加味疏肝生发汤治疗肝郁气滞证斑秃的临床研究
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摘要
目的：
观察加味疏肝生发汤治疗肝郁气滞证斑秃的临床疗效及机理,通过检测患者治疗前后血清白介素1β的水平,了解加味疏肝生发汤在治疗肝郁气滞证斑秃过程中对患者血清白介素1β的影响。
方法：
将60例合格纳入的肝郁气滞证斑秃患者,随机分为两组,每组30例。治疗组口服加味疏肝生发汤,每次一剂,一日两次；对照组口服生发片,6片／次,一日三次,3个月为1疗程,治疗1个疗程判定疗效。观察其临床疗效,并检测治疗前后外周血白介素1β的水平(IL-1β)含量。
结果：
1.治疗前后两组观察疗效数据显示：治疗组痊愈7例,显效12例,有效9例,无效2例,总有效率93.3%；对照组痊愈3例,显效11例,有效7例,无效9例,总有效率70%。两组总有效率比较有统计学差异。(P<0.05)。
2.治疗前后两组患者积分结果显示：两组治疗后积分较治疗前有明显改善(P<0.05),但治疗组积分差值与对照组相比较,差异有统计学意义(P<0.05)。
3.治疗前后两组患者的检测血清白介素1β结果显示：两组均有不同程度的改善,治疗组改善与对照组相比较,差异有统计学意义(P<0.05)。
4.两组均按规定服药,在服药过程中未发现明显的不良反应。
结论：
加味疏肝生发汤治疗肝郁气滞证斑秃的疗效具有一定的优势,通过降低患者的血清白介素1β水平而在治疗肝郁气滞证斑秃中取得了较满意的疗效。
Objective:
To observe the clinical effect of Jia Wei Shu Gan Sheng Fa decoction in the treatment of alopecia areata with liver depression and qi stagnation type and to explore its mechanism,To understand the influence on the liver depression and qi stagnation of alopecia areata by detecting the peripheral Interleukin 1β(IL-1β) content of patients pre and post treatment.
Methods:
60 cases of alopecia areata patients with liver depression and qi stagnation type qualified with the inclusion criteria were randomly divided into 2 groups with 30 cases each.treatment group were treated by Jia Wei SHU GAN SHENG FA, one dose each time and once a day.comparative group were treated by SHENG FA TABLET,six tablets each time,three times a day,The treatment course was three months, and evaluted the effect of treatment after one course.Observed the clinical efficacy and detected peripheral Interleukin 1β(IL-1β) content of patients pre and post treatment.
Results:
1. After a period oft clinical observation showed that after treatment:30 cases of treatment group:7 cases of clinical cure,12 cases markedly effective,9 cases effective,2 cases of invalid,the total effective rate was 93.3 percent;30 cases of control group:3 cases clinical cured,markedly effective in 11 cases and effective 7 cases,invalid 9 cases,the total efficiency of 70 percent.the two groups to al more efficient statistical difference (P<0.05) of comparision.
2. Points of pre and post treatment showed that two groups:two groups post-treatment points were significantly improved compared with pre-treatment (P<0.05),and the points difference between the treatment group compared with the control group which was statistically significant (P<0.05).
3. The two groups of pre and post treatment in patients with serum levels of interleukin-1 (3 results showed that:There were varying degrees of improvement,and the treatment group improved compared with the control group,statistically significant differences(P<0.05) in two groups.
4. The two groups in accordance with the provisions of treatment,adverse reactions did not appeared.
conclusion:
Jia Wei Shu Gan Sheng Fa decoction can significantly reduce the serum levels of interleukin-1βin alopecia areata with liver depression and qi stagnation type, which can treat the alopecia areata of liver depression and qi stagnation type with certain advantages.
