火针治疗寻常型银屑病（静止期）的临床观察及实验研究

发布时间：2018-06-15 22:59

本文选题：银屑病 + 寻常型　；参考：《成都中医药大学》2013年硕士论文

【摘要】：目的：通过火针与卡泊三醇软膏治疗寻常型银屑病的疗效比较,明确火针治疗寻常型银屑病的疗效。运用咪喹莫特诱导的银屑病动物模型,观察火针治疗银屑病对皮损的病理改变,为火针治疗银屑病提供实验依据。方法：本研究分为临床和实验研究两部分。 1.临床研究：纳入62例患者,随机分为治疗组31例,对照组31例。治疗组采用火针点刺皮损,2周为1个疗程,共治疗3个疗程。对照组采用卡泊三醇软膏(达力士)外搽,每日2次,2周为一个疗程,共治疗3个疗程。分别在治疗前、治疗第2、4、6周进行PASI及瘙痒评分,并记录不良反应,随访2个月。 2.实验研究：将昆明小鼠24只背部去毛约2×2cm2裸露皮肤后单笼饲养。随机分为空白对照组,模型组,空白治疗组,模型治疗组。模型组和模型治疗组于背部涂抹咪喹莫特(Imiquimod,IQM)30mg,每日1次,连续8天。空白组与空白治疗组于背部同等部位等量涂抹凡士林,每日1次,连续8天。空白治疗组和模型治疗组给予火针点刺背部皮损间隔距离0.2cm,每隔2日一次,8天后处死小鼠取背部皮损经苏木精-伊红(hematoxylin and eosin,HE)染色。光镜下进行皮损区域组织病理观察,分析火针对银屑病样皮损的改变。结果：1、治疗组和对照组总有效率分别为83.9%和80.6%,两组疗效差异无统计学意义(P0.05)。两组在各观察时间点上的PASI评分,差异均无统计学意义(P0.05)。瘙痒评分在治疗2、4、6周均呈下降趋势,治疗组均优于对照组差异有统计学意义(P0.05)。随访2个月,两组患者未见复发加重,治疗过程中无严重不良反应。 2、经咪喹莫特乳膏造模后肉眼及镜下均表现出银屑病样皮损,镜下观察表皮典型角化过度、角化不全、棘层增厚、炎性浸润等病理表现；模型治疗组皮损红斑、鳞屑、浸润程度较模型组减轻,镜下观察角化不全、炎性浸润均减轻,棘层厚度较模型组变薄。结论：1.火针治疗有效,对瘙痒症状的改善优于卡泊三醇。 2.同时火针能部分逆转咪喹莫特诱导小鼠银屑病模型的病理改变,其机制有待进一步研究。
[Abstract]:Objective: to compare the efficacy of fire acupuncture and carpotriol ointment in the treatment of psoriasis vulgaris. The animal model of psoriasis induced by Imiquimod was used to observe the pathological changes of psoriasis treated by fire acupuncture. Methods: this study is divided into two parts: clinical and experimental research. 1. Clinical study: 62 patients were randomly divided into treatment group (n = 31) and control group (n = 31). The treatment group was treated with fire acupuncture for 2 weeks and 3 courses of treatment. The control group was treated with carpotriol ointment (Dalius) twice a day for 2 weeks for 3 courses of treatment. PASI and pruritus scores were evaluated before and 4 weeks after treatment, and adverse reactions were recorded and followed up for 2 months. Experimental study: 24 Kunming mice were exposed to naked skin for 2 脳 2cm2 on their back. They were randomly divided into blank control group, model group, blank treatment group and model treatment group. The model group and the model treatment group were smeared with Imiquimodod IQM 30 mg on the back once a day for 8 days. The same amount of vaseline was applied to the back of the blank group and the blank treatment group, once a day for 8 days. The rats in blank treatment group and model group were treated with fire acupuncture for 0.2cm. The mice were killed for 8 days after every 2 days. The lesions were stained by hematoxylin and eosin hehe (hematoxylin and eosin hehe). The pathological changes of psoriatic lesions were analyzed under light microscope. Results the total effective rates of the treatment group and the control group were 83.9% and 80.6%, respectively. There was no significant difference in the curative effect between the two groups (P 0.05). There was no significant difference in PASI score between the two groups at each observation time point (P 0.05). The score of pruritus showed a decreasing trend at 6 weeks after treatment, and the treatment group was better than the control group (P 0.05). After 2 months follow-up, no recurrence and aggravation were found in the two groups, and no serious adverse reactions were observed during the treatment. 2. Psoriatic lesions were observed in the naked eye and under microscope after imiquimod cream, and the typical keratosis of the epidermis was observed under the microscope. The pathological manifestations of keratosis, thickening of spinous layer and inflammatory infiltration were observed in the model group, and the degree of erythema, scale and infiltration in the model group was less than that in the model group, the keratosis was not complete and inflammatory infiltration was alleviated under microscope, and the thickness of the spinous layer was thinner than that in the model group. Conclusion 1. Fire acupuncture treatment is effective, the improvement of pruritus symptoms is better than carpotriol. 2. At the same time, fire acupuncture can partially reverse the pathological changes of mice psoriasis model induced by Imiquimod, and its mechanism needs further study.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R246.7

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