疏肝祛白方联合NB-UVB治疗面颈部白癜风临床观察及对生活质量影响
发布时间：2018-10-19 09:51
【摘要】：目的：1.疏肝祛白方是我科临床上经过长期验证治疗肝郁气滞型白癜风的经验方,本研究旨在观察疏肝祛白方联合窄谱中波紫外线治疗肝郁气滞型面颈部白癜风的临床疗效,评价此中西医结合方案在临床具体实践中对面颈部白癜风的确切治疗效果及其安全性。2.调查面颈部白癜风对患者的生活质量的影响,评价治疗前后患者生活质量的变化情况。方法：选取门诊符合条件的白癜风患者共90例,随机分为治疗组、对照1组、对照2组,各组人数分别为30人。治疗组予口服中药疏肝祛白方(日一剂)、外用消斑酊(外擦于白斑处,早晚各一次)及窄谱中波紫外线照射(起始剂量0.05J/cm2,以后每次递增0.01 J/cm2,每周2次)。对照1组予窄谱中波紫外线照射及外用消斑酊治疗(方法同治疗组)；对照2组予口服中药疏肝祛白方及外用消斑酊(方法同治疗组)。各组连续治疗12周,分别于治疗后4周、8周、12周观察记录白斑面积,并分别于治疗前及治疗后填写“皮肤病生活质量指标调查表”。结果：1.治疗4周后,治疗组与对照1组疗效差异无统计学意义(P0.05),与对照2组差异有统计学意义(P0.05),对照1组与对照2组疗效差异有统计学意义(P0.05)；治疗8周后,治疗组与对照1组疗效差异无统计学意义(P0.05),与对照2组差异有统计学意义(P0.05),对照1组与对照2组疗效差异无统计学意义(P0.05)；治疗12周后,治疗组与对照1组疗效差异有统计学意义(P0.05),与对照2组差异有统计学意义(P0.05),对照1组与对照2组疗效差异无统计学意义(P0.05)。2.83例面颈部白癜风患者治疗前DLQI评分平均9.17±3.662分,其中治疗组DLQI评分8.61±3.695分,对照1组DLQI评分9.29±4.026分,对照2组DLQI评分9.63±3.272分。经治疗后DLQI评分均较前下降,治疗组DLQI评分3.61±2.644分,对照1组DLQI评分6.89±3.573分,对照2组DLQI评分5.26±2.581分,对每组治疗前后评分进行配对t检验,三组差异均有统计学意义(P0.05)。进一步对治疗后三组间患者DLQI评分多重比较(LSD法),三组间均存在显著差异(P0.05)。结论：1.治疗4周后采用联合治疗与窄谱中波紫外线治疗疗效相当,且疗效均优于口服中药组；治疗8周后采用联合治疗疗效优于口服中药组,但并不优于窄谱中波紫外线照射组；治疗12周以后采用联合治疗法疗效优于窄谱中波紫外线照射组及口服中药组,而窄谱中波紫外线照射组及口服中药组疗效相当。采用疏肝祛白方结合窄谱中波紫外线照射的联合治疗法治疗肝郁气滞型面颈部白癜风具有良好疗效,且不良反应少,值得临床推广。2.面颈部白癜风对患者生活质量存在相当影响,采用联合治疗法、窄谱中波紫外线照射治疗或口服中药治疗均可改善患者生活质量,治疗组对生活质量的改善情况优于对照1组及对照2组,对照2组对生活质量改善优于对照1组。采用疏肝祛白方治疗肝郁气滞型白癜风在改善患者生活质量方面效果更优。
[Abstract]:Purpose 1. The prescription of soothing liver and removing white is an empirical prescription for treating vitiligo with stagnation of liver-qi and qi after long-term verification. The purpose of this study was to observe the clinical effect of soothing the liver and removing white prescription combined with narrow-spectrum ultraviolet B on the treatment of vitiligo on the face and neck of liver-stagnation qi stagnation type. Objective: to evaluate the effect and safety of the treatment of vitiligo on the opposite neck in clinical practice. 2. To investigate the effect of face and neck vitiligo on the quality of life of patients and evaluate the changes of quality of life before and after treatment. Methods: 90 patients with vitiligo were randomly divided into treatment group (n = 30), control group (n = 1) and control group (n = 2). The treatment group was treated with oral Shugan Qubai prescription (one dose per day), external application of Xiaoban tincture (external rubbing on white spot, one time in the morning and evening) and narrow band ultraviolet B radiation (initial dose 0.05J / cm ~ (2), increase by 0.01 J / cm ~ (2), twice a week). Control group 1 was treated with narrow-spectrum ultraviolet B irradiation and external application of Xiaoban tincture (same as treatment group), control group 2 was treated with oral Chinese medicine Shugan Qubai recipe and external application of Xiaoban tincture (same treatment group). The area of leukoplakia was observed at 4 weeks, 8 weeks and 12 weeks after treatment in each group for 12 weeks, and the quality of life index questionnaire for skin diseases was completed before and after treatment. The result is 1: 1. After 4 weeks of treatment, there was no significant difference between the treatment group and