火针联合苍肤止痒酊治疗神经性皮炎的疗效观察

目的观察火针联合苍肤止痒酊治疗神经性皮炎的临床疗效。方法共纳入180例神经性皮炎患者,采用简单随机化分组方法分为3组,每组60例。对照组给予卤米松乳膏治疗,火针组在对照组治疗基础上另予火针治疗,联合组给予火针联合苍肤止痒酊治疗。3组均治疗5周,并对治疗后基本治愈的患者进行6个月的随访。观察各组的总有效率、皮损中医证候评分、炎症因子肿瘤坏死因子α(TNF-α)、白介素(IL)-1β、IL-4和IL-6]、皮肤屏障功能指标(皮肤皮脂水平、皮肤水合度)和不良反应,并采用Pearson相关性分析探究炎症因子与临床疗效的相关性。观察随访时各组的复发率。结果联合组总有效率为93.3%,高于火针组的76.7%和对照组的51.7%,3组之间的差异均具有统计学意义(P<0.05)。治疗后,联合组的皮损总面积、色泽、丘疹和瘙痒评分均低于火针组和对照组(P<0.05),且火针组上述各项评分也低于对照组(P<0.05);联合组TNF-α、IL-1β、IL-4、IL-6水平均低于火针组和对照组(P<0.05),且TNF-α、IL-1β、IL-4、IL-6水平均与临床疗效呈负相关;联合组皮肤皮脂水平、皮肤水合度均高于火针组和对照组(P<0.05),且火针组高于对照组(P<0.05)。联合组和火针组的复发率均低于对照组(P<0.05)。结论火针联合苍肤止痒酊治疗神经性皮炎,能改善患者临床症状体征与皮肤屏障功能,提高疗效,减少疾病的复发,其机制可能与改善炎症反应有关。

Efficacy Observation of Fire Needle Combined with Cang Fu Zhi Yang Tincture for Neurodermatitis

Objective To observe the clinical efficacy of fire needle combined with Cang Fu Zhi Yang tincture in treating neurodermatitis.Method A total of 180 neurodermatitis patients were divided into three groups using a simple randomized grouping method,with 60 cases in each group.The control group was treated with Halometasone cream,the fire needle group was given fire needle therapy based on the treatment in the control group,and the combination group was intervened by fire needle therapy plus Cang Fu Zhi Yang tincture.The treatment lasted for 5 weeks in the three groups,and a 6-month follow-up was conducted in the substantially recovered patients.The total effective rate,symptom and sign score of skin lesion of traditional Chinese medicine(TCM),inflammatory factorstumor necrosis factor(TNF)-α,interleukin(IL)-1β,IL-4 and IL-6],skin barrier function parameters(skin sebum level and skin hydration degree)and adverse reactions were observed in each group.Pearson correlation analysis was adopted to discover the correlation between the inflammatory factors and clinical efficacy.The relapse rate was observed in each group at the follow-up.Result The total effective rate was 93.3%in the combination group,higher than 76.7%in the fire needle group and 51.7%in the control group,and the differences amongst the three groups were statistically significant(P<0.05).After treatment,the scores of total area of skin lesion,color,spots,and itching were lower in the combination group than in the fire needle and control groups(P<0.05),and the above scores in the fire needle group were lower than those in the control group(P<0.05);the levels of TNF-α,IL-1β,IL-4 and IL-6 were lower in the combination group than in the fire needle and control groups(P<0.05),and the levels of TNF-α,IL-1β,IL-4 and IL-6 were all negatively correlated with clinical efficacy;the skin sebum level and hydration degree were higher in the combination group than in the fire needle and control groups(P<0.05),and were higher in the fire needle group than in the control group(P<0.05).The relapse rate was lower in the combination and fire needle groups than in the control group(P<0.05).Conclusion Fire needle combined with Cang Fu Zhi Yang tincture can improve the clinical symptoms and signs and skin barrier function,enhance clinical efficacy and reduce relapse in treating neurodermatitis,and the mechanism may be associated with the improvement of inflammatory reactions.