观察加味疏肝生发汤治疗肝郁气滞证斑秃的临床疗效及机理,通过检测患者治疗前后血清白介素1β的水平,了解加味疏肝生发汤在治疗肝郁气滞证斑秃过程中对患者血清白介素1β的影响。
方法：
将60例合格纳入的肝郁气滞证斑秃患者,随机分为两组,每组30例。治疗组口服加味疏肝生发汤,每次一剂,一日两次；对照组口服生发片,6片／次,一日三次,3个月为1疗程,治疗1个疗程判定疗效。观察其临床疗效,并检测治疗前后外周血白介素1β的水平(IL-1β)含量。
结果：
1.治疗前后两组观察疗效数据显示：治疗组痊愈7例,显效12例,有效9例,无效2例,总有效率93.3%；对照组痊愈3例,显效11例,有效7例,无效9例,总有效率70%。两组总有效率比较有统计学差异。(P<0.05)。
2.治疗前后两组患者积分结果显示：两组治疗后积分较治疗前有明显改善(P<0.05),但治疗组积分差值与对照组相比较,差异有统计学意义(P<0.05)。
3.治疗前后两组患者的检测血清白介素1β结果显示：两组均有不同程度的改善,治疗组改善与对照组相比较,差异有统计学意义(P<0.05)。
4.两组均按规定服药,在服药过程中未发现明显的不良反应。
结论：
加味疏肝生发汤治疗肝郁气滞证斑秃的疗效具有一定的优势,通过降低患者的血清白介素1β水平而在治疗肝郁气滞证斑秃中取得了较满意的疗效。
Objective:
To observe the clinical effect of Jia Wei Shu Gan Sheng Fa decoction in the treatment of alopecia areata with liver depression and qi stagnation type and to explore its mechanism,To understand the influence on the liver depression and qi stagnation of alopecia areata by detecting the peripheral Interleukin 1β(IL-1β) content of patients pre and post treatment.
Methods:
60 cases of alopecia areata patients with liver depression and qi stagnation type qualified with the inclusion criteria were randomly divided into 2 groups with 30 cases each.treatment group were treated by Jia Wei SHU GAN SHENG FA, one dose each time and once a day.comparative group were treated by SHENG FA TABLET,six tablets each time,three times a day,The treatment course was three months, and evaluted the effect of treatment after one course.Observed the clinical efficacy and detected peripheral Interleukin 1β(IL-1β) content of patients pre and post treatment.
Results:
1. After a period oft clinical observation showed that after treatment:30 cases of treatment group:7 cases of clinical cure,12 cases markedly effective,9 cases effective,2 cases of invalid,the total effective rate was 93.3 percent;30 cases of control group:3 cases clinical cured,markedly effective in 11 cases and effective 7 cases,invalid 9 cases,the total efficiency of 70 percent.the two groups to al more efficient statistical difference (P<0.05) of comparision.
2. Points of pre and post treatment showed that two groups:two groups post-treatment points were significantly improved compared with pre-treatment (P<0.05),and the points difference between the treatment group compared with the control group which was statistically significant (P<0.05).
3. The two groups of pre and post treatment in patients with serum levels of interleukin-1 (3 results showed that:There were varying degrees of improvement,and the treatment group improved compared with the control group,statistically significant differences(P<0.05) in two groups.
4. The two groups in accordance with the provisions of treatment,adverse reactions did not appeared.
conclusion:
Jia Wei Shu Gan Sheng Fa decoction can significantly reduce the serum levels of interleukin-1βin alopecia areata with liver depression and qi stagnation type, which can treat the alopecia areata of liver depression and qi stagnation type with certain advantages.
引文
1刘爱民,榻国维,陈达灿,等.广东汉族斑秃及其中医证型与HLA-DRB1基因的相关性研究[J].中国麻风皮肤病杂志,2006,22(11)：900-901.
2蔡晓伟,李惠.细胞因子在斑秃发病机制中的研究进展[J].皮肤与性病,2005,27(2)：7-9.
3陈泽奇,陈国林,胡随瑜,等.肝气郁结证辅助实验诊断指标的初步研究[J].中国现代医学杂志,2001,11(12)：8-9.
4黄卫宁,候显曾,卢浩锵,等.T淋巴细胞亚群与斑秃发病关系的研究[J].岭南皮肤性病杂志,2007,14(4)：208-210.
5李建红,李萍,刘建中,等.斑秃患者外周血单个核细胞产生Th1/Th2细胞因子研究[J].岭南皮肤性病科杂志,2008,15(2)：61-63.
