中西药序贯疗法治疗复发性单纯疱疹临床疗效观察

发布时间：2018-03-21 23:21

本文选题：复发性单纯疱疹　切入点：序贯疗法　出处：《安徽中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：1目的本研究旨在观察中西药序贯疗法治疗复发性单纯疱疹临床疗效,对比观察对缩短皮损愈合时间及复发次数的影响。观察中西药序贯疗法治疗复发性单纯疱疹的有效性和安全性,以期找到一种对复发性单纯疱疹的有效的治疗方案以降低复发频率。2方法62例纳入课题研究的患者随机分为各31例的治疗组和对照组。治疗组予以伐昔洛韦300mg bid,共5d,后继服8周中药(大青叶15g、白花蛇舌草10g、板蓝根15g、金银花10g、连翘10g、党参10g、黄芪10g、白术10g、当归10g、女贞子15g、墨旱莲15g、薏苡仁30g、生甘草10g;日一剂,水煎分服);对照组予以伐昔洛韦300mg bid,共5d。同时两组均针对皮损予以局部外用药进行对症处理。两组治疗结束后均观察6个月,记录每次复发皮损变化及每个月病情变化,并于观察期结束后比较两组患者皮损评分、中医证候评分、复发情况、远期疗效、焦虑情况、DLQI评分,同时观察整个研究过程中有无不良反应。3结果比较两组治疗后的复发情况,4个月,(49)=0.032;6个月,(49)=0.037,((49)0.05),差异均有统计学意义,治疗组在减少复发情况上治疗组优于仅服用伐昔洛韦的对照组。比较两组远期疗效,治疗后6个月,治疗组无效5例,有效8例,显效17例,总有效率83.33%;对照组无效6例,有效15例,显效9例,总有效率80%,(49)=0.046,(49)0.05,差异具有统计学意义,治疗组远期疗效优于对照组。两组治疗前一般情况、皮损评分和愈合时间、中医证候评分、DLQI评分、半年复发次数均具有可比性,差异无统计学意义,治疗前后皮损情况相比,均可改善皮损且疗效相当,并且在治疗后1周皮损愈合上均有所改善。两组治疗前后中医证候评分治疗组效果明显优于对照组,在对患者生活质量和焦虑抑郁的改善,治疗组效果亦优于对照组。治疗期间,治疗组有1例经期延期、1例轻度胃炎反应,对照组仅有1例腹泻。两组不良反应发生率分别为6.67%、3.33%,无统计学意义。4结论中西药序贯疗法治疗复发性单纯疱疹有确切的临床疗效,优势在于可有效降低复发频率且无明显不良反应,值得在临床推广。
[Abstract]:Objective to observe the clinical effect of sequential therapy of Chinese and western medicine on recurrent herpes simplex. The effect of sequential therapy of Chinese and western medicine on the treatment of recurrent herpes simplex was observed. In order to find an effective treatment for recurrent herpes simplex, 62 patients included in the study were randomly divided into treatment group (n = 31) and control group (n = 31). The treatment group was treated with valciclovir 300mg bidbid. A total of 5 days, followed by 8 weeks of traditional Chinese medicine (Daqingye 15g, white hyacinth 10g, Isatis lanceolata 15g, honeysuckle 10g, Forsythia 10g, Codonopsis 10g, Astragalus 10g, Atractylodes macrocephala 10g, Angelica sinensis 10g, Ligustrum lucidum 15g, Upland lotus 15g, Coix seed 30g, raw liquorice 10g; The patients in the control group were treated with 300mg bidae for 5 days. Both groups were treated with local external medicine for the skin lesions. The patients in both groups were observed for 6 months after the treatment, and the changes of the recurrent lesions and the monthly changes of the disease were recorded. At the end of the observation period, the scores of skin lesions, TCM syndromes, recurrence, long-term effects, anxiety and DLQI were compared between the two groups. At the same time, we observed whether there were adverse reactions in the whole course of the study and compared the recurrence rate of the two groups after treatment, 4 months after treatment and 0.032 months after treatment, and 6 months after treatment, there were significant differences between the two groups. In reducing recurrence, the treatment group was better than the control group which only took valaciclovir. After 6 months of treatment, the treatment group had no effect in 5 cases, effective in 8 cases, remarkable effect in 17 cases, the total effective rate was 83.33 cases, while the control group had no effect in 6 cases. There were 15 cases of effective and 9 cases of remarkable effect. The total effective rate was 80%. The difference was statistically significant. The long-term curative effect of the treatment group was better than that of the control group. The general situation before treatment, the score of skin lesion and healing time, the score of TCM syndromes and DLQI score in the two groups were better than those in the control group. The number of recurrence in half a year was comparable, but the difference was not statistically significant. Compared with before and after treatment, the number of recurrent lesions could be improved and the curative effect was similar. The curative effect of the treatment group was obviously better than that of the control group before and after treatment, and the quality of life and anxiety and depression of the patients were improved. The effect of the treatment group was also better than that of the control group. During the treatment period, there was 1 case of delayed menstrual period and 1 case of mild gastritis in the treatment group. There was only one case of diarrhea in the control group. The incidence of adverse reactions in the two groups was 6.67 and 3.33, respectively. No statistical significance was found in the treatment of recurrent herpes simplex with sequential therapy of Chinese and western medicine. The advantage is that it can reduce the recurrence frequency effectively and has no obvious adverse reaction, so it is worth popularizing in clinic.
【学位授予单位】：安徽中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R752.11

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