枳术赤豆饮加味治疗痒疹的临床疗效观察
摘要
目的：
痒疹是一种常见的皮肤疾病,好发于四肢伸侧,两侧对称,可泛发全身,下肢病变往往较上肢为重。本病的发生原因尚不清楚,西医多认为与变态反应有关,中医认为此病是因感受风、湿、热之邪,聚结皮肤；或因饮食不节脏腑功能失调,湿热内生；日久不愈,化热化火,伤阴耗血,血燥生风,肌肤失养所致。由于本病瘙痒剧烈,给患者带来痛苦,影响了患者的正常工作、生活,甚至给人们的社交活动带来尴尬和不便。目前对于这类皮肤病,西医主要给予抗组胺、维生素C、钙剂及皮质类固醇等药物治疗,中医多予疏风清热、利湿润燥之法治疗,临床疗效不甚理想,我院皮肤科多年来运用枳术赤豆饮一方加味,用于治疗痒疹,取得了较好的临床疗效,为了进一步了解此方的疗效,为此药的临床推广提供理想依据,故进行该方应用于临床的进一步研究。
方法：
1.临床资料
所有病例均为2008年11月-2009年11月武汉市中医院皮肤科门诊病人及住院部收治病人,共80例。按就诊先后随机分为治疗组和对照组,各40例。两组病例在年龄、性别、病程上的比较,无显著性差异,具有可比性。
2.治疗方法
治疗组给予枳术赤豆饮加味,方药组成：枳壳10 g、白术10 g、陈皮10 g、砂仁6g、赤小豆15 g、荆芥10 g、防风10 g、蝉衣6 g、甘草10 g。徐长卿10 g、乌梢蛇10 g、连翘12 g、黄芩10 g。辨证加减：皮疹泛发,损害鲜红加紫草、丹皮、仙鹤草；皮疹坚实,难以软化加王不留行、土贝母、地龙；夜难以入睡加远志、百合、生龙骨、生牡蛎、合欢皮等；纳呆加炒二芽、鸡内金。水煎服,每日一剂,每次200ml,Bid,两周为一疗程,治疗两个疗程；对照组给予消风止痒颗粒,组成：荆芥、防风.蝉蜕.地骨皮.炒苍术.亚麻子.当归.地黄.木通.石膏.甘草.冲服,每次2袋,Tid,两周为一疗程,治疗两个疗程。整个试验遵循随机、单盲原则,治疗后根据疾病疗效,自觉症状及皮损评分标准进行统计分析。
3.统计学方法
凡符合入选标准的病例纳入试验,进行分析比较治疗前和治疗后的各项症状、体征。计数资料用卡方检验.计量资料用t检验。
结果：
临床观察：治疗组有效率为95%,对照组有效率为87.5%,经统计学分析无显著的差异；但是治疗组痊愈率为65%,对照组痊愈率为45%,治疗组痊愈率高于对照组,经统计学分析有非常显著的差异(p<0.01)
结论：
枳术赤豆饮加味方中枳壳行气,白术燥湿,赤小豆清解热毒、利水除湿,三药共为君药；荆芥祛风解表、透疹,防风祛风胜湿,蝉蜕发表散风、透疹,乌梢蛇祛风,黄芩清热燥湿,泻火解毒,连翘清热解毒、疏散风热,并为臣药,以助君药以增祛风、清热、除湿之功；陈皮、砂仁均能行气,徐长卿功善活血,共助君药以祛风,为佐药；甘草解毒、兼调和诸药,为使。全方共奏祛风清热、除湿止痒之功。经治疗后,多数痒疹患者瘙痒程度明显缓解,皮损减轻,皮损范围缩小。枳术赤豆饮加味治疗痒疹疗效较显著,且安全、无毒副作用,值得临床推广应用。
1.Objective:
Prurigo is a common skin disease,occur in the extensor surfaces of extremities,bilaterally symmetrical,generalized body weight can lower extremity lesions are usually higher than upper else.The cause of this disease is not yet clear, many doctors think and allergy related to Chinese medicine, disease is a result of feeling the wind. Wet.Heat of evil,coalescence skin; or because of diet section of organs dysfunction, hot and humid endogenous;Day long unhealed, chemical heating fire Shangyin consumption of blood, Xuezao wind, and the skin caused by dystrophy. As the disease severe itching,painful for patients,affecting the patient's normal work. Life, and even to the people's social activities have brought embarrassment and inconvenience. At present, for these skin diseases,Western medicine mainly to give anti-histamine. Vitamin C. Calcium and corticosteroids such as drug treatment,Chinese heat more than I Shufeng.Lishi Runzao of treating the clinical efficacy of less than ideal,our hospital dermatology Over the years the use of one party Zhizhu bean flavored drink, for the treatment of prurigo,and achieved better clinical efficacy, in order to further understand this side effect,this drug provides an ideal basis for clinical practice, so for that party applies to clinical further study.
