加味泻黄散治疗复发性口腔溃疡的临床研究
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摘要
研究背景：复发性口腔溃疡是口腔黏膜病中较为常见的疾病,患病率高达20%左右。目前现代医学认为本病可能跟免疫、感染、病毒、精神因素等有关,治疗上常用的药物有消炎类、止痛类、腐蚀性、免疫增强剂等,效果一般,复发率较高。本病在传统医学中属于“口疡”或“口疮”的范畴,对本病病因病机的认识主要包括“心脾积热”,“阴虚火旺”,治疗上实火以清热泻火、解毒止痛为主,虚火以养阴生津,清降虚火为主,临床疗效较好。
研究目的：通过理论研究和文献研究,探讨中西医对本病的认识及研究进展,统计并分析治疗复发性口疮的主治脏腑、治法治则,并探析常用方剂的用药配伍意义等；通过临床研究探讨加味泻黄散治疗复发性口腔溃疡心脾积热证的临床疗效及安全性。
研究方法：理论研究和文献研究通过检索文献进行归纳、总结、统计分析；临床研究按照随机、对照的原则,将患者分为治疗组和对照组,治疗组采用加味泻黄散,药物组成：生石膏、山栀、藿香、防风、生甘草、黄连、菖蒲、乌梅；每日一剂,在第一次就诊治疗时,连续用药3天,在下一个月按照第一次剂量继续服药三天,巩固疗效,两个月后观察复发。西药组对照组口服维生素B2片10mg/次,3次/d,维生素C片0.2g/次,3次/d。在第一次就诊治疗时,连续用药3天,在下一个月按照第一次剂量继续服药三天,巩固疗效,两个月后观察复发。
结果：文献研究结果示：复发性口疮临床常用的治法主要集中在清热泻火祛湿法33例(32.03%),益气温阳健脾法29例(28.16%),以及养阴清热法16例(15.53%)；治疗口疮实证的方剂以泻黄汤、导赤散重复率最高,其次为甘草泻心汤、黄连解毒汤,治疗口疮虚证的方剂以六味地黄丸、玉女煎重复率最高,其次为补中益气汤、黄连阿胶汤。临床研究结果示：治疗组的证候疗效总有效率为86.67%,对照组总有效率为56.67%；两组比较有显著统计学差异；治疗组的病损疗效总有效率为80.0%；对照组总有效率为50.0%,两组比较有统计学差异。对主要症状、体征的研究结果显示治疗组和对照组的溃疡数目、溃疡疼痛、烧灼感、口干口渴、大便、舌象等指标有统计学意义(P<0.05)。
结论：目前临床上治疗复发性口疮的方法以清热泻火祛湿法为主,其次为益气温阳健脾法以及养阴清热法；在口疮实证的治疗中以清热泻火解毒的方剂为主；口疮虚证的治疗中以养阴、补气的方剂为主,尤其是补肾阴、补脾气的方剂。加减泻黄散治疗复发性口腔溃疡心脾积热证疗效确切,安全性高,能明显改善溃疡大小、溃疡数目、溃疡疼痛、烧灼感、口干口渴、大便、舌象等,明显优于西药组,西药组仅对溃疡本身有改善,对反应全身状况的指标如口干口渴、大便、舌象等指标无改善,说明加减泻黄散对复发性口疮的治疗作用在于整体调节。
Background:Recurrent oral ulcers are more common oral mucosal diseases, the disease prevalence rate reaches as high as about 20%. At present western medicine with the disease may be immunity, infection, virus, spiritual factors related to the treatment of commonly used anti-inflammatory drugs, anesthesia, corrosive, immune enhancer, etc., the effect generally, a higher recurrence rate. The disease in traditional Chinese medicine is classified as "oral ulcers" or "aphthous", The pathological features of this disease include "Intense heat in heart-spleen", "Yin deficiency and heat bloom," the treatment of real fire is to purge fire, virtual fire to YangYinShengJin, There is a better clinical effect.
Objective: Through the theoretical research and literature search,we discuss the different cognition and the research development between the traditional Chinese medicine and western medicine about RAU, counting and analyzing the treatment recurrence aphthous of mainly internal organs treated and the method by law, and searching the commonly used formulas to blend the significance and so on.Through clinical research,we discuss the clinical efficacy and safety of Modified Xie Huang powder on treating the intense heat in heart-spleen syndrome of RAU.
