荨麻汤联合依巴斯汀治疗血虚风燥型荨麻疹临床疗效观察

发布时间：2019-04-15 17:46

【摘要】：目的:本文通过对治疗前后各项观测指标的客观评价,研究荨麻汤联合依巴斯汀治疗血虚风燥型荨麻疹的临床疗效,初步探讨中西医结合治疗慢性荨麻疹的特点和优势。方法:病例选取2015年9月—2016年9月就诊于辽宁中医药大学附属医院皮肤科门诊患者,经中医辨证诊为荨麻疹血虚风燥证,符合纳入标准者共计64例。随机分为治疗组(荨麻汤联合依巴斯汀组)和对照组(依巴斯汀组)各32例,疗程8周。根据发病因素和临床症状制定“荨麻疹临床资料调查表”,通过患者各项症状的评分变化,运用统计学方法对风团数目、风团大小、瘙痒程度等积分下降指数以及发病因素、不良反应、复发率等情况进行分析。通过观察实验室指标分析慢性荨麻疹的发病与免疫功能的相关性。结果:1.两组临床疗效比较,经秩和检验P㩳0.05,治疗组(总有效率90.3%)与对照组(总有效率73.3%)治疗前后组内和组间均存在显著性差异。2.治疗8周后两组症状总积分较治疗前均有下降,组内比较存在明显差异(P㩳0.05),组间比较无显著性差异。3.治疗8周后两组间的风团数目、瘙痒程度、发作频率及皮肤划痕征四项观察指标,治疗组明显优于对照组,均有显著性差异(P㩳0.05),其他客观症状组间比较无明显差异。4.停药4周后随访,发现治疗组复发率17.4%,对照组53.3%,两组比较具有显著性差异(P㩳0.05)。5.两组临床资料统计显示,荨麻疹男女性患者分别占比34.4%和65.5%(约1:2),18-35岁年龄段患者占比41.0%,夜间为起病及加重者占比52.4%,因食物和环境因素发病者占总例数的70.5%,91.8%患者就诊前曾服用抗组胺药物。6.实验室指标:IgE、IgA、IgG、IgM阳性率分别为50.8%、42.6%、26.2%、29.5%。7.不良反应发生率:两组比较无显著性差异(P0.05)。结论:1.荨麻汤联合依巴斯汀治疗血虚风燥型荨麻疹的疗效优于单独应用后者,且显著减轻风团数目、发作频率、瘙痒及皮肤划痕征症状,且不良反应轻微,复发率低,值得临床推广应用。2.荨麻疹好发人群的年龄、性别、时间分别集中于中青年女性和夜间,以食物和环境为主要诱发因素。3.免疫球蛋白(血清总IgE、IgA、IgG、IgM)对慢性荨麻疹的发病可能存在一定相关性。
[Abstract]:Objective: to study the clinical efficacy of urticaria decoction combined with ebastin in the treatment of chronic urticaria before and after treatment, and to explore the characteristics and advantages of combination of traditional Chinese and western medicine in the treatment of chronic urticaria. Methods: cases were selected from September 2015 to September 2016 in the outpatient department of dermatology of affiliated Hospital of Liaoning University of traditional Chinese Medicine, and 64 cases were diagnosed as urticaria blood deficiency wind dryness syndrome according to TCM syndrome differentiation. They were randomly divided into two groups: the treatment group (n = 32) and the control group (n = 32). The course of treatment was 8 weeks. According to the factors and clinical symptoms of urticaria, the clinical data questionnaire of urticaria was established. The number of wind masses, the size of wind masses, the degree of itching and the incidence factors were measured by statistical method, through the changes of the scores of each symptom of the patients. Adverse reactions, recurrence rate and so on were analyzed. The correlation between the pathogenesis of chronic urticaria and immune function was analyzed by observing laboratory indexes. Results: 1. The comparison of clinical efficacy between the two groups showed that there was a significant difference between the treatment group (90.3%) and the control group (73.3%) before and after treatment by rank sum test P < 0.05. There was a significant difference between the two groups before and after treatment. 2. After 8 weeks of treatment, the total score of symptoms in the two groups decreased compared with that before treatment, and there was a significant difference between the two groups (P < 0.05), and there was no significant difference between the two groups. After 8 weeks of treatment, the number of wind masses, the degree of pruritus, the frequency of attack and the skin scratch sign between the two groups were significantly higher than those in the control group (P < 0.05), and there was a significant difference between the two groups (P < 0.05). There was no significant difference between other objective symptoms. 4. 4 weeks after withdrawal, the recurrence rate was 17.4% in the treatment group and 53.3% in the control group. There was a significant difference between the two groups (P < 0.05). The clinical data of the two groups showed that male and female patients with urticaria accounted for 34.4% and 65.5% (about 1:2), 18-year-old 35-year-old patients accounted for 41.0%, and night-time onset and aggravation accounted for 52.4%. Food and environmental factors accounted for 70.5% of the total, 91.8% of the patients had taken antihistamines before treatment. 6. Laboratory indexes: the positive rates of IgE,IgA,IgG,IgM were 50.8%, 42.6%, 26.2%, 29.5% respectively. Incidence of adverse reactions: there was no significant difference between the two groups (P0.05). Conclusions: 1. Urticaria decoction combined with ebastin in the treatment of blood-deficiency wind-dryness type urticaria was better than the latter alone, and significantly reduced the number of wind masses, frequency of attacks, itching and skin scratches symptoms, with mild adverse reactions, low recurrence rate. Worthy of clinical popularization and application. 2. Age, sex and time of urticaria-prone population were concentrated in young and middle-aged women and nighttime, respectively, and food and environment were the main inducing factors. Immunoglobulin (serum total IgE,IgA,IgG,IgM) may be associated with the pathogenesis of chronic urticaria.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R758.24

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