火针加灸法为主治疗神经性皮炎的疗效及对外周血Th1/Th2细胞调控的影响
|
摘要
目的观察火针加灸法联合清肝益肤汤治疗肝郁化火型神经性皮炎患者的临床疗效及对外周血Th1/Th2细胞调控的影响。方法选取肝郁化火型神经性皮炎患者共80例,按随机数字表法分为对照组和观察组,每组40例。对照组采用口服中药清肝益肤汤治疗,观察组在对照组的基础上给予火针加灸法治疗,疗程均为8周。比较两组疗效,比较两组治疗前后血清中细胞因子干扰素-γ(IFN-γ)、白细胞介素-2(IL-2)、白细胞介素-4(IL-4)和白细胞介素-5(IL-5)水平的变化。结果观察组总有效率为92.5%,高于对照组的75.0%(P<0.05);观察组治疗后皮损积分及症状积分的降低均比对照组显著(P<0.05);治疗后IFN-γ、IL-2较治疗前明显升高(P<0.05),且观察组高于对照组(P<0.05);两组治疗后IL-4、IL-5明显低于治疗前(P<0.05),且观察组低于对照组(P<0.05)。结论火针加灸法联合清肝益肤汤治疗肝郁化火型神经性皮炎疗效确切,能改善患者外周血Th1、Th2细胞因子水平。
Objective To observe the clinical efficacy of fire-needle acupuncture plus moxibustion and Qinggan Yifu decoction in treating neurodermatitis due to depressed liver-qi transforming into fire and its regulation of Th1/Th2 cells in peripheral blood. Method Eighty patients with neurodermatitis due to depressed liver-qi transforming into fire were divided into a control group and an observation group by the random number table method, with 40 cases in each group. The control group was intervened by oral administration of Qinggan Yifu decoction, and the observation group was additionally given fire-needle acupuncture plus moxibustion, both for 8 weeks. The therapeutic efficacies were compared, as well as the post-treatment changes in serum cytokines interferon(IFN)-γ, interleukin(IL)-2, IL-4 and IL-5. Result The total effective rate was 92.5% in the observation group, higher than 75.0% in the control group(P<0.05); the decreased in skin lesion score and symptom score in the observation group were more significant than those in the control group(P<0.05); the levels of IFN-γ and IL-2 increased significantly after treatment(P<0.05), and the observation group was higher than the control group(P<0.05); the levels of IL-4 and IL-5 dropped significantly after treatment(P<0.05), and the observation group was lower than the control group(P<0.05). Conclusion Fire-needle acupuncture plus moxibustion and Qinggan Yifu decoction is effective for neurodermatitis due to depressed liver-qi transforming into fire. It can improve the Th1 and Th2 cytokine levels in peripheral blood.
Objective To observe the clinical efficacy of fire-needle acupuncture plus moxibustion and Qinggan Yifu decoction in treating neurodermatitis due to depressed liver-qi transforming into fire and its regulation of Th1/Th2 cells in peripheral blood. Method Eighty patients with neurodermatitis due to depressed liver-qi transforming into fire were divided into a control group and an observation group by the random number table method, with 40 cases in each group. The control group was intervened by oral administration of Qinggan Yifu decoction, and the observation group was additionally given fire-needle acupuncture plus moxibustion, both for 8 weeks. The therapeutic efficacies were compared, as well as the post-treatment changes in serum cytokines interferon(IFN)-γ, interleukin(IL)-2, IL-4 and IL-5. Result The total effective rate was 92.5% in the observation group, higher than 75.0% in the control group(P<0.05); the decreased in skin lesion score and symptom score in the observation group were more significant than those in the control group(P<0.05); the levels of IFN-γ and IL-2 increased significantly after treatment(P<0.05), and the observation group was higher than the control group(P<0.05); the levels of IL-4 and IL-5 dropped significantly after treatment(P<0.05), and the observation group was lower than the control group(P<0.05). Conclusion Fire-needle acupuncture plus moxibustion and Qinggan Yifu decoction is effective for neurodermatitis due to depressed liver-qi transforming into fire. It can improve the Th1 and Th2 cytokine levels in peripheral blood.
引文
[1]李敏,周琦.神经性皮炎中医治疗进展[J].实用中医药杂志,2013,29(1):73-74.
[2]闫科列.牛皮癣的病因与治疗[J].科学中国人,1999,(6):33-34.
[3]王文霞,张春艳.火针为主治疗神经性皮炎体会[J].中国中医基础医学杂志,2015,(1):83-84.
[4]王兆阳,王洪环.顽癣灵软膏治疗神经性皮炎36例疗效观察[J].内蒙古中医药,1997,(3):12.
[5]封晓红,邱渝.梅花针治疗神经性皮炎的临床进展[J].世界最新医学信息文摘(电子版),2018,18(58):58-59.
[6]官扬,官昌,何洁,等.神经性皮炎临床治疗研究进展[J].江西中医药,2013,44(10):79-80.
