针刺从心脾论治亚急性湿疹的临床研究
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摘要
目的
通过针刺从心脾论治亚急性湿疹的临床研究,观察、评价其临床疗效及安全性,为临床提供一种疗效确切、利于推广的针刺治疗方法。
方法
1分组
将入选的90例患者随机分为治疗组(针刺)和对照组(西药),每组各45例。
2治疗方案
治疗组(针刺)：取穴：双侧神门、通里、少府、大陵,太白、三阴交、阴陵泉、血海、足三里、丰隆、天枢、曲池、合谷、皮疹部位阿是穴。针具：华佗牌0.25×40mm毫针；中号火针(直径为0.75mm)。操作方法：俯卧位,常规消毒,先予毫针刺各经穴,得气后,施以平补平泻,均匀地提插、捻转,每隔10mi n行针1次,留针30min后出针。再于局部阿是穴用火针散刺法,将针尖针体烧至通红或发白后刺入皮损部位,每2cm×2cm皮损面积点刺1针。疗程：隔天1次,每周治疗3次,连续2周,共治疗6次。
对照组(西药)：外用丁酸氢化可的松软膏(尤卓尔),每日2次,用药2周。
3观察指标及观察时点
观察指标包括EASI评分、VAS评分、中医症状评分。
EASI评分、VAS评分：分别于治疗前、治疗1周后、治疗2周后进行记录；中医症状评分：分别于治疗前,治疗2周后进行记录；随访：治疗结束2周后、4周后进行记录
4疗效评定
治疗前后EASI评分变化为主要疗效判定指标,VAS评分及治疗前后中医证候观察指标评分变化为次要疗效判定指标。同时进行安全性及疗后2周、4周后复发率判定。
结果
1两组疗前性别、年龄、病程、发病部位、EASI评分、VAS评分及中医证候评分比较均无统计学意义(P>0.01),两组具有可比性。
2EASI评分：①两组组内比较：治疗1周后、2周后分别与治疗前比较均有统计学意义(P<0.01),表明两种疗法均能改善亚急性湿疹局部皮损。②两组组间比较：治疗1周后、2周后,EASI评分均有统计学意义(P<0.01),表明在改善亚急性湿疹局部皮损方面,对照组优于治疗组。
3依据EASI评分进行疗效判定,两组总有效率及愈显率无统计学意义(P>0.01),痊愈率有统计学意义(P<0.01),表明在改善亚急性湿疹局部皮损方面,两组均有较好疗效,对照组疗效更为显著。
4VAS评分：①两组组内比较：治疗1周后、2周后与治疗前相比,VAS值有统计学意义(P<0.01),表明两组均能改善亚急性湿疹瘙痒症状；②两组组间比较：治疗1周后、2周后,VAS值改善有统计学意义(P<0.01),表明治疗组能够显著改善亚急性湿疹瘙痒症状,且优于对照组。
5中医症状评分：治疗组治疗前后比较,有统计学意义(P<0.01)；对照组治疗前后比较,无统计学意义(P>0.01)；两组组间比较,治疗后症状观察指标评分改善有统计学意义(P<0.01);表明治疗组能够改善亚急性湿疹伴随症状表明,而对照组对亚急性湿疹伴随症状无治疗作用。
6针灸治疗组患者未出现相关不良反应,表明针剌治疗湿疹安全。
7疗后2周、4周复发率,两组比较均有统计学意义(P<0.01),表明在减低近期复发率方面,治疗组优于对照组
结论
1针刺从心脾论治亚急性湿疹疗效确切,止痒效果显著。
2针刺能够改善亚急性湿疹患者整体状况,缓解心烦失眠、口干口渴、小便黄赤、便溏不爽、腹胀纳呆、身重肢困等主要中医伴随症状。
3针刺从心脾论治亚急性湿疹能够减低近期复发率。
4针刺从心脾论治亚急性湿疹安全可靠。
Objects
Aims are observing and evaluating the clinical curative effects and safety of acupuncture on treating subacute eczema from heart and spleen, thus providing an effective acupuncture treatment conducive to the promotion.
Methods
●Groups:Separate90selected patients randomly and averagely into two groups, the acupuncture treatment group and Western medicine control group, and the course of treatment is two weeks.
●Therapeutic schedules:
Treatment group (acupuncture group):Acupoints:Both sides of Shenmen, Tongli, Shaofu, Daling, Taibai, Sanyinjiao, Yinlingquan, Xuehai, Zusanli, Fenglong, Tianshu, Quchi, Hegu and local lesions, ashi points. Needles: Huotuo brand stainless steel filiform needle(0.25x40mm) and medium-sized fire needle. Operations:Patients take the prone positions, after sterilization, needling selected acupoints with filiform needles and lifting, thrusting and twirling equably after getting the needling response, every10minutes to manipulate needles one time and the whole course is30minutes. The second step is to needle on the local lesions by using the fire needle, and every2cmx2cm squares one needle. Courses:Two weeks, and three times a week of treating.
Control group (Western medicine group):Using hydrocortisone butyrate ointment externally for two weeks, and twice a day.
