化瘀解毒散结饮联合刺络拔罐法治疗脾胃积热型痤疮的临床疗效观察

发布时间：2018-11-17 11:11

【摘要】：痤疮是一种常见的发生于毛囊皮脂腺的慢性炎症性皮肤病,好发于青春期男性和女性,且男性略高于女性。在北方某城市调查了955例受访者,总患病率为59.6%,男性患病率为64.7%,女性为54.8%,呈现出痤疮发病率高,男性较女性稍高的特点。有研究者对大学生进行UPI问卷调查,结果显示痤疮对生活质量的影响,表现在多个方面,例如自信、情绪、社交等,且痤疮对生活的影响程度与其严重程度呈正相关。因此,可以说痤疮不但是患病率高的一种皮肤病,而且其对人的心理和生活质量的影响更是不容小觑,应引起医务工作者的广泛关注。但是,目前痤疮治疗方法种类繁多,疗效不一,化瘀解毒散结饮是临床应用有良好疗效的经验方,通过前期研究,临床已证实化瘀解毒散结饮治疗痤疮安全有效,但是其结合刺络拔罐作为一个整体疗法的作用及优势尚缺少实验研究支持。目的:本研究通过观察化瘀解毒散结饮联合刺络拔罐法治疗脾胃积热型寻常痤疮的临床疗效及对痤疮患者生活质量的影响,探讨本联合疗法治疗痤疮的优势。方法:将2016年4月至2016年12月于我院皮肤科门诊就诊的患者进行筛选,从中挑选出与本课题纳入标准相符合的寻常型痤疮患者60例,将60例受试者随机分为对照组和治疗组,各30例。治疗组予化瘀解毒散结饮联合刺络拔罐法治疗,对照组予化瘀解毒散结饮口服治疗,化瘀解毒散结饮每日1剂,分早晚饭后温服,刺络拔罐法每周治疗—次,两组均治疗4周,观察治疗前后患者的症状、皮损改善情况及DLQI量表评分的变化,将治疗前后皮损积分、症状积分、DLQI量表评分作为观察指标进行对照分析,以此来评价本研究方法对脾胃积热型痤疮的的治疗效果。结果:通过观察4周治疗后的效果,经统计结果,两组患者症状改善总有效率对比,治疗组化瘀解毒散结饮联合刺络拔罐法为86.7%,对照组单服化疲解毒散结饮为73.3%,两组治疗有统计学意义(P0.05),联合疗法优于对照组;两组患者皮损消退率对比,治疗组有效率为83.3%,对照组有效率为73.3%,两组治疗对皮损消退改善有效,但两组差异无统计学意义(P0.05);两组患者治疗前后皮损个数减少情况比较,治疗组皮损减少率为56.37±11.10,对照组皮损减少率为50.81±8.53,两组治疗均有效,治疗组对皮损减少情况优于对照组(P0.05);两组治疗前后皮损积分比较,治疗组皮损积分改善率为58.97± 11.607,对照组皮损积分改善率为52.68±8.46,两组治疗均有效,治疗组对皮损积分改善情况优于对照组(P0.05);两组患者治疗前后症候总积分改善情况比较,治疗组总积分改善率为61.72±10.46,对照组改善率为56.00±7.26,两组治疗均有效,治疗组优于对照组(P0.05);两组患者治疗前后DLQI量表评分改善情况比较,治疗组DLQI改善率为81.10±8.3,对照组为73.87±11.37,可以认为治疗组对痤疮患者DLQI影响程度高于对照组(P0.05)。结论:通过临床试验观察表明,化瘀解毒散结饮联合刺络拔罐法治疗脾胃积热型痤疮安全有效,可以改善患者症状,减少皮损,能改善痤疮对患者生活质量的影响,且联合疗法优于单用化瘀解毒散结饮,值得临床推广。
[Abstract]:Aphtha is a common chronic inflammatory skin disease that occurs in the sebaceous glands of the hair follicle, which is good for adolescent males and females, and is slightly higher in males than in females. A total of 955 respondents were investigated in a city in the north, with a total prevalence of 59.6%, a male prevalence of 65.7% and a female of 54. 8%, showing a high incidence of aphtha and a slightly higher number of men. The results showed that the effect of aphtha on the quality of life, such as self-confidence, emotion, social, etc., was positively related to the degree of life. Therefore, it can be said that the skin-sore is not only a kind of skin disease with high prevalence, but also its influence on the psychological and quality of life of the person is not allowed to be small, it should cause the medical worker's extensive attention. However, the present invention has a wide variety of treatment methods, the curative effect is not one, the blood stasis removing and detoxication and the accumulation of the hard mass are the experience of the clinical application of good curative effect, However, it is still lack of experimental research and support for the effect and advantage of the combination of the acupuncture and cupping as a whole therapy. Objective: To study the clinical effect and the effect of the combination therapy on the quality of life of the patients with heat of the spleen and the stomach by observing the effect of the combination of the blood-stasis removing and the mass-clearing and mass-clearing and the combination of the acupuncture and cupping on the quality of the life of the patients with the heat of the spleen and stomach, and to discuss the advantages of the combination therapy in the treatment of the sore. Methods: From April 2016 to December 2016, the patients who were treated in the Department of Dermatology of our hospital were selected to select 60 cases of the patients with common aphtha according to the standard of the subject, and 60 subjects were