[7]胡银娥.羌月乳膏治疗慢性单纯性苔藓的临床观察[J].中药药理与临床,2015,31(6):195-197.
[8]尤敏玲.神经性皮炎的中医药治疗近况[J].内蒙古中医药,2004,(4):32-34.
[9]李敏,周琦.神经性皮炎中医治疗进展[J].实用中医药杂志,2013,29(1):73-74.
[10]江善明,吴艳华,李其林,等.神经性皮炎的病因及发病机制研究进展[J].湖南中医杂志,2017,(6):205-207.
[11]廖人燕,何跃,唐定书,等.刮痧疗法治疗神经性皮炎的机理探讨[J].光明中医,2010,25(6):1124-1125.
[12]刘扬声.神经性皮炎的患病率调查及其危险因素分析[J].山西医科大学学报,2017,48(2):167-171.
[13]王丹,闵玮,冯雪梅.卡泊三醇软膏联合糠酸莫米松软膏外用治疗神经性皮炎疗效观察[J].中国美容医学,2015,24(2):34-36.
[14]温伟伦,吴艳华,孟珍珍.火针疗法配合中药汤剂对中医血虚风燥型患者神经性皮炎的临床疗效评价[J].抗感染药学,2018,15(7):1200-1202.
[15]梁凡.针灸治疗神经性皮炎的临床研究进展[J].四川中医,2014,(1):183-185.
[16]王云娜,黎波,杜元灏,等.针灸治疗神经性皮炎临床随机对照试验疗效及安全性评价[J].辽宁中医杂志,2009,(12):2160-2163.
[17]赵辨.中国临床皮肤病学[M].南京:江苏科学技术出版社,2010:705-706.
[18]杨志波,范瑞强,邓丙戌.中医皮肤性病学[M].北京:中国中医药出版社,2010:128-130.
[19]赵辨.湿疹面积及严重度指数评分法[J].中华皮肤科杂志,2004,(37):3-4.
[20]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:277-278.
[21]王帅.清肝疗癣汤联合火针治疗局限性神经性皮炎的临床观察[D].哈尔滨:黑龙江中医药大学,2017.
[22]尹鑫莹.两种药物联合治疗神经性皮炎和慢性湿疹效果观察[J].中国卫生标准管理,2019,10(5):62-64.
[23]葛帮友,刘影.药物联合心理干预治疗神经性皮炎临床研究[J].中国麻风皮肤病杂志,2016,32(9):573-573,576.
[24]刘中华.神经性皮炎药物治疗的临床应用[J].航空航天医学杂志,2014,25(7):978-979.
[25]杨文峰.火针烙法治疗局限性神经性皮炎(肝郁化火证)的临床研究[D].成都:成都中医药大学,2017.
[26]梁瑞,张荣,石家宴,等.激光联合紫外线对神经性皮炎的疗效分析[J].中国医学创新,2016,13(22):124-126.
[27]王剑.液氮冷冻联合左西替利嗪片治疗神经性皮炎临床观察[J].中国初级卫生保健,2012,26(8):119-120.
[28]王梦.火针结合穴位注射治疗神经性皮炎的临床疗效及随访研究[D].成都:成都中医药大学,2015.
[29]杨健生.针刺治疗肝郁化火型神经性皮炎疗效观察[D].广州:广州中医药大学,2015.
[30]毕斌,樊超.清肝疗癣汤联合火针治疗局限性神经性皮炎的临床观察[J].中医临床研究,2018,10(22):76-77.
[31]翟炎冰,刘志顺.针灸治疗神经性皮炎诊疗特点文献分析[J].吉林中医药,2015,35(2):193-195.
[32]姜颖娟,李元文,孙占学,等.清肝益肤汤联合甘石青黛膏治疗神经性皮炎肝郁化火型82例[J].中医杂志,2011,52(24):2136-2137.
[33]江善明,吴艳华,李其林,等.神经性皮炎的病因及发病机制研究进展[J].湖南中医杂志,2017,33(6):205-207.
[34]李纬,张丰川,李元文.青石止痒软膏联合消风止痒汤加减治疗神经性皮炎的疗效评价[J].中国实验方剂学杂志,2017,23(21):194-199.
[35]李超然,仇立波,张秦宏,等.火针疗法治疗皮肤病概况[J].山东中医杂志,2015,34(4):313-314.
[36]樊蔷薇.他克莫司软膏治疗皮炎湿疹的疗效及对外周血Th1、Th2细胞因子水平的影响[J].医学综述,2016,22(3):596-599.
[2]闫科列.牛皮癣的病因与治疗[J].科学中国人,1999,(6):33-34.
[3]王文霞,张春艳.火针为主治疗神经性皮炎体会[J].中国中医基础医学杂志,2015,(1):83-84.