the control group (P0.05), but there was a significant difference between the treatment group and the control group (P0.05), the difference between the control group 1 and the control group 2 was statistically significant (P0.05); after 8 weeks of treatment, there was a significant difference in the curative effect between the control group and the control group (P0.05). There was no significant difference between the treatment group and the control group (P0.05), but there was no significant difference between the control group (P0.05) and the control group (P0.05), but there was no significant difference between the control group (P0.05) and the control group (P0.05). There was significant difference between treatment group and control group (P0.05), but there was no significant difference between control group 1 (P0.05) and control group 2 (P0.05). 2.83 patients with face and neck vitiligo had an average DLQI score of 9.17 卤3.662 before treatment. The DLQI score of the treatment group was 8.61 卤3.695, the DLQI score of the control group was 9.29 卤4.026, and the DLQI score of the control group was 9.63 卤3.272. After treatment, the DLQI scores were all decreased. The DLQI score of the treatment group was 3.61 卤2.644, the DLQI score of the control group was 6.89 卤3.573, and the DLQI score of the two control groups was 5.26 卤2.581.The scores of each group were matched t test before and after treatment, and there were significant differences among the three groups (P0.05). Further more, there were significant differences among the three groups in DLQI scores after treatment (LSD method) (P0.05). Conclusion 1. After 4 weeks of treatment, the therapeutic effect of combined treatment was similar to that of narrow band ultraviolet B, and the curative effect was better than that of oral Chinese medicine group after 8 weeks, but not better than that of narrow band ultraviolet B irradiation group. After 12 weeks of treatment, the therapeutic effect of combined therapy was better than that of narrow band ultraviolet B irradiation group and oral Chinese medicine group, but the narrow band ultraviolet B radiation group and oral Chinese medicine group had the same curative effect. The combination therapy of soothing liver and removing white prescription combined with narrow spectrum ultraviolet B irradiation has good curative effect and few adverse reactions in treating face and neck vitiligo of liver stagnation and qi stagnation type, which is worth popularizing in clinic. 2. The quality of life of patients with vitiligo on the face and neck was significantly affected, and the quality of life could be improved by combined therapy, narrow band ultraviolet B irradiation or oral Chinese medicine. The improvement of quality of life in treatment group was better than that in control group 1 and control group 2, and the improvement of quality of life in control group 2 was better than that in control group 1. Treating vitiligo with stagnation of liver and qi with the prescription of soothing the liver and removing the white is better in improving the quality of life of the patients.