2.Method:
All cases were in November 2008-2009 years,in November Wuhan City Chinese Medicine Hospital inpatient dermatology outpatients and admitted patients,Chixiaodou Sechi Entering the Heart Sutra, can antipyretic drugs.Can also dehumidification, the shamisen is the King and medicine;"itch from the wind, the itching must first Shufeng "Nepeta Qufeng solution table,Touzhen, wind Qufeng wins wet oneself issued a casual wind, Touzhen, Zaocys expelling wind, dampness heat skullcap, Xiehuo detoxification, forsythia Qingrejiedu, evacuation wind-heat,and Robinson a total of 80 cases. By treatment successively randomly divided into treatment group and control group, all 40 cases. Two groups of patients in age. Sex. Course of the disease on the comparison, no significant difference between comparable.
Group was treated with red bean drink flavored Jianfu Zhizhu day one, each 200ml,Bid, two weeks for a course of treatment,two courses;control group was given blunt Xiaofeng itching particles, each 2 bags,Tid.the whole randomized trial to follow, single-blind principle,depending on the disease after the treatment efficacy, subjective symptoms and skin lesions of assessment criteria for statistical analysis.
Who meet the inclusion criteria of cases under the pilot to carry out analysis and comparison of treatment before and after treatment of the symptoms.Signs.Count data using chi-square test. Measurement data using t test.
3. Result:
Clinical observation:the treatment group was 95% in the control group was 87.5%, by statistical analysis no significant differences;treatment group, but the cure rate was 65% in the control group cure rate of 45% cure rate of treatment group, in the control group, by statistical analysis is a very significant difference (p<0.01)
4.Conclusion:
Zhizhu red bean flavored drink were mainly from Citrus aurantium. Atractylodes. Citrus. Villosum. Chixiaodou. Ambrosioides.Wind. Chantui.Xu Changqing, Zaocys,Huang Qin, forsythia,licorice component.Qi Fang Fructus,Atractylodes dampness, Chixiaodou clear antipyretic drugs,diuresis dehumidification,three drugs were King and medicine;Nepeta Qufeng solution table, Touzhen, wind Qufeng wins wet oneself issued a casual wind,Touzhen, Zaocys expelling wind,dampness heat skullcap, Xiehuo detoxification, forsythia Qingrejiedu, evacuation wind-heat,For "the first rule governing the wind of blood,blood PROFESSIONAL MORALS self-destroy",Citrus aurantium can do gas,and the "gas is the commander of blood, blood for the mother of qi", gas lines are the blood line, blood line of the wind from the eradication of ears,so the wind Since the addition. Atractylodes dampness,"Zhu primary concern sores Spleen Qi.Urgency pain. Qingrejiedu. Reconcile various drugs and Robinson drug,to help to increase Qufeng Jun drugs,heat,dehumidification of the power; dried tangerine peel,Amomum can Qi,Xu Changqing Gong good blood circulation, a total of Jun medicine to help with expelling wind, in order to adjuvant;licorice detoxification.and reconcile the various drugs,in order. All parties were played Qufeng heat. Desiccant anti-itch achievements.After treatment,the majority of patients with prurigo pruritus is significantly alleviated to reduce skin lesions,skin lesions to narrow the scope.Zhizhu bean Decoction Prurigo more significant efficacy, and safety. Non-toxic side effects,worthy to be popularized.
