止痒颗粒治疗糖尿病皮肤瘙痒症血虚风燥证的临床疗效观察

发布时间：2017-12-27 19:05

本文关键词：止痒颗粒治疗糖尿病皮肤瘙痒症血虚风燥证的临床疗效观察　出处：《北京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：糖尿病是临床高发疾病,皮肤瘙痒症是其主要并发症之一,主要表现为全身或局部皮肤瘙痒,呈游走性、阵发性,以夜间发作为重,严重影响患者的生活质量。西医学研究认为其发病原因主要与皮肤干燥,血糖异常,皮肤感染,神经损伤,药物过敏等密切相关。在治疗上以抗组胺H1受体拮抗剂、糖皮质激素、免疫调节及局部UV照射治疗为主,但常因出现不良反应无法长期应用,治疗间断后,瘙痒迅速复发,为治疗带来了极大的困难。中医认为该病的病因病机与气阴两虚、血热、血瘀、血虚风燥有关,故在治疗上多以养血活血、滋阴凉血、祛风润燥为法,取得良好的疗效,有效的规避了西医的缺陷。止痒颗粒是我院皮肤科的常用方,在治疗皮肤瘙痒症方面收效颇著,其滋阴养血、祛风润燥的功效符合糖尿病皮肤瘙痒症血虚风燥证的中医病机,因此会取得令人满意的疗效。本课题通过进一步的临床实践研究以期为止痒颗粒的临床应用奠定理论基础及拓展思路,在治疗糖尿病皮肤瘙痒症方面展现中医临床特色,阔宽其应用前景。研究目的:采用临床观察研究方法,观察止痒颗粒方治疗血虚风燥型糖尿病皮肤瘙痒症的临床疗效及对其安全性进行评估。研究方法:采用随机、对照的临床观察方法,病例均来源于2016年9月一 2017年2月北京中医药大学第三附属医院皮肤科门诊及内分泌科门诊和病房的患者,符合糖尿病皮肤瘙痒症血虚风燥证的纳入标准,通过填写《止痒颗粒治疗糖尿病皮肤瘙痒症血虚风燥证临床观察表》,采集证候症状、舌脉等相关信息,纳入符合研究条件的患者。将符合纳入的糖尿病皮肤瘙痒症血虚风燥证患者60例随机分为两组:治疗组、对照组各30例,分别予止痒颗粒方和依巴斯汀片治疗,2周为一个疗程,分别在治疗前、治疗中(用药1周)、治疗后进行瘙痒、干燥等指标比较和疗效评价,并于结束治疗2周后进行随访,记录相关指标变化。研究结果:本临床观察研究共纳入60例患者,治疗组和对照组各30例,两组患者在性别、年龄、病程治疗前症状积分方面比较无显著性差异(p0.05),具有可比性。两组疗效比较,治疗组总有效率90.0%,对照组总有效率50.0%,差异有统计学意义(p0.05);治疗组用药1周、2周后,瘙痒总评分、皮损总评分均比治疗前降低,且在瘙痒程度、瘙痒面积、瘙痒频率、持续时间方面分值低于对照组,差异有统计学意义(p0.05)。停药2周后随访,瘙痒症状和皮损症状积分仍比治疗前降低(p0.05)。在治疗过程中,患者依从性良好,无中途退出患者,且血常规、尿常规、肝肾功能检测结果均基本在临床正常范围内,治疗前后无明显较大差异。结论:止痒颗粒方能有效改善患者瘙痒症状积分和皮肤干燥、鳞屑、抓痕血痂等皮损症状积分,是治疗血虚风燥型糖尿病皮肤瘙痒症的有效方剂。且该方法安全可靠,复发率小,值得临床推广应用。
[Abstract]:Diabetes is a clinical common disease, skin pruritus is one of the main complications, mainly for systemic or local skin itching, a walk, paroxysmal, at night as heavy, serious impact on quality of life of patients. Western medicine research believes that the cause of the disease is mainly related to skin drying, abnormal blood sugar, skin infection, nerve injury, drug allergy and so on. In terms of treatment, anti histamine H1 receptor antagonist, glucocorticoid, immunomodulation and local UV irradiation are the main treatments, but they often fail to be applied for a long time because of adverse reactions. After treatment, pruritus rapidly recurrences, which brings great difficulties for treatment. Chinese medicine believes that the disease pathogenesis and syndrome of Qi Yin deficiency, blood stasis, blood heat, blood deficiency and wind dryness, so in most of the treatment of nourishing and activating blood, nourishing yin and moistening method for dispelling wind, cooling blood, has a good curative effect, effectively avoid the defects of Western medicine. Zhiyang granule is commonly used in our hospital department of Dermatology, in the treatment of skin pruritus effect has its pathogenesis, nourishing Yin, expelling Runzao effect with diabetic skin pruritus of blood deficiency and wind dryness, thus satisfying curative effect. This topic through further clinical practice in order to study the clinical application of Qufengzhiyang particles theory foundation and develop ideas, to show clinical characteristics in the field of Chinese medicine treatment of diabetic skin pruritus, broad application prospect. Objective: using the research methods of clinical observation, to observe the clinical curative effect of Zhiyang granule Decoction in the treatment of blood deficiency and wind dryness skin pruritus and diabetes and to evaluate its safety. Methods: the clinical observation of the randomized and controlled method, the patients from outpatient and inpatient outpatient department of Dermatology and Department of Endocrinology Affiliated Hospital of Beijing University of Chinese Medicine in September 2016 February 2017 third patients with diabetic skin pruritus of blood deficiency and wind dryness of the inclusion criteria, by completing the "Zhiyang granule in the treatment of diabetic skin pruritus of blood deficiency and wind dryness syndrome clinical observation table", acquisition the syndrome symptoms, tongue and pulse and other related information, the conditions of the patients included in the study. Will meet the inclusion of the diabetic skin pruritus of blood deficiency and wind dryness, 60 cases of patients were randomly divided into two groups: treatment group and control group with 30 cases in each group, were treated with Qufengzhiyang particles and Ebastine Tablets for 2 weeks for a course of treatment, respectively, before treatment, treatment (1 weeks), after treatment for pruritus, dry indicators and evaluation of curative effect, treatment and follow-up after 2 weeks on end, record the related index changes. Results: a total of 60 patients were included in the study. There were 30 cases in the treatment group and the control group. There was no significant difference in the symptom score between the two groups in terms of gender, age and course of treatment (P0.05). To compare the effects of two groups, the total effective rate of treatment group 90%, control group total effective rate was 50%, the difference was statistically significant (P0.05); the treatment group for 1 weeks and 2 weeks, the total score, total skin pruritus scores were lower than before treatment, and the degree of itching, itching, itching area frequency, duration the score lower than the control group, the difference was statistically significant (P0.05). After 2 weeks of drug withdrawal, the symptoms of itching and the symptom score of skin lesions were still lower than those before the treatment (P0.05). During the course of treatment, patients had good compliance and no withdrawal from their patients. Blood routine, urine routine and liver and kidney function tests were basically in the normal clinical range. There was no significant difference between before and after treatment. Conclusion: Zhiyang granule can improve the symptoms of itching integral and dry skin, scales, such as scratches blood scab skin symptoms, is an effective prescription for treatment of blood deficiency and wind dryness diabetic skin pruritus. The method is safe and reliable, and the recurrence rate is small. It is worthy of clinical application.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

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