randomly divided into the control group and the treatment group, and 30 cases were randomly divided into the control group and the treatment group. The treatment group is used for treating blood stasis, removing toxic substance and resolving hard mass, and is used for the treatment of acupuncture and cupping. The control group is used for the treatment of blood stasis, detoxication, hard mass, oral treatment, blood stasis removing, detoxication, hard mass, and the like, and the two groups are treated once a week for four weeks, and the symptoms of the patients before and after the treatment are observed. The improvement of the lesions and the change of the DLQI scale score were used to compare the scores of skin lesion, symptom and DLQI as the observation index to evaluate the therapeutic effect of this study on the heat type of the spleen and stomach. Results: Through observation of the effect of 4-week treatment, the results showed that the total effective rate of the two groups of patients improved the total effective rate, and the combination of the treatment group with the stasis-removing and detoxication and the mass-clearing and the combination of the two groups was 86.7%. The effective rate of the treatment group was 83.3%, the effective rate of the control group was 73.3%, and the response rate of the two groups was 73.3%. The difference of the two groups was not significant (P0.05), and the number of lesions before and after the treatment of the two groups was less than that of the control group (P0.05). The reduction rate of the skin lesions in the treatment group was 56. 37 to 11. 10, and the reduction rate of the skin lesions in the control group was 50. 81 to 8.53, and the treatment group was more effective in the treatment of the lesions than in the control group (P0.05). The score of the skin lesions in the treatment group was compared with that of the control group (P0.05). The improvement rate of the score of the skin lesions in the treatment group was 58. 97-11.607, In the control group, the improvement rate of the skin lesions was 52. 68 to 8.46, and the two groups were effective. The improvement of the score of the treatment group was better than that of the control group (P0.05). The improvement rate of the total score of the treatment group was 61.72 and 10.46, and the improvement rate of the control group was 6.00, 7.26, respectively. The treatment group was superior to the control group (P0.05). The improvement rate of DLQI in the treatment group was 81.10% and 80.3, and the control group was 73.87-11.37, and it was considered that the effect of the treatment group on the DLQI of the patients with ulcers was higher than that in the control group (P0.05). Conclusion: Through the observation of clinical trials, it is shown that the combination of the combination of the stasis-removing and detoxication, and the combination of the acupuncture and cupping to treat the heat type of the spleen and the stomach is safe and effective, can improve the symptoms of the patients, reduce the skin lesions, can improve the quality of the patients' living, and the combination therapy is superior to that of the single-purpose blood-removing and toxin-removing and hard-resolving hard drink, and is worthy of clinical popularization.
【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】：2017
【分类号】：R275.9

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