毫火针配合中药治疗脾虚湿蕴型慢性湿疹的疗效观察

发布时间：2018-03-20 15:33

本文选题：毫火针　切入点：中药方　出处：《广州中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过观察毫火针配合中药与单纯中药疗法治疗脾虚湿蕴型慢性湿疹的临床疗效,对比两种疗法并探讨毫火针配合中药治疗脾虚湿蕴型慢性湿疹的作用,寻求治疗慢性湿疹快捷有效的方法,并为之后慢性湿疹中医内外结合疗法的应用提供可靠的临床资料。方法:收集病例66例,通过SPSS 19.0得出随机数字,制成随机分配卡共66张,分别装入66个不透明信封内,信封号同卡片序号,按1:1比例分成治疗组(毫火针配合中药组)和对照组(单纯中药组),随后根据纳入病例前来就诊的顺序进行分配,按信封内卡片规定的分组进行对应治疗,治疗组和对照组各33例。对照组予以中药方(苍术10g,白术15g,陈皮6g,炒麦芽30g,茯苓15g,苡仁30g,滑石18g,泽泻15g,生甘草10g,黄柏10g,白芷10g,蝉衣10g,苦参10g,白鲜皮15g,地肤子12g)加减治疗,每日1剂,水煎分2次早晚服用,连服5周。治疗组在对照组治疗的基础上加用毫火针治疗,主要点刺皮损局部,每周治疗2次,连续治疗5周。治疗前后分别记录患者的湿疹面积及严重度指数评分(EASI评分)和瘙痒评分,用于统计分析及临床疗效评价。结果:将两组病例的年龄、性别、病程、治疗前EASI评分和瘙痒评分等进行比较,差异无统计学意义(p0.05),提示两组具有可比性。两组患者经治疗后,采用EASI评分和瘙痒评分,得分均较治疗前有所降低,治疗前后差异有统计学意义(p0.05)。与对照组相比,治疗组治疗前后瘙痒评分差优于对照组,差异有统计学意义(p0.05),而EASI评分差和全身红斑、丘疹、鳞屑、苔藓症状评分差的差异不具有统计学意义(p0.05)。治疗组显效13例,有效17例,无效0例,总有效率为100%,对照组显效4例,有效16例,无效11例,总有效率为64.5%,差异具有统计学意义(p0.05),其中治疗组显效率(43.3%)明显高于对照组(12.9%),可见在5周的治疗时间内治疗组的整体疗效比对照组更好,且对瘙痒的改善作用更加显著。结论:慢性湿疹是临床常见的皮肤病,以皮损局部的慢性炎症为特征,中药方专为脾虚湿蕴型皮肤病而设,健脾行气,祛湿利水,内调以改善患者脾虚湿盛的体质,毫火针速刺局部皮损,通过其温热刺激,以达到疏经通络、祛腐生肌、引邪外出的外治作用,两者内外同治,更好地改善慢性湿疹的皮损,达到治疗的目的。毫火针配合中药和单纯中药疗法治疗脾虚湿蕴型慢性湿疹均能取得良好的临床疗效,而且相比单纯中药疗法,毫火针配合中药疗法疗效更好,且两组在治疗过程中均未见不良反应,值得临床推广和应用。
[Abstract]:Objective: to observe the clinical curative effect of traditional Chinese medicine and traditional Chinese medicine on chronic eczema with spleen deficiency and dampness accumulation, and to compare the two kinds of therapy and to explore the effect of acupuncture combined with traditional Chinese medicine on chronic eczema with spleen deficiency and dampness accumulation. To seek a quick and effective method for the treatment of chronic eczema, and to provide reliable clinical data for the later application of internal and external therapy of TCM for chronic eczema. Methods: 66 cases of chronic eczema were collected and the random numbers were obtained by SPSS 19.0. A total of 66 random distribution cards were made. In 66 opaque envelopes, the envelope number was the same as the card number. According to 1: 1 ratio, they were divided into two groups: the treatment group and the control group, which were then assigned according to the order in which the patients were included. The corresponding treatment is carried out according to the grouping specified by the card in the envelope, Treatment group and control group (33 cases each). The control group was treated with traditional Chinese medicine prescription (Atractylodes Atractylodes 10g, Atractylodes macrocephala 15g, pericarp 6g, fried malt 30g, Poria cocos 15g, lachryma seed 30g, talc 18g, alisma 15g, licorice 10g, yellow cypress 10g, angelica dahurica 10g, Sophora flavescens 10g, fresh skin 15g, skin 12g). One dose per day, water decoction is taken twice in the morning and evening, even for 5 weeks. The treatment group is treated with acupuncture on the basis of the treatment in the control group, mainly prick local lesions, 2 times a week, The area and severity index scores of eczema (EASI) and pruritus score were recorded before and after treatment for 5 weeks. There was no significant difference between the two groups in EASI score and pruritus score before treatment, indicating that the two groups were comparable. After treatment, the EASI score and the pruritus score in the two groups were lower than those before treatment. Compared with the control group, the difference of pruritus score before and after treatment in the treatment group was better than that in the control group, and the difference was statistically significant (p 0.05), while the EASI score was lower and the systemic erythema, papules, scales were lower than those in the control group. The difference of moss symptom score was not statistically significant (p 0.05). In the treatment group, there were 13 cases of marked effect, 17 cases of effective effect, 0 cases of ineffective, the total effective rate was 100%, while in the control group, there were 4 cases of marked effect, 16 cases of effective and 11 cases of failure. The total effective rate was 64.5, and the difference was statistically significant (P 0.05). The effective rate of treatment group was significantly higher than that of control group (43.3%). It was obvious that the overall effect of treatment group was better than that of control group within 5 weeks of treatment. Conclusion: chronic eczema is a common skin disease, characterized by local chronic inflammation of skin lesions. Chinese medicine prescription is specially designed for skin diseases of spleen deficiency and dampness accumulation. In order to improve the body of spleen deficiency and dampness of patients, acupuncture with fire to prick the local skin lesions, through its warm and heat stimulation, to achieve the external treatment effect of thinning the meridians and clearing the collaterals, dispel the rotten muscles, and induce evil to go out, and treat both inside and outside together, the skin lesions of chronic eczema can be improved better, so as to improve the skin lesions of chronic eczema. To achieve the purpose of the treatment, both Chinese herbal medicine and traditional Chinese medicine alone can achieve good clinical efficacy in treating chronic eczema with spleen deficiency and dampness accumulation, and compared with traditional Chinese medicine alone, the curative effect of Chinese herbal medicine therapy is better than that of point fire acupuncture combined with traditional Chinese medicine. There was no adverse reaction in both groups, which was worth popularizing and applying.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.7

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