目的：探讨养血祛邪汤联合盐酸西替利嗪治疗血虚风燥证中重症湿疹性皮炎（moderately severe eczematous dermatitis,MSED）患者的临床效果,并分析其对皮肤屏障功能的影响。方法：将我院2019年9月—2023年9月收治的94例MSED患者按随机数字表法分为对照组（47例）与观察组（47例）,对照组给予盐酸西替利嗪治疗,观察组采取养血祛邪汤联合盐酸西替利嗪治疗。治疗4周,评估两组临床疗效、中医证候积分、皮肤屏障指标、湿疹面积和严重程度指数（eczema area and severity index,EASI）、湿疹严重程度评分（scoring atopic dermatitis,SCORAD）、整体评分（investigator's global assessment,IGA）、皮肤病生活质量指数（dermatology life quality index,DLQI）、皮损和瘙痒评分、血清炎症因子水平,并记录不良反应发生情况。结果：观察组与对照组相比总有效率更高（95.74％ vs 80.85％）,差异具有统计学意义。相比对照组,观察组治疗后主症、次症、舌脉象、总分均明显更低;观察组治疗后角质层含水量、皮肤油脂水平均更高,经皮水分丢失水平更低;观察组治疗后EASI、SCORAD、IGA、DLQI评分均更低;观察组治疗后色泽、面积、瘙痒、总积分均更低;观察组治疗后血清炎症因子肿瘤坏死因子-α（tumor necrosis factor-α,TNF-α）、白细胞介素-4（interleukin-4,IL-4）、嗜酸细胞阳离子蛋白（eosinophil cationic protein,ECP）水平均更低。观察组不良反应发生率与对照组比较（4.26% vs 12.77%）,无明显差异。结论：养血祛邪汤联合盐酸西替利嗪治疗血虚风燥证MSED患者临床疗效确切,改善症状和皮肤屏障功能,调节炎症因子,提高生活质量,安全性较好。
Abstract
Objective This study aimed to evaluate the clinical efficacy of Yangxue Quxie Decoction combined with cetirizine hydrochloride in treating patients with moderately severe eczematous dermatitis (MSED) with blood deficiency and wind-dryness syndrome, and to assess its impact on skin barrier function. Methods Ninety-four patients with MSED, admitted to our hospital between September 2019 and September 2023, were randomly divided into two groups: a control group (47 cases) treated with cetirizine hydrochloride, and an observation group (47 cases) receiving a combination of Yangxue Quxie Decoction and cetirizine hydrochloride. After four weeks of treatment, clinical efficacy, Traditional Chinese Medicine (TCM) syndrome scores, skin barrier indicators, eczema area and severity Index (EASI), scoring atopic dermatitis (SCORAD), investigator's global assessment (IGA), Dermatology Life Quality Index (DLQI), skin lesion and pruritus scores, serum inflammatory markers, and adverse events were evaluated. Results The observation group had a higher overall efficacy rate compared to the control group (95.74% vs 80.85%), with a statistically significant difference. In addition, the observation group exhibited significantly lower TCM syndrome scores (main and secondary symptoms, tongue, and pulse characteristics). Post-treatment, the observation group had higher skin hydration and sebum levels, and reduced transepidermal water loss. EASI, SCORAD, IGA, DLQI scores, and serum levels of tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4), and eosinophil cationic protein (ECP) were also significantly lower. Adverse event rates were comparable between the groups (4.26% vs 12.77%). Conclusion Yangxue Quxie Decoction combined with cetirizine hydrochloride demonstrates clear clinical efficacy in treating MSED, improving symptoms and skin barrier function, regulating inflammatory factors, and enhancing quality of life, with good safety.
关键词
养血祛邪汤 /
盐酸西替利嗪 /
重症湿疹性皮炎 /
皮肤屏障功能 /
疗效
Key words
Yangxue quxie decoction /
cetirizine hydrochloride /
moderately severe eczematous dermatitis /
skin barrier function /
therapeutic efficacy
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基金
河北省中医药管理局科研计划项目“刘建设教授固本祛邪法治疗湿疹性皮炎临床研究”（2020602）
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