足三里自血穴位注射联合药物治疗慢性荨麻疹的临床观察

发布时间：2018-12-26 08:54

【摘要】：研究目的：近年来,较多的学者采用自血、卡介菌多糖核酸注射疗法治疗慢性荨麻疹并取得较好的疗效。但鲜有二者疗效比较的临床研究。本实验分别将其联合以中药配合依巴斯汀为基础的治疗,对比自血和卡介菌多糖核酸治疗慢性荨麻疹的临床疗效,探讨两种疗法治疗慢性荨麻疹的可行性及安全性,为慢性荨麻疹的联合治疗提供参考依据。研究方法：选择符合标准的慢性荨麻疹患者68例,随机分为治疗组34例、对照组34例,治疗组给予中药联合依巴斯汀及自血足三里穴位注射治疗,对照组给予中药联合依巴斯汀及卡介菌多糖核酸注射液足三里穴位注射治疗。观察记录患者治疗前、治疗期间、治疗结束后的症状、体征及不良反应,分别在治疗后的第7、14、28天对疗效和安全性进行评价。疗程结束后,对痊愈患者随访1个月。采用SPSS20.0统计软件进行数据分析。统计学方法采用t检验、秩和检验或卡方检验等。研究结果：共入选病例68例,治疗组和对照组可评价疗效和安全性的病例分别为32、33例。治疗组和对照组治疗前性别、年龄、病程、病情严重程度比较,差异均无统计学意义(P0.05),两组均衡性良好,具有可比性。治疗组在治疗后第7天、第14天、第28天总有效率(痊愈+显效)分别为43.75%、53.13%、84.38%,对照组在治疗后第7天、第14天、第28天分别为39.39%、48.48%、81.82%,治疗组略优于对照组。组间同期比较经卡方检验,χ2值分别为0.022、0.015、0.076,P值分别为0.883、0.903、0.783,差异没有显著性。治疗组治疗后第7、14、28天总有效率分别与治疗前比较,差异具有显著性(均P0.05)。治疗后第7、14天组内比较差异无显著性,第14、28天比较差异具有显著性(χ2=0.567,P=0.451和χ2=8.576,P=0.003)。对照组治疗后第7、14、28天总有效率分别与治疗前比较,差异具有显著性(均P0.05)。治疗后第7、14天组内比较差异无显著性,第14、28天比较差异具有显著性(χ2=0.547,P=0.459和χ2=10.882,P=0.001)。治疗组治疗后第7、14、28天与治疗前比较,各观察指标与总积分均有显著差异(均P0.05)；第7、14天比较,各项指标与总积分均无显著差异(均P0.05)；第14、28天比较,各项指标与总积分均有显著差异(均P0.05)。对照组组内前后比较结果与治疗组相似。组间治疗前后同期比较均无显著差异(均P0.05)。疗程结束1月内随访,治疗组复发2例,对照组复发2例,复发率分别为20%、18.18%。经卡方检验,差异无统计学意义(P0.05)。治疗组与对照组与药物相关的不良反应发生率分别为6.25%、3.03%,两组不良反应发生率的差异无统计学意义(P0.05)。结论：实验证明所采用的两种治疗方案都能有效控制慢性荨麻疹,且不良反应及复发率低,但两种方案的疗效和安全性不具有显著差异。治疗组和对照组均在第7、28天体现出显著的治疗作用,在第14天治疗效果则不明显。表明依巴斯汀对使用该药敏感的患者见效快,中药和穴位注射在治疗慢性荨麻疹时发挥作用相对较慢。由此可见：1、自血和卡介菌多糖核酸穴位注射疗效相近,临床可以根据实际情况进行选择；2、在临床工作中,对经依巴斯汀治疗1-2周效果不明显的患者,可变更抗组胺药的剂量、种类或联用其他抗组胺药；3、中药和穴位注射应当坚持较长时间的疗程,不少于28天。
[Abstract]:Objective: In recent years, more and more scholars have used the self-blood, the BCG polysaccharide nucleic acid injection therapy to treat chronic urticaria and get better curative effect. But there are few clinical studies on the curative effect of the two. This experiment is based on the combination of the traditional Chinese medicine and the bastine, and compared the clinical curative effect of the self-blood and the BCG-polysaccharide nucleic acid in the treatment of chronic urticaria. The feasibility and the safety of the two treatments for the treatment of chronic urticaria are discussed, and the reference basis for the combination therapy of chronic urticaria is provided. Methods: 68 patients with chronic urticaria were randomly divided into treatment group (34 cases) and control group (34 cases). The control group was given a combination of the traditional Chinese medicine and the injection of the polysaccharide nucleic acid injection of ebastine and the BCG. The efficacy and safety were evaluated on the 7th, 14th and 28th day after treatment, before and after the treatment, and the symptoms, signs and adverse reactions after treatment. The patient was followed up for 1 month after the course of treatment. Data analysis was performed using the SPSS10.0 statistical software. The statistical method is t-test, rank sum test or card-side test. The results of the study were as follows: 68 cases were selected, and 32 and 33 cases were evaluated in the treatment group and the control group. The difference of sex, age, course and severity of the treatment group and the control group was not significant (P0.05), and the two groups were well-balanced and comparable. The total effective rate (cure + effect) of the treatment group was 43. 75%, 53. 13%, 84. 