痒疹是一种常见的皮肤疾病,好发于四肢伸侧,两侧对称,可泛发全身,下肢病变往往较上肢为重。本病的发生原因尚不清楚,西医多认为与变态反应有关,中医认为此病是因感受风、湿、热之邪,聚结皮肤；或因饮食不节脏腑功能失调,湿热内生；日久不愈,化热化火,伤阴耗血,血燥生风,肌肤失养所致。由于本病瘙痒剧烈,给患者带来痛苦,影响了患者的正常工作、生活,甚至给人们的社交活动带来尴尬和不便。目前对于这类皮肤病,西医主要给予抗组胺、维生素C、钙剂及皮质类固醇等药物治疗,中医多予疏风清热、利湿润燥之法治疗,临床疗效不甚理想,我院皮肤科多年来运用枳术赤豆饮一方加味,用于治疗痒疹,取得了较好的临床疗效,为了进一步了解此方的疗效,为此药的临床推广提供理想依据,故进行该方应用于临床的进一步研究。
方法：
1.临床资料
所有病例均为2008年11月-2009年11月武汉市中医院皮肤科门诊病人及住院部收治病人,共80例。按就诊先后随机分为治疗组和对照组,各40例。两组病例在年龄、性别、病程上的比较,无显著性差异,具有可比性。
2.治疗方法
治疗组给予枳术赤豆饮加味,方药组成：枳壳10 g、白术10 g、陈皮10 g、砂仁6g、赤小豆15 g、荆芥10 g、防风10 g、蝉衣6 g、甘草10 g。徐长卿10 g、乌梢蛇10 g、连翘12 g、黄芩10 g。辨证加减：皮疹泛发,损害鲜红加紫草、丹皮、仙鹤草；皮疹坚实,难以软化加王不留行、土贝母、地龙；夜难以入睡加远志、百合、生龙骨、生牡蛎、合欢皮等；纳呆加炒二芽、鸡内金。水煎服,每日一剂,每次200ml,Bid,两周为一疗程,治疗两个疗程；对照组给予消风止痒颗粒,组成：荆芥、防风.蝉蜕.地骨皮.炒苍术.亚麻子.当归.地黄.木通.石膏.甘草.冲服,每次2袋,Tid,两周为一疗程,治疗两个疗程。整个试验遵循随机、单盲原则,治疗后根据疾病疗效,自觉症状及皮损评分标准进行统计分析。
3.统计学方法
凡符合入选标准的病例纳入试验,进行分析比较治疗前和治疗后的各项症状、体征。计数资料用卡方检验.计量资料用t检验。
结果：
临床观察：治疗组有效率为95%,对照组有效率为87.5%,经统计学分析无显著的差异；但是治疗组痊愈率为65%,对照组痊愈率为45%,治疗组痊愈率高于对照组,经统计学分析有非常显著的差异(p<0.01)
结论：
枳术赤豆饮加味方中枳壳行气,白术燥湿,赤小豆清解热毒、利水除湿,三药共为君药；荆芥祛风解表、透疹,防风祛风胜湿,蝉蜕发表散风、透疹,乌梢蛇祛风,黄芩清热燥湿,泻火解毒,连翘清热解毒、疏散风热,并为臣药,以助君药以增祛风、清热、除湿之功；陈皮、砂仁均能行气,徐长卿功善活血,共助君药以祛风,为佐药；甘草解毒、兼调和诸药,为使。全方共奏祛风清热、除湿止痒之功。经治疗后,多数痒疹患者瘙痒程度明显缓解,皮损减轻,皮损范围缩小。枳术赤豆饮加味治疗痒疹疗效较显著,且安全、无毒副作用,值得临床推广应用。
1.Objective:
Prurigo is a common skin disease,occur in the extensor surfaces of extremities,bilaterally symmetrical,generalized body weight can lower extremity lesions are usually higher than upper else.The cause of this disease is not yet clear, many doctors think and allergy related to Chinese medicine, disease is a result of feeling the wind. Wet.Heat of evil,coalescence skin; or because of diet section of organs dysfunction, hot and humid endogenous;Day long unhealed, chemical heating fire Shangyin consumption of blood, Xuezao wind, and the skin caused by dystrophy. As the disease severe itching,painful for patients,affecting the patient's normal work. Life, and even to the people's social activities have brought embarrassment and inconvenience. At present, for these skin diseases,Western medicine mainly to give anti-histamine. Vitamin C. Calcium and corticosteroids such as drug treatment,Chinese heat more than I Shufeng.Lishi Runzao of treating the clinical efficacy of less than ideal,our hospital dermatology Over the years the use of one party Zhizhu bean flavored drink, for the treatment of prurigo,and achieved better clinical efficacy, in order to further understand this side effect,this drug provides an ideal basis for clinical practice, so for that party applies to clinical further study.