6张弛,肖风丽,张学军,等.斑秃毛囊免疫赦免机制的进展[J].国际皮肤性病学杂志,2006,32(4)：241-243.
7谭城,朱文元,闵仲生.未累及皮损内白发的斑秃[J].临床皮肤科杂志,2008,37(8)：521-522.
8 Colombe BW,Lou CD. Price VH. Th egenetic basis of alopecia areata: HLA associations witⅡ patchy alopecia areata versus alopecia totalis and alopecia universalis.J Investig Dermatol Symp Proc,1999,4(3):216-219.
9 Akar A,Orkunoglu E,Sengul A,et al.HLA class Ⅱ alleles in patients with alopecia areata.Eur J Dermatol.2002,12(3):236-239.
10莫报翰.局部封闭结合免疫治疗斑秃500例临床观察[J].广西医 学,2008,30(7)：1083-1084.
11 Beard HD J Am Acad Dermatol 1986,14(4):697.
12马蔷薇,张志勤,等.50例斑秃患者脑血流图分析[J].中国皮肤性病学杂志,1991(1)：19.
13巩杰,罗汉超等.斑秃患者的个性和心理社会因素与发病关系的初步探讨[J],中华皮肤科杂志,1989,22(4)：230-233.
14赵辩.临床皮肤病学[M].3版.南京：江苏科学技术出版社,2001：947-948.
15 Liakopoulou M,Alifieraki T,KatideniouA,et al.Children with alopecia areata:Psychiatirc symptomatology and life events Am Acad Child Adolesc Psychiatry,1997,May;36(5):678-684.
16北京中医医院.赵炳南临床经验集[M].北京：人民卫生出版社,2006(第二辑)：289-290.
17邓中光,符惠珍.邓铁涛教授治疗斑秃的经验[J].新中医,1981,13(2)：17.
18刘惠芸.论内治斑秃六法[J].光明中医,2004,19(4)：31-32.
19邹学敏,付相钰,张利君.辨证施护联合中药外搽治疗斑秃效果观察[J].护理学杂志,2008,23(1)：42-43.
20魏静.加味补阳还五汤治疗斑秃30例[J].陕西中医,2008,29(7)：831-832.
21和建林,和成斌.六味地黄汤合四物汤治疗斑秃80例[J].陕西中医学院学报,2008,31(4)：35-36.
22洪彪.正发酊外擦配合穴位按压治疗斑秃50例[J].中华临床医学研究杂志,2006,11(21)：3096.
23王萍.隔姜灸加体针治疗斑秃33例[J].中国中医药科技,2006,13(2)：12.
24 Muller N.Role of the cytokine in the CNS and psychiatric disorders. Nervenarzt,1997,68(1):11.
25胡大吉,丁桂霞,李有田.细胞因子异常与抑郁症的发生[J].中华中医药学刊,2007,25(3)：516-517.
26吕永良,吴爱勤,李鸣,等.老年抑郁症病人免疫功能及其心理状态的对照研究[J].中国行为医学科学,2003,12(6)：634-635.
27 Anesman H,Ravindran AV,Greffiths J,et al.Endocrine and cytokine correlates of major depression and dysthymia with typical or atypical featuers.Molpsychiatry,1994,4:182-188.
28陈群,罗小年.抑郁症病人细胞因子的产生与治疗反应[J].国外医学精神病分册,2002,29(3)147-150.
29王东林,林文娟.细胞因子与抑郁症发病机制研究进展[J].中国神经精神病杂,2007,33(9)：572-574.
30 Mather FO,Martin DSD,Lynch MA.Increased IL-1βin cortex of aged rats is accompanied By downregulation of ERK and PI-3 kinase. Neurobiol Aging,2004,25(6):795.
31何郁芳,周挺进.姜黄素对缺血性及损伤炎症反应的影响[J].医药论坛杂志,2008,29(14)：24-26.
2蔡晓伟,李惠.细胞因子在斑秃发病机制中的研究进展[J].皮肤与性病,2005,27(2)：7-9.
3陈泽奇,陈国林,胡随瑜,等.肝气郁结证辅助实验诊断指标的初步研究[J].中国现代医学杂志,2001,11(12)：8-9.
