清热除湿解毒方治疗寻常痤疮肠胃湿热证的临床研究

摘要

OBJECTIVE To explore the influences of Qingre Chushi Jiedu Formula on skin physiological indexes and im-mune indexes in patients with acne due to damp-heat in spleen and stomach.METHODS 102 cases with acne caused by damp-ness-heat in the spleen and stomach hospitalized in our hospital from June,2015 to September,2016 were chosen and randomly divided into the observation group and control group based on random number method,with 51 cases in each group.Patients in the control group were given Danshentong Capsule,while those in the observation group were treated with Qingre Chushi Jiedu Formula.The treatment lasted for four weeks in total.Then the improvement of clinical symptoms were observed,with skin physiological indexes(including skin moisture content,skin oil and pH value),serum interleukin(IL-2,IL-4,IL-10)as well as interferon(INF-γ) being tested before and after treatment to evaluate the clinical therapeutic effects of both groups.RESULTS Scores of lesion extent,lesion amount,lesion color,lesion swelling and pain as well as total lesion scores and TCM symptom scores of both groups went down significantly(P<0.01),with the observation group being better than the control group(P<0.01).The total therapeutic effect rate of observation group was 90.2%,notably higher than 66.7% of the control group(P<0.01);Heart,liver and kidney function,together with blood routine test and urine routine test of the both groups were within the normal range,with no side effects being noticed.The skin moisture extent of the two groups after treatment went up evi-dently(P<0.01),whereas the skin oil went down significantly(P<0.01).The two groups enjoyed evidently increased level of IL-2 and INF-γafter treatment(P<0.01)and decreased level of IL-4 and IL-10(P<0.01).while the recurrence rate of the observation group either four weeks or eight weeks after treatment was much lower than that of the control group(P<0.05). CONCLUSION Qingre Chushi Jiedu Formula can efficiently improve the clinical symptoms of patients with acne due to damp-heat accumulation in spleen and stomach and reduce the recurrence rate,whose mechanism might be related to the improve-ment of patients'skin physiological indexes and immune function.%目的 探讨清热除湿解毒方对寻常痤疮肠胃湿热证皮肤生理指标和免疫指标的影响.方法 选取2015年6月-2016年9月我院收治的102例寻常痤疮,且中医辨证为肠胃湿热证患者,将其按照随机数字法随机分为观察组和对照组,每组51例,对照组给予丹参酮胶囊进行治疗,观察组给予清热除湿解毒方进行治疗,2组均治疗4周,分别观察2组治疗后临床症状改善情况,并检测治疗前后皮肤生理指标(皮肤水分含量、皮肤油脂及p H值),同时检测2组治疗前后血清白细胞介素(IL-2、IL-4、IL-10)和干扰素(INF-γ)水平,对治疗前后2组的临床疗效进行评价.结果 治疗后2组皮损程度积分、皮损数量积分、皮损颜色积分、皮损肿痛积分、皮损总积分、中医证候总积分均显著降低(P<0.01),但观察组降低更为明显(P<0.01).观察组总有效率分别为90.2%,显著高于对照组的66.7%(P<0.01);2组治疗期间心、肝、肾功能及血、尿常规均在正常范围内,未发现明显的不良反应.治疗后2组皮肤水分均显著升高(P<0.01)、皮肤油脂均显著下降(P<0.01),观察组优于对照组(P<0.01).治疗后2组的IL-2、INF-γ均显著升高(P<0.01),IL-4、IL-10均显著下降(P<0.01),观察组优于你对照组(P<0.01).观察组治疗后4周、8周的复发率均显著低于对照组(P<0.05).结论 清热除湿解毒方可以显著改善寻常痤疮肠胃湿热证患者的临床症状,复发率低,其作用机制可能与改善患者皮肤的生理功能及提高免疫功能有关.