摘要
目的：湿疹是一种由于多种内、外因素引起的皮肤炎症反应,一般认为与变态反应有较密切的关系。现代医学认为湿疹和变应性接触性皮炎同属变态反应炎症性皮肤病。导师在中医传统理论基础上,结合临床经验和现代病因,分析总结出亚急性、慢性湿疹的发病根本在于“脾虚湿盛,湿邪内蕴”。本课题针对其病因病机采用清热化湿之法,拟定除湿饮,观察该法治疗亚急性、慢性湿疹的疗效,并对其作用机理进行了初步探讨。此外,现代医学认为本病的发病与嗜酸性细胞有着密切的关系,本课题观察清热化湿法对嗜酸细胞阳离子蛋白的影响,并探讨血清ECP指标在湿疹发病中的作用和临床意义,以佐证清热化湿法的科学性。
方法：选取符合标准的亚急性、慢性湿疹患者60例,分为治疗组和对照组,以清热化湿为治疗原则,选用中药方剂除湿饮。设西药西替利嗪为对照,两组疗程均为4周。参照1990年10月中国中医药出版社制定的(《常见疾病的诊断与疗效判断标准》及1998年6月人民军医出版社制定的《临床疾病诊断依据治愈好转标准》,进行疗效观察。同时,两组治疗前后均检测嗜酸细胞阳离子蛋白(ECP)的水平变化。使用EASI评分法,观察治疗前后皮损面积及严重程度变化以及调查患者对治疗的满意度。
结果：治疗组症候、体征改善率达93.33%,略高于西替利嗪组,但无统计学意义。嗜酸细胞阳离子蛋白(ECP)水平检测：治疗组ECP水平下降水平优于对照组,表明相比于西药对照组,中药治疗组对湿疹患者ECP水平变化有着更好的改善作用。
意义：通过观察清热化湿法治疗湿疹的疗效及对血清ECP的影响,可以更好的找到湿疹发病与血清ECP的关系,从而进一步优化亚急性、慢性湿疹的临床治疗。
Purpose:Eczema is inflammatory and allergic reactions of skin due to varieties of internal and external factors, and generally considered more closely related to type IVand I allergic reaction. In Modern medicine, both eczema and contact dermatitis are allergic inflammatory skin disease. Professor Chen-Li summarizes that spleen deficiency and damp accumulation leading to internal dampness stagnation is fundamental pathogenesis of eczema, based on the analysis of traditional Chinese medicine theory, personal clinical experience and new research findings of western medicine.
In our study,the principle of invigorating spleen and dispelling dampness principle and herbs decoction named'CHU SHI YIN'were determined according to the etiology and pathogenesis of subacute and chronic eczema, which aimed to observe the efficacy of the formula in the treatment of subacute and chronic eczema, meanwhile its mechanism was discussed.
In addition to understanding of the close relationship between eczema and type IV allergic reaction, recognition that type I allergic reaction and serum eosinophil change are also associated with pathogenesis of eczema. So in our study, the level of the eosinophil cationic protein in serum were tested before and after the clinical observation course in order to obtain some new findings between between pathogenesis of eczema and type IVallergic reaction and its indicators of serum ECP. Meanwhile, the influence of herbs decoction on the clinical process of eczema patients and on their serum ECP changes were observed in order to realize the clinical significance of serum ECP in eczema. Method:Select compliant 60 cases of eczema patients were divided into treatment and control groups to the spleen for the treatment of the principles of dehumidification, dehumidification prescription medicine used to drink. Based medicine cetirizine as control, were treated for 4 weeks. Reference to October 1990 established Chinese Medicine Press ("common disease diagnosis and therapeutic evaluation standards "and in June 1998 the People's Medical Publishing House to develop a "cure disease diagnosis based on improved standards" for patients. At the same time, Two groups were detected before and after treatment eosinophil cationic protein (ECP) level changes. using EASI score, observation area before and after treatment and severity of skin lesions and to investigate changes in patient satisfaction with treatment.
Result:Treatment group symptom and signs rate of 93.33%, slightly higher than the cetirizine group, but not statistically significant. Eosinophil cationic protein (ECP) levels of detection:the treatment group decreased levels of ECP levels than the control group, indicating that the control group compared to Western medicine, Chinese medicine treatment group ECP levels in patients with eczema and better regulation.
Meaning:To investigate the treatment of eczema spleen desiccant effect and impact on serum ECP, the incidence of eczema can be better to find the relationship between serum ECP and thus further optimize the clinical treatment of eczema.
引文
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