Methods:The theoretical research and the literature search carry on the induction, the summary, the statistical analysis through the reviewing literature. Clinical research in accordance with the randomized, controlled the principle of the patients were divided into treatment group and control group, treatment group were Modified Xie Huang powder, medicine composition: gypsum, shanzhiside, Agastache rugosa, wind, raw licorice, berberine, calamus, ebony plum. Every day a medicinal preparation, when first seeing a doctor treatment, applies drugs continuously for 3 days, continues in the next month according to the first dosage to take medicine for three days, consolidated curative effect, two months later observes the recrudescence. The western medicine group and the control group was treated with vitamin B2 tablet lOmg/time,3 times/d, vitamin C tablets 0.2g/times,3 times/d, for 3days. When first seeing a doctor treatment, applies drugs continuously for 3 days, continues in the next month according to the first dosage to take medicine for three days, consolidated curative effect, two months later observes the recrudescence.
Results: The literature study indicated: RAU clinical therapies commonly used governs the law mainly to concentrate in heat purging fire dampness in 33 cases (32.03%), spleen Act Yiqiwenyang 29 (28.16%), and Yin and Clearing Heat 16 cases (15.53%). Treatment of oral ulcers empirical formulas to Modified Xie Huang powder, guide scattered red, yellow soup spilled the highest repetition rate, followed by licorice Xie Xin Tang, Huanglian, deficiency of the prescription treatment of oral ulcers with Liu Wei Di Huang Wan, Yu Nvjian the highest repetition rate, followed by Pi Huanglian Ejiao soup. Clinical studies show: the treatment group syndromes total effective rate was 86.67%, total effective rate of the control group 56.67%; between the two groups was significant statistical difference; treatment group lesions total effective rate was 80.0%; control The total effective rate was 50.0%, a significant difference between the two groups. The main symptoms and signs results showed the treatment group and the control group the number of ulcers, ulcer pain, burning sensation, dry mouth and thirst, stool, tongue and other indicators are statistically significant (P<0.05).
Conclusion: Treatment of Recurrent clinical approach to heat purging fire dampness, followed by spleen Act Yiqiwenyang and yang and nourishing yin and clearing heat. By law-based method; in the empirical treatment of oral ulcers purging fire to heat the main prescription detoxification; aphthous Deficiency of treatment with Yin, the intake of prescription-based, in particular, Kidney Yin, replenishing prescription. Modified Xie Huang powder treated in Recurrent oral ulcers of Intense heat in heart-spleen patients is effective and safe, can improve the ulcer size, ulcer number, ulcer pain, burning sensation, dry mouth, thirst, stool, tongue, obviously superior in the western group, Western group only ulcer itself improve the situation on the reaction of the body, such as dry mouth and thirst of indicators, stool, tongue, etc. showed no improvement, indicating Modified Xie Huang powder on the treatment of recurrent aphthous ulcers is an overall adjustment.
研究目的：通过理论研究和文献研究,探讨中西医对本病的认识及研究进展,统计并分析治疗复发性口疮的主治脏腑、治法治则,并探析常用方剂的用药配伍意义等；通过临床研究探讨加味泻黄散治疗复发性口腔溃疡心脾积热证的临床疗效及安全性。
研究方法：理论研究和文献研究通过检索文献进行归纳、总结、统计分析；临床研究按照随机、对照的原则,将患者分为治疗组和对照组,治疗组采用加味泻黄散,药物组成：生石膏、山栀、藿香、防风、生甘草、黄连、菖蒲、乌梅；每日一剂,在第一次就诊治疗时,连续用药3天,在下一个月按照第一次剂量继续服药三天,巩固疗效,两个月后观察复发。西药组对照组口服维生素B2片10mg/次,3次/d,维生素C片0.2g/次,3次/d。在第一次就诊治疗时,连续用药3天,在下一个月按照第一次剂量继续服药三天,巩固疗效,两个月后观察复发。
结果：文献研究结果示：复发性口疮临床常用的治法主要集中在清热泻火祛湿法33例(32.03%),益气温阳健脾法29例(28.16%),以及养阴清热法16例(15.53%)；治疗口疮实证的方剂以泻黄汤、导赤散重复率最高,其次为甘草泻心汤、黄连解毒汤,治疗口疮虚证的方剂以六味地黄丸、玉女煎重复率最高,其次为补中益气汤、黄连阿胶汤。临床研究结果示：治疗组的证候疗效总有效率为86.67%,对照组总有效率为56.67%；两组比较有显著统计学差异；治疗组的病损疗效总有效率为80.0%；对照组总有效率为50.0%,两组比较有统计学差异。对主要症状、体征的研究结果显示治疗组和对照组的溃疡数目、溃疡疼痛、烧灼感、口干口渴、大便、舌象等指标有统计学意义(P<0.05)。
结论：目前临床上治疗复发性口疮的方法以清热泻火祛湿法为主,其次为益气温阳健脾法以及养阴清热法；在口疮实证的治疗中以清热泻火解毒的方剂为主；口疮虚证的治疗中以养阴、补气的方剂为主,尤其是补肾阴、补脾气的方剂。加减泻黄散治疗复发性口腔溃疡心脾积热证疗效确切,安全性高,能明显改善溃疡大小、溃疡数目、溃疡疼痛、烧灼感、口干口渴、大便、舌象等,明显优于西药组,西药组仅对溃疡本身有改善,对反应全身状况的指标如口干口渴、大便、舌象等指标无改善,说明加减泻黄散对复发性口疮的治疗作用在于整体调节。
Background:Recurrent oral ulcers are more common oral mucosal diseases, the disease prevalence rate reaches as high as about 20%. At present western medicine with the disease may be immunity, infection, virus, spiritual factors related to the treatment of commonly used anti-inflammatory drugs, anesthesia, corrosive, immune enhancer, etc., the effect generally, a higher recurrence rate. The disease in traditional Chinese medicine is classified as "oral ulcers" or "aphthous", The pathological features of this disease include "Intense heat in heart-spleen", "Yin deficiency and heat bloom," the treatment of real fire is to purge fire, virtual fire to YangYinShengJin, There is a better clinical effect.