38%, respectively, and the control group was 39. 39%, 48. 48%, 81.82%, respectively, and the treatment group was slightly superior to the control group at the 7th day, the 14th day and the 28th day after the treatment. The results showed that the two values were 0.022, 0.015, 0.076 and 0.883, 0.903, and 0.783, respectively, and there was no significant difference between the two groups. The total effective rate of the 7th, 14th and 28th day after treatment in the treatment group was significantly higher than that of the pre-treatment group (P <0.05). There was no significant difference in group 7 and 14 after treatment, and the difference between day 14 and day 28 was significant (Sup2 = 0.567, P = 0.451 and Sup2 = 8.576, P = 0.003). The total effective rate of 7, 14 and 28 days after treatment in the control group was significantly higher than that before treatment (P0.05). There was no significant difference in group 7 and 14 after treatment, and the difference was significant in the 14th and 28th days (Sup2 = 0.547, P = 0.459 and Sup2 = 10.882, P = 0.001). The 7, 14 and 28 days after the treatment group were compared with the pre-treatment, and there was a significant difference between the observation index and the total score (P <0.05). There was no significant difference between the indexes and the total score on the 7th and 14th day (P <0.05), and there was a significant difference between the indexes and the total scores on the 14th and 28th day (all P0.05). The results of the comparison between the control group and the control group were similar to those in the treatment group. There was no significant difference in the group-to-group treatment before and after treatment (P0.05). The recurrence rate of the treatment group was 20% and 18. 18%, respectively. The difference between the two groups was not significant (P0.05). The incidence of adverse reactions in the treatment group and the control group was 6.25% and 3.03%, respectively, and there was no significant difference in the incidence of adverse reactions between the two groups (P0.05). Conclusion: The experimental results show that both treatment regimens can effectively control the chronic urticaria, and the adverse reaction and the recurrence rate are low, but the curative effect and the safety of the two schemes do not have significant difference. The treatment group and the control group showed significant treatment effect on the 7th and 28th objects, and the treatment effect was not obvious on the 14th day. It is shown that the effect of ebastine on the use of the drug is relatively slow in the treatment of chronic urticaria. it can be seen that 1, the curative effect of the self-blood and the BCG polysaccharide nucleic acid acupuncture point injection is similar, the clinic can be selected according to the actual situation, and in the clinical work, the dosage of the antihistamine can be changed for patients with the effect of 1-2 weeks after the ebastine is treated, the type or combination with other antihistamines; and 3, the traditional Chinese medicine and the acupuncture point injection should stick to a long period of treatment, not less than 28 days.
【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】：2016
【分类号】：R246.7

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