●Observation targets and time-points:
EASI Score and VAS Score:Before treatment, after the first week of treatment and the second week. Syndrome Score of TCM:Before treatment and after the second week of treatment. Follow-up visits:After the second and the fourth week of treatment.
●Treatment effect estimation
The change of EASI scores is used to determine curative effects, and the changes of VAS scores and syndrome scores of TCM are the standard of evaluating efficacy; in the meantime, safety and recurrence rate after the second and the fourth week of treating are evaluated.
Results
●The comparisons of gender, age, course of disease, pathogenic site, EASI score, VAS score and syndrome score of TCM between the two groups before treatment have no statistical significance, and the two groups have comparability.
●EASI Score.①Intra-group comparison. The comparisons between the first and second week after treatment with before the treatment all have statistical significance, which means the two kinds of treatment all can improve skin lesions of subacute eczema;②Cmparison among groups:EASI scores have statistical significance compared the first and second week after treatment, which indicates the control group has advantages in improving skin lesions of subacute eczema.
●According to the EASI scores to determine curative effects, the total effective rate and the marked effectiveness and cure rate aren't statistically significant, but the cure rate has statistical significance, which shows the control group has better effects to improve the skin lesions of subacute eczema.
●VAS score:①Intra-group comparison:The comparisons between the first and second week after treatment with before the treatment all have statistical significance, which means the two kinds of treatment all can alleviate pruritus of subacute eczema;②Comparison among groups:VAS scores have statistical significance compared the first and second week after treatment, which indicates the treatment group has advantages in alleviating pruritus of subacute eczema.
●Syndrome score of TCM:①Intra-group comparison:The comparison between before and after the treatment of treatment group has statistical significance, but the comparison of control group isn't statistically significant;②Comparison among groups:Syndrome scores have statistical significance compared before and after treatment, which indicates the treatment group can improve symptoms but the control group cannot.
●The patients in treatment group haven't shown any relative untoward effects, which indicates the therapy of acupuncture group is safety.
●The recurrent rates in the second and the fourth week after treatment of the two groups all have statistical significance, which shows the treatment group is better than the control group in the recent recurrent rate.
Conclusion
●The acupuncture treatment group has definite curative effect, and the effect of alleviating pruritus is significant compared to the Western medicine control group, though the effect of improving skin lesions is less significant than the control group.
●The treatment group can improve symptoms, such as vexation, insomnia, dry mouth and thirsty, yellow urine, loose stool with unfinished feeling, abdominal distension, heavy body with lazy limbs and other comparing symptoms of subacute eczema.
●The acupuncture treatment group has better effect in reducing the recurrent rate of subacute eczema.
●The therapy of acupuncture is safety.
通过针刺从心脾论治亚急性湿疹的临床研究,观察、评价其临床疗效及安全性,为临床提供一种疗效确切、利于推广的针刺治疗方法。
方法
1分组
将入选的90例患者随机分为治疗组(针刺)和对照组(西药),每组各45例。
2治疗方案
治疗组(针刺)：取穴：双侧神门、通里、少府、大陵,太白、三阴交、阴陵泉、血海、足三里、丰隆、天枢、曲池、合谷、皮疹部位阿是穴。针具：华佗牌0.25×40mm毫针；中号火针(直径为0.75mm)。操作方法：俯卧位,常规消毒,先予毫针刺各经穴,得气后,施以平补平泻,均匀地提插、捻转,每隔10mi n行针1次,留针30min后出针。再于局部阿是穴用火针散刺法,将针尖针体烧至通红或发白后刺入皮损部位,每2cm×2cm皮损面积点刺1针。疗程：隔天1次,每周治疗3次,连续2周,共治疗6次。
对照组(西药)：外用丁酸氢化可的松软膏(尤卓尔),每日2次,用药2周。
3观察指标及观察时点
观察指标包括EASI评分、VAS评分、中医症状评分。
EASI评分、VAS评分：分别于治疗前、治疗1周后、治疗2周后进行记录；中医症状评分：分别于治疗前,治疗2周后进行记录；随访：治疗结束2周后、4周后进行记录
4疗效评定
治疗前后EASI评分变化为主要疗效判定指标,VAS评分及治疗前后中医证候观察指标评分变化为次要疗效判定指标。同时进行安全性及疗后2周、4周后复发率判定。
结果
1两组疗前性别、年龄、病程、发病部位、EASI评分、VAS评分及中医证候评分比较均无统计学意义(P>0.01),两组具有可比性。
2EASI评分：①两组组内比较：治疗1周后、2周后分别与治疗前比较均有统计学意义(P<0.01),表明两种疗法均能改善亚急性湿疹局部皮损。②两组组间比较：治疗1周后、2周后,EASI评分均有统计学意义(P<0.01),表明在改善亚急性湿疹局部皮损方面,对照组优于治疗组。
3依据EASI评分进行疗效判定,两组总有效率及愈显率无统计学意义(P>0.01),痊愈率有统计学意义(P<0.01),表明在改善亚急性湿疹局部皮损方面,两组均有较好疗效,对照组疗效更为显著。
4VAS评分：①两组组内比较：治疗1周后、2周后与治疗前相比,VAS值有统计学意义(P<0.01),表明两组均能改善亚急性湿疹瘙痒症状；②两组组间比较：治疗1周后、2周后,VAS值改善有统计学意义(P<0.01),表明治疗组能够显著改善亚急性湿疹瘙痒症状,且优于对照组。
5中医症状评分：治疗组治疗前后比较,有统计学意义(P<0.01)；对照组治疗前后比较,无统计学意义(P>0.01)；两组组间比较,治疗后症状观察指标评分改善有统计学意义(P<0.01);表明治疗组能够改善亚急性湿疹伴随症状表明,而对照组对亚急性湿疹伴随症状无治疗作用。
6针灸治疗组患者未出现相关不良反应,表明针剌治疗湿疹安全。
7疗后2周、4周复发率,两组比较均有统计学意义(P<0.01),表明在减低近期复发率方面,治疗组优于对照组
结论
1针刺从心脾论治亚急性湿疹疗效确切,止痒效果显著。
2针刺能够改善亚急性湿疹患者整体状况,缓解心烦失眠、口干口渴、小便黄赤、便溏不爽、腹胀纳呆、身重肢困等主要中医伴随症状。
3针刺从心脾论治亚急性湿疹能够减低近期复发率。
4针刺从心脾论治亚急性湿疹安全可靠。
Objects
Aims are observing and evaluating the clinical curative effects and safety of acupuncture on treating subacute eczema from heart and spleen, thus providing an effective acupuncture treatment conducive to the promotion.