Objective: Through the theoretical research and literature search,we discuss the different cognition and the research development between the traditional Chinese medicine and western medicine about RAU, counting and analyzing the treatment recurrence aphthous of mainly internal organs treated and the method by law, and searching the commonly used formulas to blend the significance and so on.Through clinical research,we discuss the clinical efficacy and safety of Modified Xie Huang powder on treating the intense heat in heart-spleen syndrome of RAU.
Methods:The theoretical research and the literature search carry on the induction, the summary, the statistical analysis through the reviewing literature. Clinical research in accordance with the randomized, controlled the principle of the patients were divided into treatment group and control group, treatment group were Modified Xie Huang powder, medicine composition: gypsum, shanzhiside, Agastache rugosa, wind, raw licorice, berberine, calamus, ebony plum. Every day a medicinal preparation, when first seeing a doctor treatment, applies drugs continuously for 3 days, continues in the next month according to the first dosage to take medicine for three days, consolidated curative effect, two months later observes the recrudescence. The western medicine group and the control group was treated with vitamin B2 tablet lOmg/time,3 times/d, vitamin C tablets 0.2g/times,3 times/d, for 3days. When first seeing a doctor treatment, applies drugs continuously for 3 days, continues in the next month according to the first dosage to take medicine for three days, consolidated curative effect, two months later observes the recrudescence.
Results: The literature study indicated: RAU clinical therapies commonly used governs the law mainly to concentrate in heat purging fire dampness in 33 cases (32.03%), spleen Act Yiqiwenyang 29 (28.16%), and Yin and Clearing Heat 16 cases (15.53%). Treatment of oral ulcers empirical formulas to Modified Xie Huang powder, guide scattered red, yellow soup spilled the highest repetition rate, followed by licorice Xie Xin Tang, Huanglian, deficiency of the prescription treatment of oral ulcers with Liu Wei Di Huang Wan, Yu Nvjian the highest repetition rate, followed by Pi Huanglian Ejiao soup. Clinical studies show: the treatment group syndromes total effective rate was 86.67%, total effective rate of the control group 56.67%; between the two groups was significant statistical difference; treatment group lesions total effective rate was 80.0%; control The total effective rate was 50.0%, a significant difference between the two groups. The main symptoms and signs results showed the treatment group and the control group the number of ulcers, ulcer pain, burning sensation, dry mouth and thirst, stool, tongue and other indicators are statistically significant (P<0.05).
Conclusion: Treatment of Recurrent clinical approach to heat purging fire dampness, followed by spleen Act Yiqiwenyang and yang and nourishing yin and clearing heat. By law-based method; in the empirical treatment of oral ulcers purging fire to heat the main prescription detoxification; aphthous Deficiency of treatment with Yin, the intake of prescription-based, in particular, Kidney Yin, replenishing prescription. Modified Xie Huang powder treated in Recurrent oral ulcers of Intense heat in heart-spleen patients is effective and safe, can improve the ulcer size, ulcer number, ulcer pain, burning sensation, dry mouth, thirst, stool, tongue, obviously superior in the western group, Western group only ulcer itself improve the situation on the reaction of the body, such as dry mouth and thirst of indicators, stool, tongue, etc. showed no improvement, indicating Modified Xie Huang powder on the treatment of recurrent aphthous ulcers is an overall adjustment.
引文
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