归灵汤加减治疗血虚风燥型慢性湿疹的临床疗效观察-中医外科学专业论文.docxVIP

成都 成都中医药大学硕士学位论文 万方数据 万方数据 中文摘要 目的：本观察根据“异病同治”的思想，结合对名医辨证论治慢性湿疹 规律总结及导师认识，对《外科正宗》原方归灵汤进行加减，用于治疗血虚 风燥型慢性湿疹并进行相应的临床疗效观察，包括“湿疹面积严重指数”、 瘙痒程度评分等指标，综合评价其疗效及安全性。 方法：将符合条件的 60 例病例，随机分配为两组：治疗组（中药归灵 汤加减组）和对照组（盐酸依匹斯汀组）。两组的外治法相同，均外搽蛇黄 软膏。所有患者每两周复诊一次，观察并记录相关症状与体征变化（皮损面 积、红斑、丘疹、苔藓样变、瘙痒程度等评分变化）。连续治疗并观察 4 周 为一疗程。 结果：（1）通过对临床观察数据的汇总分析，得知治疗组总有效率为 76.67％，对照组总有效率为 56.67％，治疗组总有效率优于对照组总有效 率（P＜0.05）。（2）两组治疗前后各自的 EASI 评分和瘙痒程度评分均有改 善。在 EASI 评分方面，治疗组与对照组比较，差异有统计学意义（P＜0.05）， 表明治疗组药物在改善皮损评分方面优于对照组；在瘙痒程度评分的比较 上，两组之间的差异无统计学意义（P＞0.05），表明两组药物在改善瘙痒 程度方面的效果相当。（3）治疗过程中未见因明显不良反应导致退出试验 者。 结论：（1）归灵汤加减治疗血虚风燥型慢性湿疹与对照组药物的综合疗 效相比效果更明显； （2）本方治疗慢性湿疹有效且不良反应小，有临床推广潜力； （3）本方治疗慢性湿疹再次验证了中医“异病同治”思想，体现了“辨 证论治”是中医临床的核心思维。 关键词： 归灵汤加减 慢性湿疹 血虚风燥证 临床观察 1 Abstract Objective: According to the thought of “different diseases with same treatment”, this clinical observation, based on the summary of TCM masters’ experience of treating eczema as well as my tutor’s, was associated with chronic eczema typical of blood-deficiency and wind-dryness syndrome by the treatment of an oral modified formula called Guiling decoction from a classical book Orthodox Manual of External Medicine written by ChenShigong in Ming dynasty, and to get comprehensive assessment of clinical efficacy including change of EASI and itching-degree scores together with safety. Methods: We recruited 60 eligible patients of chronic eczema, and divided them into two groups randomly with 30 members in each group. Members in the routine group were received by oral formula of modified Guiling decoction, and the control group by oral Epinastine Hydrochloride Tablets. Shehuang ointment was the common external medicine of the two groups. All subjects were required to review their cases in order to observe and record changes of related symptoms and signs including lesions area, erythema, papula, lichenification and itching-degree, etc. The course of treatment for each subject in this clinical trial was set as an internal of four weeks. Result: (1) After analysi