冰醋酸联合清热利湿中药外用治疗肠胃湿热型痤疮机理探究

发布时间：2019-06-15 17:40

【摘要】： 目的：通过临床观察和动物实验,观察0.5%冰醋酸联合清热利湿中药方剂(以茵陈蒿汤为基础方剂)治疗肠胃湿热型痤疮的临床疗效及0.5%冰醋酸联合清热利湿中药外用对动物皮脂腺斑的作用,探究0.5%冰醋酸联合清热利湿中药外用对肠胃湿热型痤疮的治疗机理。方法：临床观察：62例临床确定为肠胃湿热型痤疮患者,随机分为试验组与对照组,试验组给予清热利湿中药方剂口服,同时隔日给予0.5%冰醋酸联合清热利湿中药外敷痤疮皮疹,每次30分钟；对照组给予单纯口服上述中药汤剂,连续观察4周,判定用药后皮肤情况,评价疗效。实验研究：选用金黄地鼠背部皮脂腺斑作为痤疮模型,将30只金黄地鼠随机分为5组,每组6只,分别为0.5%冰醋酸组、中药组、0.1%冰醋酸联合中药组、0.5%冰醋酸联合中药组、正常对照组,通过在金黄地鼠背部皮脂腺斑处分别外敷0.5%冰醋酸、蒸馏水联合中药、0.1%冰醋酸联合中药、0.5%冰醋酸联合中药以及蒸馏水,隔日一次,每次30分钟,4周后取金黄地鼠背部皮脂腺斑,经过固定、染色、切片,制成病理图片,借助于图像分析系统,观察皮脂腺斑的微观结构变化。结论：临床试验：试验组明显优于对照组(P0.05),说明对于肠胃湿热型痤疮患者在口服中药汤剂基础上增加0.5%冰醋酸联合清热利湿中药外用有利于痤疮治疗,优于单纯口服清热利湿中药汤剂者。动物试验：0.5%冰醋酸联合清热利湿中药外用能够使金黄地鼠背部皮脂腺斑角质层厚度变薄,毛囊皮脂腺漏斗部角质细胞堆积减少,脱离,毛囊内的角化物质明显减少,皮脂腺细胞缩小,明显优于其它组,其次为0.1%冰醋酸联合中药组和纯中药组亦有明显疗效,两组之间比较无明显差异,0.5%冰醋酸单纯外用仅仅能够使角质细胞层细胞粘合作用减弱,角质细胞层疏松,蒸馏水组对皮脂腺斑无作用。
[Abstract]:Objective: to observe the clinical effect of 0.5% acetic acid combined with traditional Chinese medicine for clearing heat and dampness (based on Yinchenhao decoction) in the treatment of acne due to gastrointestinal dampness and heat and dampness, and to explore the therapeutic mechanism of 0.5% acetic acid combined with traditional Chinese medicine for clearing away heat and dampness on acne due to dampness and dampness of intestines and stomach, and to explore the therapeutic mechanism of 0.5% acetic acid combined with traditional Chinese medicine for clearing heat and dampness on acne due to dampness and heat in intestines and stomach. Methods: clinical observation: 62 patients with acne of gastrointestinal dampness and heat were randomly divided into experimental group and control group. The experimental group was given Qingre and dampness prescription, and 0.5% acetic acid combined with clearing heat and dampness traditional Chinese medicine was given to acne rash every other day for 30 minutes. The control group was treated with the above traditional Chinese medicine decoction for 4 weeks, the skin condition after treatment was judged and the curative effect was evaluated. Experimental study: 30 golden hamsters were randomly divided into 5 groups with 0.5% acetic acid group, traditional Chinese medicine group, 0.1% acetic acid combined with traditional Chinese medicine group, 0.5% glacial acetic acid combined with traditional Chinese medicine group and normal control group by external application of 0.5% glacial acetic acid and distilled water to the back sebaceous gland spot of golden hamster, and 30 golden hamsters were randomly divided into 5 groups with 0.5% glacial acetic acid, distilled water and traditional Chinese medicine, respectively, and the other 30 golden hamsters were randomly divided into 5 groups with 0.5% glycolic acid group, 0.1% acetic acid combined with traditional Chinese medicine group, 0.5% acetic acid combined with traditional Chinese medicine group and normal control group. 0.1% acetic acid combined with traditional Chinese medicine, 0.5% acetic acid combined with traditional Chinese medicine and distilled water, once every other day for 30 minutes, 4 weeks later, the back sebaceous gland spot of golden hamster was taken and fixed, stained and sliced to make pathological pictures. With the help of image analysis system, the microstructure of sebaceous gland spot was observed. Conclusion: the clinical trial: the experimental group is obviously superior to the control group (P 0.05), indicating that the addition of 0.5% acetic acid combined with Qingre and dampness Chinese medicine is beneficial to the treatment of acne on the basis of oral traditional Chinese medicine decoction, and is superior to the simple oral Qingre and dampness traditional Chinese medicine decoction. Animal experiment: 0.5% acetic acid combined with traditional Chinese medicine for clearing heat and dampness could make the thickness of keratin layer of sebaceous gland on the back of golden hamster thinner, the accumulation of keratinocytes in funnel part of hair follicles decreased, detachment, the keratinizing substance in hair follicles decreased obviously, the sebaceous gland cells decreased obviously, which was obviously better than that in other groups, followed by 0.1% acetic acid combined with traditional Chinese medicine group and pure traditional Chinese medicine group, and there was no significant difference between the two groups. 0.5% acetic acid alone could only weaken the adhesion of keratinocyte layer and loose keratinocyte layer. Distilled water group had no effect on sebaceous gland spot.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R758.733

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