2.Method:
All cases were in November 2008-2009 years,in November Wuhan City Chinese Medicine Hospital inpatient dermatology outpatients and admitted patients,Chixiaodou Sechi Entering the Heart Sutra, can antipyretic drugs.Can also dehumidification, the shamisen is the King and medicine;"itch from the wind, the itching must first Shufeng "Nepeta Qufeng solution table,Touzhen, wind Qufeng wins wet oneself issued a casual wind, Touzhen, Zaocys expelling wind, dampness heat skullcap, Xiehuo detoxification, forsythia Qingrejiedu, evacuation wind-heat,and Robinson a total of 80 cases. By treatment successively randomly divided into treatment group and control group, all 40 cases. Two groups of patients in age. Sex. Course of the disease on the comparison, no significant difference between comparable.
Group was treated with red bean drink flavored Jianfu Zhizhu day one, each 200ml,Bid, two weeks for a course of treatment,two courses;control group was given blunt Xiaofeng itching particles, each 2 bags,Tid.the whole randomized trial to follow, single-blind principle,depending on the disease after the treatment efficacy, subjective symptoms and skin lesions of assessment criteria for statistical analysis.
Who meet the inclusion criteria of cases under the pilot to carry out analysis and comparison of treatment before and after treatment of the symptoms.Signs.Count data using chi-square test. Measurement data using t test.
3. Result:
Clinical observation:the treatment group was 95% in the control group was 87.5%, by statistical analysis no significant differences;treatment group, but the cure rate was 65% in the control group cure rate of 45% cure rate of treatment group, in the control group, by statistical analysis is a very significant difference (p<0.01)
4.Conclusion:
Zhizhu red bean flavored drink were mainly from Citrus aurantium. Atractylodes. Citrus. Villosum. Chixiaodou. Ambrosioides.Wind. Chantui.Xu Changqing, Zaocys,Huang Qin, forsythia,licorice component.Qi Fang Fructus,Atractylodes dampness, Chixiaodou clear antipyretic drugs,diuresis dehumidification,three drugs were King and medicine;Nepeta Qufeng solution table, Touzhen, wind Qufeng wins wet oneself issued a casual wind,Touzhen, Zaocys expelling wind,dampness heat skullcap, Xiehuo detoxification, forsythia Qingrejiedu, evacuation wind-heat,For "the first rule governing the wind of blood,blood PROFESSIONAL MORALS self-destroy",Citrus aurantium can do gas,and the "gas is the commander of blood, blood for the mother of qi", gas lines are the blood line, blood line of the wind from the eradication of ears,so the wind Since the addition. Atractylodes dampness,"Zhu primary concern sores Spleen Qi.Urgency pain. Qingrejiedu. Reconcile various drugs and Robinson drug,to help to increase Qufeng Jun drugs,heat,dehumidification of the power; dried tangerine peel,Amomum can Qi,Xu Changqing Gong good blood circulation, a total of Jun medicine to help with expelling wind, in order to adjuvant;licorice detoxification.and reconcile the various drugs,in order. All parties were played Qufeng heat. Desiccant anti-itch achievements.After treatment,the majority of patients with prurigo pruritus is significantly alleviated to reduce skin lesions,skin lesions to narrow the scope.Zhizhu bean Decoction Prurigo more significant efficacy, and safety. Non-toxic side effects,worthy to be popularized.
引文
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[3]陈德宇主编. 中西医结合皮肤性病学. 中国中医药出版社.2005.10：289-291
[4]吴谦等.医宗金鉴.人民卫生出版社.2004.7：430
[5]胡晓峰主编.中医外科商客名著集成.华夏出版社.1997.8.10：626
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