【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】：2016
【分类号】：R758.41
[Abstract]:Purpose 1. The prescription of soothing liver and removing white is an empirical prescription for treating vitiligo with stagnation of liver-qi and qi after long-term verification. The purpose of this study was to observe the clinical effect of soothing the liver and removing white prescription combined with narrow-spectrum ultraviolet B on the treatment of vitiligo on the face and neck of liver-stagnation qi stagnation type. Objective: to evaluate the effect and safety of the treatment of vitiligo on the opposite neck in clinical practice. 2. To investigate the effect of face and neck vitiligo on the quality of life of patients and evaluate the changes of quality of life before and after treatment. Methods: 90 patients with vitiligo were randomly divided into treatment group (n = 30), control group (n = 1) and control group (n = 2). The treatment group was treated with oral Shugan Qubai prescription (one dose per day), external application of Xiaoban tincture (external rubbing on white spot, one time in the morning and evening) and narrow band ultraviolet B radiation (initial dose 0.05J / cm ~ (2), increase by 0.01 J / cm ~ (2), twice a week). Control group 1 was treated with narrow-spectrum ultraviolet B irradiation and external application of Xiaoban tincture (same as treatment group), control group 2 was treated with oral Chinese medicine Shugan Qubai recipe and external application of Xiaoban tincture (same treatment group). The area of leukoplakia was observed at 4 weeks, 8 weeks and 12 weeks after treatment in each group for 12 weeks, and the quality of life index questionnaire for skin diseases was completed before and after treatment. The result is 1: 1. After 4 weeks of treatment, there was no significant difference between the treatment group and the control group (P0.05), but there was a significant difference between the treatment group and the control group (P0.05), the difference between the control group 1 and the control group 2 was statistically significant (P0.05); after 8 weeks of treatment, there was a significant difference in the curative effect between the control group and the control group (P0.05). There was no significant difference between the treatment group and the control group (P0.05), but there was no significant difference between the control group (P0.05) and the control group (P0.05), but there was no significant difference between the control group (P0.05) and the control group (P0.05). There was significant difference between treatment group and control group (P0.05), but there was no significant difference between control group 1 (P0.05) and control group 2 (P0.05). 2.83 patients with face and neck vitiligo had an average DLQI score of 9.17 卤3.662 before treatment. The DLQI score of the treatment group was 8.61 卤3.695, the DLQI score of the control group was 9.29 卤4.026, and the DLQI score of the control group was 9.63 卤3.272. After treatment, the DLQI scores were all decreased. The DLQI score of the treatment group was 3.61 卤2.644, the DLQI score of the control group was 6.89 卤3.573, and the DLQI score of the two control groups was 5.26 卤2.581.The scores of each group were matched t test before and after treatment, and there were significant differences among the three groups (P0.05). Further more, there were significant differences among the three groups in DLQI scores after treatment (LSD method) (P0.05). Conclusion 1. After 4 weeks of treatment, the therapeutic effect of combined treatment was similar to that of narrow band ultraviolet B, and the curative effect was better than that of oral Chinese medicine group after 8 weeks, but not better than that of narrow band ultraviolet B irradiation group. After 12 weeks of treatment, the therapeutic effect of combined therapy was better than that of narrow band ultraviolet B irradiation group and oral Chinese medicine group, but the narrow band ultraviolet B radiation group and oral Chinese medicine group had the same curative effect. The combination therapy of soothing liver and removing white prescription combined with narrow spectrum ultraviolet B irradiation has good curative effect and few adverse reactions in treating face and neck vitiligo of liver stagnation and qi stagnation type, which is worth popularizing in clinic. 2. The quality of life of patients with vitiligo on the face and neck was significantly affected, and the quality of life could be improved by combined therapy, narrow band ultraviolet B irradiation or oral Chinese medicine. The improvement of quality of life in treatment group was better than that in control group 1 and control group 2, and the improvement of quality of life in control group 2 was better than that in control group 1. Treating vitiligo with stagnation of liver and qi with the prescription of soothing the liver and removing the white is better in improving the quality of life of the patients.
【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】：2016
【分类号】：R758.41
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