活血祛淤解毒方治疗寻常型银屑病血淤证的临床研究

1、活血祛淤解毒方治疗寻常型银屑病血淤证的临床研究                    作者：王倩，王萍，蔡念宁，王禾，张广中，王莒生 【摘要】  目的评价北京地区名老中医经验方活血祛淤解毒方治疗寻常型银屑病血淤证的临床疗效及安全性，以及对患者血液流变学及皮损浸润程度的影响。方法将42例寻常型银屑病血淤证患者随机分为治疗组和对照组，治疗组口服活血祛淤解毒方，对照组口服接诊医师自拟

2、方。观察两组的临床疗效及PASI评分,并同时检测两组治疗前后血液流变学及皮损浸润程度的改变。结果治疗组、对照组总有效率分别为73.68%，82.61%，无统计学差异(P>0.05)。两组治疗后PASI评分均降低(P<0.01)、血浆粘度均降低(P<0.05)，治疗组皮损真皮厚度明显降低(P<0.01)，对照组皮损表皮、真皮厚度均降低(P<0.05)。结论活血祛淤解毒方治疗寻常型银屑病血淤证疗效满意，与医师自拟方疗效相当，值得临床推广应用。其作用机制可能在于降低血液粘度、改善微循环、减轻皮损浸润程度。 【关键词】  银屑病； 血淤证； 活血祛瘀解毒方； 血

3、液流变学； 皮损厚度Abstract：ObjectiveTo evaluate the clinical effects and safety of Huoxue-quyu-jiedu formula created by a few famous herbalist doctors in Beijing on blood stasis syndrome of psoriasis vulgaris，and to observe its influence on hemorheology and soakage degrees of skin lesions . Methods42 patien

4、ts were selected and randomly divided into 2 groups: therapeutic group and control group. Patients in the therapeutic group took Huoxue-quyu-jiedu formula and those in the control group had the recipe prescribed by doctors themselves for 8 weeks. Therapeutic effect and PASI scores were recorded and

5、the influence on hemorheology and soakage degrees of skin lesions were observed before and after treatment. ResultsThe effective rates were 73.68% and 82.61% in the therapeutic group and in the controll group respectively. There was no statistical difference in therapeutic effects between the two gr

6、oups(P>0.05). PASI scores decreased in both groups and showed significant difference statistically before and after treatment(P<0.01). Plasma viscosity decreased in both groups and showed statistical difference before and after treatment(P<0.05). The dermis thickness decreased significantly

7、 in therapeutic group (P<0.01). The epidermis and dermis thickness both decreased in the control group (P<0.05). ConclusionHuoxue-quyu-jiedu formula had a satisfying effect on treating blood stasis syndrome of psoriasis vulgaris, similar to the recipes prescribed by doctors themselves. It is w

8、orth to clinical application and extension. Its mechanism probably lies in reducing the plasma viscosity, improving microcirculation and reducing the soakage degree of skin rash.Key words：Psoriasis vulgaris；  Blood stasis syndrome；  Huoxue-quyu-jiedu formula；  Hemorheology；  Lesi

9、on thickness of skin    银屑病是一种慢性炎症性、红斑鳞屑性、反复发作的难治性皮肤病,发病率高,是目前国内外皮肤科领域内的重点研究课题。活血祛瘀解毒方是北京地区16位名老中医治疗银屑病血淤证的基本方，本研究观察了“活血祛淤解毒方”治疗银屑病血淤证的临床疗效，取得满意效果，并与医师自拟方进行比较，同时观察该方对银屑病血淤证患者的血液流变学及皮损浸润程度的影响，探讨该方的可能作用机制。1  临床资料1.1  诊断标准1.2  一般资料寻常型银屑病患者42例,随机分为治疗组和对照组，治疗组19例,其中男16例，女3例，

10、年龄2265岁,平均(43.84±12.63)岁；病程半年45年,平均(11.50±11.72)年；PASI评分4.8044.00分，平均(17.40±10.33)分。对照组23例，其中男19例，女4例，年龄2364岁,平均(43.48±13.20)岁，病程1 38年，平均(13.78±9.61)年；评分4.6037.60分，平均(14.40±9.20)分。两组资料构成差异无显著性，在近2月内均未使用糖皮质激素、免疫抑制剂和维甲酸类。2  治疗及检测方法2.1  治疗方法治疗组口服活血祛淤解毒方（桃仁、红花、丹参、

11、鸡血藤、莪术、鬼箭羽、白花蛇舌草），随证加减：热重：大青叶、紫草；瘀重：赤芍、三棱；夹燥：生地、麻仁、元参；夹湿：苦参、虎杖、陈皮；咽痛：北豆根。每日1剂，水煎日2次，早晚服用。    对照组口服医师自拟方（初诊医师要求主治医师以上资格、有多年临床经验，治则：活血化瘀解毒，没有规定固定的方药，从而使医师自拟方更具普遍性意义），两组病人均采用外用芩柏软膏（北京中医医院院内制剂）。连续用药8周，每2周复诊1次，疗程结束后分别统计疗效。2.2  观察项目及检测方法3  结果3.1  两组疗效比较治疗组痊愈1例，显效3例，有效10例，无效5例，痊愈显效率为21.05%，总有效率（痊愈显效有效）为73.68%；对照组痊愈0例，显效4例，有效15例，无效4例，痊愈显效率为17.39%，总有效率（痊愈显效有效）为82.61%。经2检验，两组患者临床疗效无显著性差异（P>0.05）。3.2  两组治疗前后皮损面积、红斑、鳞屑、浸润、瘙痒程度及PASI评分比较见表1。结果表明