加味四妙勇安汤治疗湿热毒蕴型白塞病的临床观察

发布时间：2018-06-05 19:49

本文选题：白塞病 + 湿热毒蕴　；参考：《中国中医科学院》2016年硕士论文

【摘要】：目的：观察加味四妙勇安汤治疗湿热毒蕴型白塞病的有效性和安全性。方法：于2015年3月至2016年3月期间中国中医科学院西苑医院风湿科门诊及病房就诊的白塞病患者,选取其中符合纳入标准的50例,根据有无服用西药分为中西药组和中药组,中药组予加味四妙勇安汤颗粒剂口服,中西药组在原有西药的基础上加用加味四妙勇安汤,疗程为4周,观察治疗前后症状体征积分变化,记录实验室疗效指标、安全性指标及不良反应,对结果进行统计分析。结果：组内治疗前后自身症状体征积分比较,发现两组在总积分、口腔溃疡、皮肤病变、关节肿痛、烦躁及乏力方面差异均具有统计学意义；此外,中药组在口苦、大便干结、大便稀溏方面差异具有统计学意义,中西药组在外阴溃疡、神疲、口干及失眠多梦方面差异具有统计学意义,其治疗后积分要显著低于治疗前,说明两组在改善患者症状体征方面均有效果,且有所侧重。组内治疗前后实验室疗效指标比较,中西药组的血沉改变有统计学差异,说明中西药组可使患者血沉下降。中药组的血沉改变,以及两组的C-反应蛋白改变均无统计学差异。中药组总有效率82.60%,中西药组总有效率88.50%,两组治疗均有效,总有效率差异无显著统计学意义。组间症状体征积分差值比较发现,两组总积分改善情况无显著差异。中药组大便稀溏积分增加多于中西药组,说明中药组能促使患者排便。其余各症状体征积分的差值比较无显著差异。两组病例治疗前后血沉及C-反应蛋白差值比较均无显著差异,两组对ESR及CRP的影响相当。在安全性方面,中西药组存在肝损害、白细胞升高的可能,中药组安全性较高。结论：加味四妙勇安汤治疗白塞病疗效确切,安全性好。
[Abstract]:Objective: to observe the efficacy and safety of modified Simiao Yong an decoction in the treatment of damp-heat toxin accumulated Behcet's disease. Methods: from March 2015 to March 2016, 50 patients with Behcet's disease were selected from the Department of Rheumatology, Xiyuan Hospital, Chinese Academy of traditional Chinese Medicine. The traditional Chinese medicine group was treated with modified Simiao Yong an decoction orally, and the Chinese and western medicine group was treated with modified Simiao Yong an decoction on the basis of the original western medicine. The course of treatment was 4 weeks. The changes of symptoms and signs were observed before and after treatment, and the laboratory curative effect indexes were recorded. Safety indexes and adverse reactions were analyzed statistically. Results: there were significant differences in total score, oral ulcer, skin lesion, joint swelling and pain, irritability and fatigue between the two groups before and after treatment. There were significant differences in loose stools between Chinese and western medicine groups in vulvar ulcers, fatigue, dry mouth and insomnia, and the scores after treatment were significantly lower than those before treatment. The results showed that the two groups were effective in improving the symptoms and signs of the patients. The changes of ESR in Chinese and western medicine group were significantly different before and after treatment, indicating that the ESR of patients in TCM group could be decreased. There was no significant difference in ESR and C-reactive protein between the two groups. The total effective rate of traditional Chinese medicine group was 82.60 and that of Chinese and western medicine group was 88.50. The two groups were all effective, and the total effective rate had no significant difference. There was no significant difference in the improvement of the total score between the two groups. The scores of loose stool in TCM group increased more than those in TCM group, indicating that TCM group can promote defecation. There was no significant difference in the scores of other symptoms and signs. There was no significant difference in ESR and C-reactive protein difference between the two groups before and after treatment. The effects on ESR and CRP were similar between the two groups. In terms of safety, liver damage and leukocytosis may occur in Chinese and western medicine group, and higher safety in traditional Chinese medicine group. Conclusion: modified Simiao Yong an decoction is effective and safe in the treatment of Behcet's disease.
【学位授予单位】：中国中医科学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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