[4]王兆阳,王洪环.顽癣灵软膏治疗神经性皮炎36例疗效观察[J].内蒙古中医药,1997,(3):12.
[5]封晓红,邱渝.梅花针治疗神经性皮炎的临床进展[J].世界最新医学信息文摘(电子版),2018,18(58):58-59.
[6]官扬,官昌,何洁,等.神经性皮炎临床治疗研究进展[J].江西中医药,2013,44(10):79-80.
[7]胡银娥.羌月乳膏治疗慢性单纯性苔藓的临床观察[J].中药药理与临床,2015,31(6):195-197.
[8]尤敏玲.神经性皮炎的中医药治疗近况[J].内蒙古中医药,2004,(4):32-34.
[9]李敏,周琦.神经性皮炎中医治疗进展[J].实用中医药杂志,2013,29(1):73-74.
[10]江善明,吴艳华,李其林,等.神经性皮炎的病因及发病机制研究进展[J].湖南中医杂志,2017,(6):205-207.
[11]廖人燕,何跃,唐定书,等.刮痧疗法治疗神经性皮炎的机理探讨[J].光明中医,2010,25(6):1124-1125.
[12]刘扬声.神经性皮炎的患病率调查及其危险因素分析[J].山西医科大学学报,2017,48(2):167-171.
[13]王丹,闵玮,冯雪梅.卡泊三醇软膏联合糠酸莫米松软膏外用治疗神经性皮炎疗效观察[J].中国美容医学,2015,24(2):34-36.
[14]温伟伦,吴艳华,孟珍珍.火针疗法配合中药汤剂对中医血虚风燥型患者神经性皮炎的临床疗效评价[J].抗感染药学,2018,15(7):1200-1202.
[15]梁凡.针灸治疗神经性皮炎的临床研究进展[J].四川中医,2014,(1):183-185.
[16]王云娜,黎波,杜元灏,等.针灸治疗神经性皮炎临床随机对照试验疗效及安全性评价[J].辽宁中医杂志,2009,(12):2160-2163.
[17]赵辨.中国临床皮肤病学[M].南京:江苏科学技术出版社,2010:705-706.
[18]杨志波,范瑞强,邓丙戌.中医皮肤性病学[M].北京:中国中医药出版社,2010:128-130.
[19]赵辨.湿疹面积及严重度指数评分法[J].中华皮肤科杂志,2004,(37):3-4.
[20]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:277-278.
[21]王帅.清肝疗癣汤联合火针治疗局限性神经性皮炎的临床观察[D].哈尔滨:黑龙江中医药大学,2017.
[22]尹鑫莹.两种药物联合治疗神经性皮炎和慢性湿疹效果观察[J].中国卫生标准管理,2019,10(5):62-64.
[23]葛帮友,刘影.药物联合心理干预治疗神经性皮炎临床研究[J].中国麻风皮肤病杂志,2016,32(9):573-573,576.
[24]刘中华.神经性皮炎药物治疗的临床应用[J].航空航天医学杂志,2014,25(7):978-979.
[25]杨文峰.火针烙法治疗局限性神经性皮炎(肝郁化火证)的临床研究[D].成都:成都中医药大学,2017.
[26]梁瑞,张荣,石家宴,等.激光联合紫外线对神经性皮炎的疗效分析[J].中国医学创新,2016,13(22):124-126.
[27]王剑.液氮冷冻联合左西替利嗪片治疗神经性皮炎临床观察[J].中国初级卫生保健,2012,26(8):119-120.
[28]王梦.火针结合穴位注射治疗神经性皮炎的临床疗效及随访研究[D].成都:成都中医药大学,2015.
[29]杨健生.针刺治疗肝郁化火型神经性皮炎疗效观察[D].广州:广州中医药大学,2015.
[30]毕斌,樊超.清肝疗癣汤联合火针治疗局限性神经性皮炎的临床观察[J].中医临床研究,2018,10(22):76-77.
[31]翟炎冰,刘志顺.针灸治疗神经性皮炎诊疗特点文献分析[J].吉林中医药,2015,35(2):193-195.
[32]姜颖娟,李元文,孙占学,等.清肝益肤汤联合甘石青黛膏治疗神经性皮炎肝郁化火型82例[J].中医杂志,2011,52(24):2136-2137.
[33]江善明,吴艳华,李其林,等.神经性皮炎的病因及发病机制研究进展[J].湖南中医杂志,2017,33(6):205-207.
[34]李纬,张丰川,李元文.青石止痒软膏联合消风止痒汤加减治疗神经性皮炎的疗效评价[J].中国实验方剂学杂志,2017,23(21):194-199.
[35]李超然,仇立波,张秦宏,等.火针疗法治疗皮肤病概况[J].山东中医杂志,2015,34(4):313-314.
[36]樊蔷薇.他克莫司软膏治疗皮炎湿疹的疗效及对外周血Th1、Th2细胞因子水平的影响[J].医学综述,2016,22(3):596-599.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |