三种基质调制的如意金黄散药膏引发皮肤过敏现象观察

目的 比较三种基质（酒、蜜、水）调制的中药外敷药膏（如意金黄散）引发皮肤过敏的差异,以减少如意金黄散药膏引发皮肤过敏或接触性皮炎的发生,加速损伤恢复.方法 本研究以非随机取样方式共计受试者30名,其中女性12名,男性18名,年龄23～62岁,平均（38.40-11.20）岁.用斑贴实验来检测不同基质调制的药膏是否会对皮肤造成刺激而引发接触性皮炎,以DASI量表来评估药膏所引发的接触性皮炎的轻重程度.用Friedman二因子变异数分析三种基质（酒、蜜、水）调制的如意金黄散药膏在做斑贴实验后48 h、72 h及1周皮肤表面变化状况的差异.结果 在斑贴试验后48 h,以蜜调制的如意金黄散药膏的DASI值（0.00±0.00）较以酒调制者的DASI值（1.80±3.53）和以水调制者的DASI值（1.20±2.07）明显降低（P=0.01）.在斑贴实验后72 h,以蜜调制的如意金黄散药膏的DASI值（0.40±2.19）较以酒调制者的DASI值（4.00±6.60）和以水调制者的DASI值（3.67±7.91）明显降低（P=0.00）.在斑贴实验后1周时,以蜜调制的如意金黄散药膏的DASI值（0.21±0.12）较以酒调制者的DASI值（3.64±4.15）和以水调制者的DASI值（3.14±1.05）明显降低（P=0.00）.结论 以蜜调制的如意金黄散药膏比以酒或水调制者较不易引发接触性皮炎,此结果可为中医临床外敷如意金黄散药膏提供参考.

Skin allergic reactions to the traditional chinese medicine Ru Yi Jin Huang San in three different medium bases

Objective To compare skin allergic reaction of Ru Yi Jin Huang San mixed in the three different medium bases： rice wine, honey or water, and help the Chinese medicine doctor select the best base to increase the contact time-span of the plaster and speed up the recovery from injury. Methods Thirty subjects （18 men and 12 women）, aged （38.40±11.20） years, were enrolled into this study. The individual components and the Ru Yi Jin Huang San compound in 3 different medium bases were tested by patch test. The severity of contact dermatitis was measured by Dyshidrotic Eczema Area and Severity Index （DASI）. Nonparametric Friedman two-way analyses of variance were used to analyze the variation in skin reaction among the three mixtures after 48 hours and 72 hours and 1 week of the patch test. Results DASI score of honey medium bases was （0.00±0.00）, lower than （1.80±3.53） of wine medium bases and （1.20±2.07） of water medium bases in 48 hours after patch test （P=-0.01）. DASI score of honey medium bas- es was （0.40±2.19）, lower than （4.00±6.60） of wine medium bases and （3.67±7.91） of water medium bases in 72 hours after patch test （P=0.00）. DASI score of honey medium bases was （0.21 ±0.12）, lower than （3.64±4.15） of wine medi- um bases and （3.14±1.05） of water medium basesin 1 week after patch test （P=0.00）. Conclusion Honey is superior to rice wine or water as the base for clinical use of Ru Yi Jin Huan San because of lower level of adverse skin reac- tions, which provides a reference for clinical decision to make Ru Yi Jin Huang San.