4黄卫宁,候显曾,卢浩锵,等.T淋巴细胞亚群与斑秃发病关系的研究[J].岭南皮肤性病杂志,2007,14(4)：208-210.
5李建红,李萍,刘建中,等.斑秃患者外周血单个核细胞产生Th1/Th2细胞因子研究[J].岭南皮肤性病科杂志,2008,15(2)：61-63.
6张弛,肖风丽,张学军,等.斑秃毛囊免疫赦免机制的进展[J].国际皮肤性病学杂志,2006,32(4)：241-243.
7谭城,朱文元,闵仲生.未累及皮损内白发的斑秃[J].临床皮肤科杂志,2008,37(8)：521-522.
8 Colombe BW,Lou CD. Price VH. Th egenetic basis of alopecia areata: HLA associations witⅡ patchy alopecia areata versus alopecia totalis and alopecia universalis.J Investig Dermatol Symp Proc,1999,4(3):216-219.
9 Akar A,Orkunoglu E,Sengul A,et al.HLA class Ⅱ alleles in patients with alopecia areata.Eur J Dermatol.2002,12(3):236-239.
10莫报翰.局部封闭结合免疫治疗斑秃500例临床观察[J].广西医 学,2008,30(7)：1083-1084.
11 Beard HD J Am Acad Dermatol 1986,14(4):697.
12马蔷薇,张志勤,等.50例斑秃患者脑血流图分析[J].中国皮肤性病学杂志,1991(1)：19.
13巩杰,罗汉超等.斑秃患者的个性和心理社会因素与发病关系的初步探讨[J],中华皮肤科杂志,1989,22(4)：230-233.
14赵辩.临床皮肤病学[M].3版.南京：江苏科学技术出版社,2001：947-948.
15 Liakopoulou M,Alifieraki T,KatideniouA,et al.Children with alopecia areata:Psychiatirc symptomatology and life events Am Acad Child Adolesc Psychiatry,1997,May;36(5):678-684.
16北京中医医院.赵炳南临床经验集[M].北京：人民卫生出版社,2006(第二辑)：289-290.
17邓中光,符惠珍.邓铁涛教授治疗斑秃的经验[J].新中医,1981,13(2)：17.
18刘惠芸.论内治斑秃六法[J].光明中医,2004,19(4)：31-32.
19邹学敏,付相钰,张利君.辨证施护联合中药外搽治疗斑秃效果观察[J].护理学杂志,2008,23(1)：42-43.
20魏静.加味补阳还五汤治疗斑秃30例[J].陕西中医,2008,29(7)：831-832.
21和建林,和成斌.六味地黄汤合四物汤治疗斑秃80例[J].陕西中医学院学报,2008,31(4)：35-36.
22洪彪.正发酊外擦配合穴位按压治疗斑秃50例[J].中华临床医学研究杂志,2006,11(21)：3096.
23王萍.隔姜灸加体针治疗斑秃33例[J].中国中医药科技,2006,13(2)：12.
24 Muller N.Role of the cytokine in the CNS and psychiatric disorders. Nervenarzt,1997,68(1):11.
25胡大吉,丁桂霞,李有田.细胞因子异常与抑郁症的发生[J].中华中医药学刊,2007,25(3)：516-517.
26吕永良,吴爱勤,李鸣,等.老年抑郁症病人免疫功能及其心理状态的对照研究[J].中国行为医学科学,2003,12(6)：634-635.
27 Anesman H,Ravindran AV,Greffiths J,et al.Endocrine and cytokine correlates of major depression and dysthymia with typical or atypical featuers.Molpsychiatry,1994,4:182-188.
28陈群,罗小年.抑郁症病人细胞因子的产生与治疗反应[J].国外医学精神病分册,2002,29(3)147-150.
29王东林,林文娟.细胞因子与抑郁症发病机制研究进展[J].中国神经精神病杂,2007,33(9)：572-574.
30 Mather FO,Martin DSD,Lynch MA.Increased IL-1βin cortex of aged rats is accompanied By downregulation of ERK and PI-3 kinase. Neurobiol Aging,2004,25(6):795.
31何郁芳,周挺进.姜黄素对缺血性及损伤炎症反应的影响[J].医药论坛杂志,2008,29(14)：24-26.