复方白芨膏联合派瑞松治疗手部角化性湿疹的临床研究
发布时间：2019-03-13 16:45
【摘要】： 手部湿疹(HE)作为一种常见的局限性湿疹类疾病,发病率越来越高。其发病人群、病因和临床表现的特殊性,皮损反复发作,缠绵难愈,使其治疗相当困难。目前,正在被作为一种相对独立的疾病受到越来越多学者的关注。外用皮质类固醇是最常用的治疗方法,并且需要长期的良好的皮肤护理措施。然而,类固醇长期应用可能会引起皮肤萎缩、毛细血管扩张、色素沉着等副作用并可能导致激素依赖,停药后易复发,因此无论病人和医生都非常期待新的治疗手部湿疹的措施。近年来中医治疗手部湿疹的研究取得了一些进展,更是出现了很多剂型,为该病的治疗提供了更多的方法。 目的 本研究拟通过观察复方白芨膏联合派瑞松治疗前后手部角化性湿疹患者的临床症状变化,评价外用派瑞松联合复方白芨膏对手部角化性湿疹的临床疗效和安全性,为进一步改进中药配方提供依据,为减轻手部湿疹的症状,提高患者的生活质量,探索更好的预防措施和治疗方法。 方法 这是一个前瞻性随机对照单盲试验,收集2009年6月~2010年2月在广东省第二中医院皮肤科就诊的轻、中度手部角化性湿疹患者。根据纳入标准和排除标准,将符合入组标准的80例患者随机分为两组,其中治疗组40人和对照组40人,治疗组每日清洁手部后,皮损处先后外搽派瑞松软膏、复方白芨膏,之后揉按1分钟,2次/天。对照组每日清洁手部后,皮损处外搽派瑞松软膏后揉按1分钟,2次/天。两组均嘱咐患者注意手部皮肤护理,避免接触碱性洗涤剂及化工产品等其他易致敏物品,并且每周复诊一次。于初诊及四周后分别对两组病人评定其手部湿疹严重性指数及瘙痒程度评分,并以此对疗效及安全性进行评价,所有数据应用SPSS17.0统计软件进行分析。 结果 治疗组38例完成临床试验,对照组39例完成临床试验。综合疗效方面,治疗组与对照组比较,治疗组治愈率为44.7%,总有效率为92.1%；对照组治愈率为17.9%,总有效率为79.5%。统计学分析,两组综合疗效比较,有显著性差异(p0.05)。皮损面积比较,治疗组与对照组比较,治疗组治愈率为21.1%,总有效率为78.9%；对照组治愈率为7.7%,总有效率为46.2%。统计学分析,两组面积疗效比较,有显著性差异(p=0.012,p0.05)。瘙痒程度方面,治疗组和对照组治疗前后,瘙痒程度均有明显下降,经统计学分析,具有非常显著性差异(P0.01)；两组疗效比较,经统计学分析,差异有显著性(p=0.007,p0.01)。治疗组和对照组在治疗前后比较,临床症状,皮损面积,HESCI评分均有不同程度下降,经统计学检验,认为具有显著性差异(P0.01)；两组临床症状、皮损面积、HESCI评分评分下降程度比较,治疗组均明显优于对照组,经统计学检验,认为差异具有显著性(P0.05)。不良反应：对照组2例患者局部出现轻度灼热感,继续用药后,灼热感消失,治疗组未见不良反应。两组患者均未见全身不良反应。 结论 复方白芨膏联合派瑞松治疗组明显降低了手部角化性湿疹患者的HESCI评分,并且明显缓解瘙痒程度、减少皮损面积,复方白芨膏联合派瑞松治疗组的临床综合疗效和各项临床指标均优于单用派瑞松对照组,且未见明显不良反应,耐受性好,值得临床推广。
[Abstract]:Hand eczema (HE), as a common type of localized eczema, has a higher incidence. The particularity of the disease, the cause and the clinical manifestation, the repeated attack of the skin lesion, the difficulty of winding the skin, and the treatment of the skin lesion are quite difficult. At present, as a relatively independent disease, more and more scholars are concerned. External corticosteroids are the most commonly used methods of treatment and require long-term good skin care. However, long-term use of steroids may cause side effects such as skin atrophy, telangiectasia, pigmentation, and the like, and may lead to hormone-dependent, easy-to-relapse after drug withdrawal, and therefore, no matter the patient and the doctor are looking forward to new measures to treat hand eczema. In recent years, some progress has been made in the study of the treatment of hand eczema by traditional Chinese medicine, and a lot of dosage forms have been made, and more methods are provided for the treatment of the disease. Objective The purpose of this study is to evaluate the clinical efficacy and safety of the combination of the compound white paste and the combination of the combination of the compound white paste and the combination of the compound white paste for the treatment of the keratosis eczema of the hand keratosis. In order to further improve the clinical symptoms, the clinical effect and the safety of the compound white-cream combined with the compound white-cream for the treatment of the keratosis eczema of the hand-keratosis were evaluated. The formulation provides the basis for relieving the symptoms of hand eczema, improving the quality of life of patients, and exploring better prevention Measures And a treatment method. The method is a prospective, randomized controlled, single-blind trial, which collects the dermatology of the second middle hospital in Guangdong Province from June 2009 to February 2010. The patients with mild and moderate hand keratosis were randomly divided into two groups according to the criteria for inclusion and exclusion criteria,40 in the treatment group and 40 in the control group, and after the treatment group was cleaned the hand once a day, the skin lesions were once cleaned with a soft extract, and the compound white Paste, and then knead for 1 minute,2 times/ day. After the control group was cleaned daily, the outside of the skin lesion The two groups instructed the patient to pay attention to the hand skin care, to avoid contact with alkaline detergent and chemical products, etc. He was easily sensitized and revisited once a week. The severity index and the degree of itching of the hand eczema of the two groups were assessed after the first visit and four weeks, and the efficacy and safety were evaluated as a result, and all the data were applied to the S PS S17.0 Statistical software analysis. Results treatment In the treatment group, the cure rate of the treatment group was 44.7% and the total effective rate was 92.1%. The cure rate of the control group was 17.9% and the total effective rate was 79.5%. Compared with the control group, the cure rate of the treatment group was 21.1% and the total effective rate was 78.9%. The cure rate of the control group was 7.7% and the total effective rate was 46.2%. There was a significant difference (p = 0.012, p0.05). The level of itching in the treatment group and the control group was significantly reduced before and after the treatment group and the control group (P <0.01). The difference was significant (p = 0.007, p0.01). The treatment group and the control group were compared with the control group before and after the treatment, and the clinical symptoms, the area of the skin lesions and the HESCI scores were decreased to a different extent, and the difference between the two groups was considered to have a significant difference (P0.01). Compared with the control group, the symptom, the area of the skin lesion and the score of the HESCI score were lower, and the treatment group was better than the control group. The results showed that there was a significant difference between the two groups (P0.05). feeling, after continuing to use the medicine, the burning sensation disappears, treatment No adverse reaction was found in the group. No adverse reaction of the whole body was found in the two groups. The HESCI scores of the patients with eczema and the degree of itching, the area of the skin lesions, the combination of the compound white-cream and the combination of the pratia were excellent.