Methods
●Groups:Separate90selected patients randomly and averagely into two groups, the acupuncture treatment group and Western medicine control group, and the course of treatment is two weeks.
●Therapeutic schedules:
Treatment group (acupuncture group):Acupoints:Both sides of Shenmen, Tongli, Shaofu, Daling, Taibai, Sanyinjiao, Yinlingquan, Xuehai, Zusanli, Fenglong, Tianshu, Quchi, Hegu and local lesions, ashi points. Needles: Huotuo brand stainless steel filiform needle(0.25x40mm) and medium-sized fire needle. Operations:Patients take the prone positions, after sterilization, needling selected acupoints with filiform needles and lifting, thrusting and twirling equably after getting the needling response, every10minutes to manipulate needles one time and the whole course is30minutes. The second step is to needle on the local lesions by using the fire needle, and every2cmx2cm squares one needle. Courses:Two weeks, and three times a week of treating.
Control group (Western medicine group):Using hydrocortisone butyrate ointment externally for two weeks, and twice a day.
●Observation targets and time-points:
EASI Score and VAS Score:Before treatment, after the first week of treatment and the second week. Syndrome Score of TCM:Before treatment and after the second week of treatment. Follow-up visits:After the second and the fourth week of treatment.
●Treatment effect estimation
The change of EASI scores is used to determine curative effects, and the changes of VAS scores and syndrome scores of TCM are the standard of evaluating efficacy; in the meantime, safety and recurrence rate after the second and the fourth week of treating are evaluated.
Results
●The comparisons of gender, age, course of disease, pathogenic site, EASI score, VAS score and syndrome score of TCM between the two groups before treatment have no statistical significance, and the two groups have comparability.
●EASI Score.①Intra-group comparison. The comparisons between the first and second week after treatment with before the treatment all have statistical significance, which means the two kinds of treatment all can improve skin lesions of subacute eczema;②Cmparison among groups:EASI scores have statistical significance compared the first and second week after treatment, which indicates the control group has advantages in improving skin lesions of subacute eczema.
●According to the EASI scores to determine curative effects, the total effective rate and the marked effectiveness and cure rate aren't statistically significant, but the cure rate has statistical significance, which shows the control group has better effects to improve the skin lesions of subacute eczema.
●VAS score:①Intra-group comparison:The comparisons between the first and second week after treatment with before the treatment all have statistical significance, which means the two kinds of treatment all can alleviate pruritus of subacute eczema;②Comparison among groups:VAS scores have statistical significance compared the first and second week after treatment, which indicates the treatment group has advantages in alleviating pruritus of subacute eczema.
●Syndrome score of TCM:①Intra-group comparison:The comparison between before and after the treatment of treatment group has statistical significance, but the comparison of control group isn't statistically significant;②Comparison among groups:Syndrome scores have statistical significance compared before and after treatment, which indicates the treatment group can improve symptoms but the control group cannot.
●The patients in treatment group haven't shown any relative untoward effects, which indicates the therapy of acupuncture group is safety.
●The recurrent rates in the second and the fourth week after treatment of the two groups all have statistical significance, which shows the treatment group is better than the control group in the recent recurrent rate.
Conclusion
●The acupuncture treatment group has definite curative effect, and the effect of alleviating pruritus is significant compared to the Western medicine control group, though the effect of improving skin lesions is less significant than the control group.
●The treatment group can improve symptoms, such as vexation, insomnia, dry mouth and thirsty, yellow urine, loose stool with unfinished feeling, abdominal distension, heavy body with lazy limbs and other comparing symptoms of subacute eczema.
●The acupuncture treatment group has better effect in reducing the recurrent rate of subacute eczema.
●The therapy of acupuncture is safety.
引文
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