温阳除湿汤治疗寒湿蕴脾型慢性湿疹的临床观察及对IFN-γ、IL-4水平影响

发布时间：2018-08-18 11:23

【摘要】：目的:观察温阳除湿汤治疗寒湿蕴脾型慢性湿疹的临床疗效,同时检测慢性湿疹患者治疗前后血清中免疫细胞因子的表达,比较分析治疗前后的变化,以期阐述温阳除湿汤治疗寒湿蕴脾型慢性湿疹的临床疗效及作用机制,为临床治疗慢性湿疹提供一种新的药物和思路。方法:在广西中医药大学第一附属医院皮肤科门诊招募60名寒湿蕴脾型慢性湿疹患者,随机分为治疗组和对照组。治疗组予以温阳除湿汤,每日一剂,免煎颗粒(江阴天江药业有限公司生产)温水冲400ml分早、晚两次内服。对照组予以盐酸左西替利嗪胶囊(规格为5mg/片,由湖南九典制药有限公司生产,国药准字H20060183)温水内服,每次一片,一日一次。治疗28天为一个疗程,共治疗一个疗程。在治疗前、治疗第4周进行EASI、VAS、生活质量评价、慢性湿疹生存质量量表以及中医全身证候积分评分,在治疗结束后第3个月末进行复发情况判定。并观察患者治疗前后外周血IL-4、IFN-γ水平,评价临床疗效。结果:治疗组与对照组治疗前后EASI积分比较,差异均有统计学意义(P0.05)。治疗组与对照组治疗前后中医全身证候积分比较,差异均有统计学意义(P0.05)。治疗4周后,治疗组总有效率为86.66%,对照组为70%,治疗组与对照组总有效率比较差异均有统计学意义(P0.05)。随访3个月,治疗组复发率明显低于对照组复发率,差异均有统计学意义(P0.05)。两组患者治疗后外周血清IL-4水平均降低,IFN-γ水平均升高,差异均有统计学意义(P0.05);两组治疗后比较,治疗组外周血清IL-4低于对照组,IFN-γ水平高于对照组,差异均有统计学意义(P0.05)。结论:(1)温阳除湿汤治疗寒湿蕴脾证慢性湿疹疗效确切,显著优于盐酸左西替利嗪对照组,在改善患者皮损体征,缓解患者临床症状,提高患者生活质量等方面,效果显著。(2)温阳除湿汤可调节外周血IL-4、IFN-γ水平。
[Abstract]:Objective: to observe the clinical effect of Wenyang dehumidification decoction on chronic eczema with cold dampness and spleen accumulation, and to detect the expression of immunocyte cytokines in serum of patients with chronic eczema before and after treatment, and to compare and analyze the changes before and after treatment. The aim is to expound the clinical effect and mechanism of Wenyang dehumidification decoction in treating chronic eczema of the type of cold and dampness retention of spleen, and provide a new medicine and thought for clinical treatment of chronic eczema. Methods: sixty patients with chronic eczema with cold and dampness and spleen were recruited in the dermatology department of the first affiliated Hospital of Guangxi University of traditional Chinese Medicine and randomly divided into treatment group and control group. The treatment group was treated with Wenyang dehumidification decoction, one dose per day, free decoction granule (Jiangyin Tianjiang Pharmaceutical Co., Ltd.) warm water flushing 400ml early and twice later. The control group was treated with levcetirizine hydrochloride capsules (5mg/ tablets, produced by Hunan Jiupin Pharmaceutical Co., Ltd.) and warm water administration of H20060183, one tablet at a time, once a day. Treatment for 28 days as a course of treatment, a total of a course of treatment. Before treatment, EASI VAS4 weeks, quality of life evaluation, chronic eczema quality of life scale and TCM syndromes score, at the end of the third month after treatment to determine the recurrence situation. The levels of IL-4 and IFN- 纬 in peripheral blood were observed before and after treatment to evaluate the clinical efficacy. Results: there were significant differences in EASI scores between the treatment group and the control group before and after treatment (P0.05). Treatment group and control group before and after treatment of TCM systemic syndrome scores, the differences were statistically significant (P0.05). After 4 weeks of treatment, the total effective rate of the treatment group was 86.66, and that of the control group was 70. The total effective rate of the treatment group and the control group were significantly different (P0.05). After 3 months follow-up, the recurrence rate in the treatment group was significantly lower than that in the control group, and the difference was statistically significant (P0.05). After treatment, the levels of IL-4 in peripheral blood of the two groups were significantly lower than those in the control group (P0.05), and the levels of serum IL-4 in the treatment group were significantly lower than those in the control group (P0.05). Conclusion: (1) Wenyang dehumidification decoction is effective in treating chronic eczema with cold dampness and spleen retention syndrome, which is superior to levo-cetirizine hydrochloride control group in improving the signs of skin lesions, relieving the clinical symptoms and improving the quality of life of the patients. (2) Wenyang dehumidification decoction could regulate the level of IFN- 纬 in peripheral blood.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R275.9

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