【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】：2010
【分类号】：R758.23
本文编号：2439577
[Abstract]:Hand eczema (HE), as a common type of localized eczema, has a higher incidence. The particularity of the disease, the cause and the clinical manifestation, the repeated attack of the skin lesion, the difficulty of winding the skin, and the treatment of the skin lesion are quite difficult. At present, as a relatively independent disease, more and more scholars are concerned. External corticosteroids are the most commonly used methods of treatment and require long-term good skin care. However, long-term use of steroids may cause side effects such as skin atrophy, telangiectasia, pigmentation, and the like, and may lead to hormone-dependent, easy-to-relapse after drug withdrawal, and therefore, no matter the patient and the doctor are looking forward to new measures to treat hand eczema. In recent years, some progress has been made in the study of the treatment of hand eczema by traditional Chinese medicine, and a lot of dosage forms have been made, and more methods are provided for the treatment of the disease. Objective The purpose of this study is to evaluate the clinical efficacy and safety of the combination of the compound white paste and the combination of the combination of the compound white paste and the combination of the compound white paste for the treatment of the keratosis eczema of the hand keratosis. In order to further improve the clinical symptoms, the clinical effect and the safety of the compound white-cream combined with the compound white-cream for the treatment of the keratosis eczema of the hand-keratosis were evaluated. The formulation provides the basis for relieving the symptoms of hand eczema, improving the quality of life of patients, and exploring better prevention Measures And a treatment method. The method is a prospective, randomized controlled, single-blind trial, which collects the dermatology of the second middle hospital in Guangdong Province from June 2009 to February 2010. The patients with mild and moderate hand keratosis were randomly divided into two groups according to the criteria for inclusion and exclusion criteria,40 in the treatment group and 40 in the control group, and after the treatment group was cleaned the hand once a day, the skin lesions were once cleaned with a soft extract, and the compound white Paste, and then knead for 1 minute,2 times/ day. After the control group was cleaned daily, the outside of the skin lesion The two groups instructed the patient to pay attention to the hand skin care, to avoid contact with alkaline detergent and chemical products, etc. He was easily sensitized and revisited once a week. The severity index and the degree of itching of the hand eczema of the two groups were assessed after the first visit and four weeks, and the efficacy and safety were evaluated as a result, and all the data were applied to the S PS S17.0 Statistical software analysis. Results treatment In the treatment group, the cure rate of the treatment group was 44.7% and the total effective rate was 92.1%. The cure rate of the control group was 17.9% and the total effective rate was 79.5%. Compared with the control group, the cure rate of the treatment group was 21.1% and the total effective rate was 78.9%. The cure rate of the control group was 7.7% and the total effective rate was 46.2%. There was a significant difference (p = 0.012, p0.05). The level of itching in the treatment group and the control group was significantly reduced before and after the treatment group and the control group (P <0.01). The difference was significant (p = 0.007, p0.01). The treatment group and the control group were compared with the control group before and after the treatment, and the clinical symptoms, the area of the skin lesions and the HESCI scores were decreased to a different extent, and the difference between the two groups was considered to have a significant difference (P0.01). Compared with the control group, the symptom, the area of the skin lesion and the score of the HESCI score were lower, and the treatment group was better than the control group. The results showed that there was a significant difference between the two groups (P0.05). feeling, after continuing to use the medicine, the burning sensation disappears, treatment No adverse reaction was found in the group. No adverse reaction of the whole body was found in the two groups. The HESCI scores of the patients with eczema and the degree of itching, the area of the skin lesions, the combination of the compound white-cream and the combination of the pratia were excellent.
【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】：2010
【分类号】：R758.23
【引证文献】
相关硕士学位论文 前1条
1 郭宇;自拟脾肾双补方治疗更年期手足部慢性湿疹的临床疗效观察[D];北京中医药大学;2013年
，本文编号：2439577
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