% in the control group,and the difference was statistically significant( P < 0. 05). The skin lesion area and severity,scores for sleep and pruritus,and SCORAD scores of both groups were decreased remarkably( P < 0. 05).More importantly,the decrease of the observation group was more significant( P <0. 05) as compared with that before treatment. The transepidermal water loss( TEWL)value of the two groups after treatment was significantly lower than that before treatment( P < 0. 05). The water content in the stratum corneum was increased significantly( P < 0. 05),which was more pronounced in the observation group( P < 0. 05). The scores of daily activities,work-learning,subjective symptoms,leisure time,interpersonal relationship,and treatment scores of the two groups after treatment were significantly lower than those before treatment( P < 0. 05),which were more remarkable in the observation group( P < 0. 05). Conclusion Jianpiqufeng decoction combined with acupuncture can effectively relieve the symptoms and signs of patients with deficiency of blood and wind-dry type AD,improve the skin lesions,and promote the repair of skin barrier function. Thus,this strategy has remarkable curative effect and high safety.
引文
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[16]朱卉雯,田静,李忻红,等.健脾养血祛风方对脾虚证慢性湿疹小鼠模型干预的实验研究[J].现代中西医结合杂志,2016,25(3):235-238.
[17]叶静静,陈宁刚.大剂量生地凉血汤对脓疱型血热证银屑病疗效观察及对血清肿瘤坏死因子-α的影响[J].中国中西医结合皮肤性病学杂志,2015,14(5):295-297.
[18]李晋奇,童荣生,佘姝娅,等.甘草酸软膏对慢性湿疹豚鼠皮肤NO和病理形态学改变的影响[J].中医药学报,2015,43(6):28-30.
[19]李芳梅,杨志波,曾宪玉.当归饮子对寻常性银屑病患者皮肤屏障功能的影响[J].中医药导报,2014,20(7):11-13.
[20]王彩霞.针灸对亚急性衰老模型小鼠皮肤的抗衰老作用研究[J].中国中医基础医学杂志,2014,20(11):1544-1546.
[21]王殷东,孙璐,范佳红,等.白鲜皮提取物外用抗炎作用实验研究[J].辽宁中医药大学学报,2015,17(6):50-53.
[22]王媛,唐宗湘,徐斌.电针曲池、血海对化合物48/80致小鼠皮肤瘙痒模型的影响[J].中华中医药杂志,2014,29(1):117-120.
[23]汪海珍,黄盼,杨志波.当归饮子配方颗粒对血虚风燥型银屑病患者皮肤屏障功能的影响[J].湖南中医药大学学报,2015,35(4):41-43.
[24]孙晓菲,杨皓然,方凯,等.参苓白术散对有皮肤机械屏障障碍小鼠皮肤屏障功能的影响[J].中国皮肤性病学杂志,2016,30(4):406-408.
[2]Neuber K,Schwartz I,Itschert G,et al.Treatment of atopic eczema with oral mycophenolate mofetil[J].Br J Dermatol,2015,143(2):385-391.
[3]陈秀华,全小红,莫秀梅,等.针药结合治疗血虚风燥型特应性皮炎的临床研究[J].中医杂志,2016,57(16):1384-1387,1392.
[4]刘月,陈春海,刘春,等.纪青山教授针灸治疗血虚风燥型慢性湿疹[J].长春中医药大学学报,2016,32(6):1107-1109.
[5]Xuan QX,Cheng S,Ma H,et al.Combination of flying needle with Chinese Herbal Medicine in the treatment of atopic dermatitis:A clinical trial.[J].Pak J Pharm Sci,2014,27(5):1687-1690.
[6]韩莉.玉屏风散配合西药治疗慢性湿疹60例[J].陕西中医,2015,36(3):322-324.
[7]牛文忠,张雪松,丁显春.玉屏风散对过敏性紫癜患儿免疫调节作用的影响[J].中国皮肤性病学杂志,2017,31(9):1024-1026,1018.
[8]王成林,张纯.加味玉屏风散联合左西替利嗪治疗慢性荨麻疹疗效及对血清免疫炎性因子的影响[J].现代中西医结合杂志,2018,27(3):291-295.
[9]Gupta D.Atopic dermatitis:a common pediatric condition and its evolution in adulthood[J].Med Clin North Am,2015,99(6):1269-1285.
[10]中国特应性皮炎诊疗指南(2014版)[J].全科医学临床与教育,2014,12(6):603-606,615.
[11]国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,2012:264-265.
[12]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,2002:298-300.
[13]吴谦.医宗金鉴[M].北京:人民卫生出版社,2006:1651.
[14]赵尚华.中医外科学[M].北京:人民卫生出版社,2002:269-270.
[15]杨玉峰,刘少芬.生石膏在治疗血虚风燥型特应性皮炎中的临床应用[J].河北中医药学报,2015,30(4):35-36.
[16]朱卉雯,田静,李忻红,等.健脾养血祛风方对脾虚证慢性湿疹小鼠模型干预的实验研究[J].现代中西医结合杂志,2016,25(3):235-238.
[17]叶静静,陈宁刚.大剂量生地凉血汤对脓疱型血热证银屑病疗效观察及对血清肿瘤坏死因子-α的影响[J].中国中西医结合皮肤性病学杂志,2015,14(5):295-297.
[18]李晋奇,童荣生,佘姝娅,等.甘草酸软膏对慢性湿疹豚鼠皮肤NO和病理形态学改变的影响[J].中医药学报,2015,43(6):28-30.
[19]李芳梅,杨志波,曾宪玉.当归饮子对寻常性银屑病患者皮肤屏障功能的影响[J].中医药导报,2014,20(7):11-13.
[20]王彩霞.针灸对亚急性衰老模型小鼠皮肤的抗衰老作用研究[J].中国中医基础医学杂志,2014,20(11):1544-1546.
[21]王殷东,孙璐,范佳红,等.白鲜皮提取物外用抗炎作用实验研究[J].辽宁中医药大学学报,2015,17(6):50-53.
[22]王媛,唐宗湘,徐斌.电针曲池、血海对化合物48/80致小鼠皮肤瘙痒模型的影响[J].中华中医药杂志,2014,29(1):117-120.
[23]汪海珍,黄盼,杨志波.当归饮子配方颗粒对血虚风燥型银屑病患者皮肤屏障功能的影响[J].湖南中医药大学学报,2015,35(4):41-43.
[24]孙晓菲,杨皓然,方凯,等.参苓白术散对有皮肤机械屏障障碍小鼠皮肤屏障功能的影响[J].中国皮肤性病学杂志,2016,30(4):406-408.