石蓝草煎剂加减治疗掌跖脓疱病的临床疗效观察

发布时间：2018-05-14 12:11

  本文选题：石蓝草煎剂 + 白芍总苷胶囊　； 参考：《辽宁中医药大学》2016年硕士论文

【摘要】：目的:掌跖脓疱病是临床上难治性皮肤病之一,皮损侵害患者手掌和足跖部位,影响患者的日常劳作和行走,且病势缠绵难愈,常反复发作,对患者的身心造成严重困扰,降低患者的生活质量。本次研究通过对石蓝草煎剂加减治疗掌跖脓疱病的疗效观察,比较分析中药汤剂与白芍总苷胶囊治疗疗效结果的差异,并作出客观评价,探究一种新的治疗方案,为掌跖脓疱病的治疗和预防提供参考依据。材料与方法:病例选自2014年3月至2015年3月就诊于辽宁中医药大学附属医院皮肤科门诊的72位掌跖脓疱病患者,采用随机化分组方法,将患者分为中药汤剂组(中药组)和白芍总苷组(白芍组)两组,各36例。中药组予中药汤剂(石蓝草煎剂加减:生石膏30g,龙胆草10g,黄芩10g,金银花20g,板蓝根30g,马齿苋30g,车前子30g,苦参10g,滑石粉30g,生地30g,丹皮15g,赤芍15g,白术20g,茯苓20g,砂仁5g,甘草6g)口服,白芍组予白芍总苷胶囊口服,两组均予外用药物辅助治疗,6周一个疗程,共治疗两个疗程。对两个疗程结束时的患者病情状态进行观察并记录评分,治疗结束后随访2次,观察疾病复发情况。结果:1.第一疗程结束时,两组患者皮损表现m-PPPASI评分差异无统计学意义(t=-0.035,P=0.9720.05),中药组总有效率为34.29%,白芍组总有效率为41.67%,表明在用药6周后,石蓝草煎剂加减治疗掌跖脓疱病同白芍总苷胶囊治疗效果相当。2.第二疗程结束时,两组患者皮损表现m-PPPASI评分呈现出显著差异(t=-3.855,P=0.0000.05),中药组总有效率为91.18%,白芍组总有效率为64.51%,表明在用药12周后,石蓝草煎剂加减治疗掌跖脓疱病具有较好疗效。3.治疗结束后,两组患者的瘙痒症状均有所缓解(P=0.0000.05),中药组止痒效果的总有效率为70.59%,白芍组止痒效果的总有效率为45.16%,表明中药汤剂的止痒效果显著优于白芍组。4.两次随访,两组患者的皮损表现评分同治疗结束时相比均有不同程度的升高,但总体分析中药组患者皮损表现评分仍低于白芍组,第二次随访时,中药组复发率为32.14%,白芍组为78.95%,表明中药组的治疗效果优于白芍组。结论:1.石蓝草煎剂加减能够有效改善掌跖脓疱病患者的皮损表现和伴随症状。2.石蓝草煎剂加减治疗掌跖脓疱病效果优于白芍总苷胶囊治疗的疗效,且远期复发率低于白芍组,值得临床推广运用。
[Abstract]:Objective: palmoplantar pustulosis is one of the clinical refractory dermatoses. Skin lesions encroach on the palms and plantar of the patients and affect their daily work and walking. Reduce the quality of life of patients. In this study, we observed the curative effect of the addition and subtraction of Ishizao decoction on palmoplantar pustular disease, compared and analyzed the difference between traditional Chinese medicine decoction and total paeony glucoside capsule, and made an objective evaluation to explore a new treatment scheme. To provide reference for the treatment and prevention of palmoplantar pustulosis. Materials and methods: from March 2014 to March 2015, 72 patients with palmoplantar pustulosis were selected from the dermatology department of affiliated Hospital of Liaoning University of traditional Chinese Medicine. The patients were divided into traditional Chinese medicine decoction group (traditional Chinese medicine group) and total glucoside of paeony group (paeony group) with 36 cases each. The traditional Chinese medicine group was given traditional Chinese medicine decoction (Chinese medicine decoction: raw gypsum 30g, gentian 10g, baicalin 10g, honeysuckle 20g, Isatidis root 30g, purslane 30g, plantain 30g, Sophora flavescens 10g, talcum powder 30g, raw land 30g, danpi 15g, Radix Paeoniae rubra 15g, Atractylodes macrocephalae 20g, Poria Ling 20g, Amomum kernel 5g, licorice 6g). Total glucoside of paeony was given orally in the paeony group and the two groups were treated with external drug adjuvant therapy for 6 weeks and two courses of treatment. The patients were observed and scored at the end of two courses of treatment. The patients were followed up for 2 times to observe the recurrence of the disease. The result is 1: 1. At the end of the first course of treatment, there was no significant difference between the two groups in the m-PPPASI score of skin lesions. The total effective rate in the traditional Chinese medicine group was 34.29 and the total effective rate in the paeoniae peony group was 41.67, indicating that after 6 weeks of treatment, the total effective rate was 34.29 and 41.67 respectively. The curative effect of Shizhicao decoction on palmoplantar pustulosis was equal to that of total paeony glucoside capsule. At the end of the second course of treatment, the m-PPPASI score of skin lesions in the two groups showed significant difference. The total effective rate of the traditional Chinese medicine group was 91.18 and the total effective rate of the white peony root group was 64.51. The results showed that after 12 weeks of treatment, the addition and subtraction of Herba chinensis decoction had a better curative effect on paw and metatarsal pustular pustule. After treatment, the symptoms of pruritus in both groups were alleviated, the total effective rate of antipruritic effect was 70.59 in the Chinese medicine group and 45.16 in the white peony group, indicating that the antipruritus effect of the traditional Chinese medicine decoction was significantly better than that of the paeoniae group. After two follow-up, the scores of skin lesions in both groups were higher than those at the end of treatment, but the scores of skin lesions in the Chinese medicine group were still lower than those in the paeoniae Alba group, and at the second follow-up, the patients in the traditional Chinese medicine group were still lower than those in the control group. The recurrence rate of Chinese medicine group was 32.14 and that of white peony group was 78.95, which indicated that the treatment effect of Chinese medicine group was better than that of white peony root group. Conclusion 1. The addition and subtraction of Herba chinensis decoction can effectively improve the palmoplantar pustulosis patients' skin lesions and accompanying symptoms. 2. 2. The addition and subtraction of Shi Lan Cao decoction in the treatment of palmoplantar pustular disease was better than that of total paeony glucoside capsule, and the long term recurrence rate was lower than that in Paeoniae Alba group, so it was worth popularizing in clinic.
【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】：2016
【分类号】：R275.9
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本文编号：1887795