中医治疗慢性荨麻疹90例临床观察发表时间:2019-05-15T09:10:42.827Z 来源:《中国结合医学》2019年第03期作者:赵云慧[导读] 以“调和营卫”方药为主,中医时间用药、健康教育为辅的中医综合治疗方案对昼夜节律性发作的慢性荨麻疹临床症状改善及降低复发率均有较好的作用,但其远期疗效及对患者生活质量的改善有待通过进一步临床观察来验证和阐明。
哈尔滨仁济中医门诊部黑龙江哈尔滨 150000摘要:目的:根据前期临床调查研究总结出的慢性荨麻疹证候规律,结合中医时间医学相关理论和心理、生活方式等相关影响因素,制定以“调和营卫”方药为主,中医时间医学干预、健康教育为辅的昼夜节律性发作的慢性荨麻疹中医综合治疗方案;并通过临床试验探讨其对改善患者临床症状,降低复发率的作用。
方法:制定慢性荨麻疹中医综合治疗方案,临床研究选取慢性荨麻疹患者90例,随机分为试验组和对照组,其中试验组45例,给予中医综合治疗方案;对照组45例,给予西药治疗。
治疗期4周,观察患者治疗前后主客观症状变化,并随访4周,观察两组的复发率。
结果:试验组痊愈10例,显效20例,有效10例,无效5例;对照组痊愈10例,显效12例,有效8例,无效15例,治疗后两组症状均有改善,试验组优于对照组,差异有统计学意义(P<0.05)。
疗程结束1月后,试验组复发2例(4.44%),对照组复发5例(11.11%),试验组复发率低于对照组,差异有统计学意义(P<0.05)。
结论:以“调和营卫”方药为主,中医时间用药、健康教育为辅的中医综合治疗方案对昼夜节律性发作的慢性荨麻疹临床症状改善及降低复发率均有较好的作用,但其远期疗效及对患者生活质量的改善有待通过进一步临床观察来验证和阐明。
关键词:慢性荨麻疹;中医药治疗效果Clinical observation on 90 cases of chronic urticaria treated with traditional Chinese medicineAbstract: objective: according to the preliminary clinical study sums up the law of syndrome of chronic urticaria, combining with the relevant theory and psychological time medicine of traditional Chinese medicine, way of life and related factors of set to "reconcile the camp who" give priority to, the formulas of traditional Chinese medicine medical intervention, health education as the auxiliary time of the onset of chronic circadian rhythm sex urticaria integrated treatment of traditional Chinese medicine;And through clinical trials to explore its effect on improving patients' clinical symptoms and reducing the recurrence rate.Methods: a comprehensive treatment program of traditional Chinese medicine for chronic urticaria was developed. 90 patients with chronic urticaria were randomly divided into the experimental group and the control group in the clinical study. 45 patients in the experimental group were given a comprehensive treatment program of traditional Chinese medicine.45 patients in the control group were treated with western medicine.The patients' subjective and objective symptoms were observed before and after the treatment for 4 weeks, and the recurrence rates of the two groups were observed during the follow-up for 4 weeks.Results: in the experimental group, 10 cases were cured, 20 cases were obviously effective, 10 cases were effective and 5 cases were invalid.In the control group, 10 cases were cured, 12 cases were obviously effective, 8 cases were effective, and 15 cases were ineffective. After treatment, symptoms in both groups were improved, and the experimental group was superior to the control group, with statistically significant differences (P < 0.05).One month after the end of the treatment course, there were 2 cases of recurrence in the experimental group (4.44%), and 5 cases of recurrence in the control group (11.11%). The recurrence rate in the experimental group was lower than that in the control group, and the difference was statistically significant (P < 0.05).Conclusion: in order to "reconcile the camp who" give priority to, the formulas of TCM drugs, health education as the auxiliary time of comprehensive treatment of traditional Chinese medicine for the onset of chronic circadian rhythm sex urticaria clinical symptoms improved and reduce the recurrence rate has a good effect, but the long-term curative effect and to improve patients quality of life yet to be proved by further clinical observation and clarify.Keywords: chronic urticaria;Therapeutic effect of traditional Chinese medicine前言:荨麻疹是一种常见的变态反应性疾病,俗称“风疹块”,是由于皮肤、黏膜小血管反应性扩张及渗透性增加而产生的一种局限性水肿反应。
慢性荨麻疹表现为皮肤反复发生风团伴剧烈瘙痒,持续6周以上[1]。
因其病因与发病机制复杂,约四分之三的患者不能找到病因,故治疗上颇为棘手。
该病发病率高,病程长,患者心身症状突出加之无特异性有效防治措施,常迁延不愈,给病人的工作和生活带来许多不便和负面影响,容易导致心理障碍,严重影响患者生存质量,也加重了社会经济负担。
笔者从2017年6月至2018年6月在内科病房及门诊以中医辨证论治方法治疗慢性算麻疹90例,效果较满意,现总结报道如下。
1、一般资料与方法1.1一般资料两组共计90例,均为确诊的慢性荨麻疹患者。
其中男性患者45例(50.00%),女性患者为45例(50.00%),平均年龄35岁,最大59岁,最小19岁,平均病程4月,最长9月,最短1.5月。
试验组45例,男性20例,女性25例,年龄(33.73±9.824)岁,病程(3.91±1.822)月;对照组45例,男性25例,女性20例,年龄(36.97±10.540)岁,病程(4.13±2.094)月,两组在性别、年龄、病程等一般资料方面经检验差异均无统计学意义(P>0.05),具有齐同可比性。
1.2方法根据本课题的特点,结合中医治疗慢性荨麻疹的前期临床观察及相关临床研究文献[2],每组至少需纳入病例45例,考虑到失访和脱落等因素的影响,设计纳入病例共90例,其中试验组和对照组各45例。
最终本研究共收集病例90例,其中试验组45例;对照组45例。
试验组予以桂枝汤加减方为主,配合健康教育、中医时间医学干预的慢性荨麻疹中医综合治疗方案,对照组给予赛庚啶+氯雷他定+西咪替丁联合疗法。
治疗期均为4周,随访4周。
试验组服用桂枝汤加减方,每日一剂,每剂水煎2次,取汁300ml,分早晚二次温服,每次150ml。
同时给予中医时间医学干预和健康教育治疗期间停用其它一切药物。
对照组给予三联疗法,即:盐酸赛庚啶片+氯雷他定胶囊+西咪替丁片联合疗法。
盐酸赛庚啶片,规格:2mg,用法:1次2mg,每日1次;氯雷他定胶囊(深圳海王药业有限公司),规格:10mg,用法:1次10mg,每日1次;西咪替丁片(天津太平洋制药),规格:200mg,用法:1次200mg,每日2次。