夏永良应用“玄府郁闭”理论治疗青春期后痤疮的经验浅析

[目的] 基于“玄府郁闭”理论,探讨夏永良老师治疗湿热郁闭型青春期后痤疮的临床经验。[方法] 通过查阅《黄帝内经》《素问玄机原病式》及后世医药典籍,分析“玄府郁闭”的理论依据,收集整理夏师门诊诊治的湿热郁闭型青春期后痤疮病例,并总结相关治疗经验及用药特色,最后分析典型案例进一步论述夏师临证经验。[结果] 夏师认为,湿热郁火之邪可致玄府闭塞、气津不通而发生痤疮,治疗中应以麻黄连轺赤小豆汤为基础,清里之湿热,开表之玄府,畅其气津,祛其郁阻,则痤疮可消。所举验案,夏师辨为湿热内蕴、经络瘀滞之证,治拟清热利湿、宣郁通络之法,方以麻黄连轺赤小豆汤合升降散、葛根芩连汤加减,辄收佳效。[结论] 夏师治疗湿热郁闭型青春期后痤疮以开通玄府为基础,标本兼顾,并注重食饮有节,起居有常,其临床经验值得学习和借鉴。     

The effects of green tea on acne vulgaris: A systematic review and meta‐analysis of randomized clinical trials

Green tea extract (GTE) has been studied for the treatment of acne based on its anti‐inflammatory/antioxidant properties. This systematic review and meta‐analysis aimed to examine the effects of GTE on acne. Electronic databases, including PubMed, Embase, and the Cochrane Library were systematically searched up to August 2019. The effect size of acne lesion counts is presented as mean differences and 95% confidence intervals (CIs). Five randomized‐controlled studies were included in the meta‐analysis (N; experimental = 125, control = 122). GTE significantly reduced the number of inflammatory lesions (?9.38; 95% CI: ?14.13 to ?4.63). In subgroup analysis, topical GTE application significantly reduced the inflammatory lesion counts (?11.39; 95% CI: ?15.91 to ?6.86) whereas oral GTE intake showed minimal effect (?1.40; 95% CI: ?2.50 to ?0.30). Although GTE did not significantly reduce the number of non‐inflammatory lesions (?21.65; 95% CI: ?47.52 to 4.22), when stratified by the route of admission, non‐inflammatory acne lesions were significantly reduced by topical GTE application (?32.44; 95% CI: ?39.27 to ?25.62) but not with oral GTE administration (0.20; 95% CI: 0.00 to 0.40). This systematic review and meta‐analysis suggest that topical GTE application is beneficial for the treatment of acne without causing significant adverse events while oral GTE intake has limited effects. Further high‐quality clinical trials are warranted.     

玫瑰痤疮各亚型的特征及临床联系的研究进展

玫瑰痤疮是一种常见的慢性面部充血性炎症性皮肤病,其临床表现具有多样性,但病因和发病机制尚不清楚,也没有组织学或血清学标志物。当前研究认为,玫瑰痤疮是一种包括多种皮肤症状组合的综合征,如:面部潮红、红斑、毛细血管扩张、水肿、丘疹、脓疱、眼部病变和鼻赘等。美国国家玫瑰痤疮协会专家委员会(The National Rosacea Society Expert Committee,NRSEC)将玫瑰痤疮分为4个亚型和1个变异型,并提出从一种亚型到另一种亚型进展的可能性,而研究这一过程可能会对玫瑰痤疮的发病机制提供重要的见解。本文主要综述了玫瑰痤疮各亚型的特征及临床联系的研究进展,希望能为临床诊治工作提供参考。     

强脉冲光联合左旋维生素C导入治疗痤疮后色素沉着疗效观察

目的:观察强脉冲光联合左旋维生素C导入治疗面部痤疮后遗留色素沉着的疗效。方法:将112例患者随机分为联合治疗组36例,强脉冲光组37例,左旋维生素C导入组39例,三组患者均治疗4个月。结果:联合治疗组有效率86.1%,强脉冲光组有效率59.4%,左旋维生素C导入组有效率53.8%。联合组疗效与其他两组疗效比较,差异分别有统计学意义(P0.05)。结论:强脉冲光联合左旋维生素C导入治疗面部痤疮后遗留色素沉着,疗效明确,不良反应发生率低,痛苦小,安全、有效,值得临床推广应用。     

异维A酸联合丹参酮胶囊短期治疗中度寻常性痤疮疗效观察

目的:观察异维A酸联合丹参酮胶囊短期治疗中度寻常性痤疮的疗效。方法:将患者随机分为两组,治疗组:口服异维A酸10mg,2次/天,4周后减为10mg,每晚1次,丹参酮胶囊1.0,3次/天;对照组:外擦1%克林霉素磷酸脂溶液,2次/天。共治疗8周。结果:治疗组有效率为82.1%,对照组有效率为37.9%,两组疗效比较,差异有统计学意义(χ2=11.6,P0.01)。结论:异维A酸联合丹参酮胶囊短期治疗中度寻常性痤疮安全、疗效好。     

自血疗法联合维胺酯和阿奇霉素治疗重度痤疮疗效观察

目的:观察自血疗法联合维胺酯和阿奇霉素治疗重度痤疮的疗效。方法:将102例重度痤疮患者按就诊顺序分为治疗组和对照组,共治疗8周。治疗组口服维胺酯和阿奇霉素,同时自血疗法每周1次;对照组口服维胺酯和阿奇霉素。结果:治疗组有效率92.30%、对照组有效率74.00%。两组有效率差别有显著性(χ2=6.18,P0.05)。结论:自血疗法联合维胺酯和阿奇霉素治疗重度痤疮疗效显著。     

异维A酸红霉素凝胶联合胶原蛋白敷料治疗中度寻常性痤疮疗效观察

目的:观察异维A酸红霉素凝胶联合胶原蛋白敷料治疗中度寻常性痤疮的临床疗效及安全性。方法:96例中度寻常性痤疮患者,随机分为治疗组和对照组各48例。对照组外用异维A酸红霉素凝胶,1次/天,治疗6周;治疗组在对照组基础上联合使用胶原蛋白敷料,1次/天,每次30min,连续使用4周,第5~6周隔日使用1次。疗程均为6周。结果:治疗组愈显率和有效率分别为89.58%和100.00%,对照组为66.67%和91.67%,两组疗效比较差异均有统计学意义(P0.05)。治疗组发生轻度局部刺激反应率为12.50%,对照组为10.42%,均未发现任何全身不良反应,两组用药不良反应比较差异无统计学意义(P0.05)。结论:异维A酸红霉素凝胶联合胶原蛋白敷料贴敷治疗痤疮安全、有效,可临床推广应用。