| 引用本文:孙田，王珺，王东.当归四逆加吴萸生姜汤加味联合枸地氯雷他定片治疗慢性荨麻疹的临床观察[J].世界中医药,2020,(02):. |
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| 当归四逆加吴萸生姜汤加味联合枸地氯雷他定片治疗慢性荨麻疹的临床观察 |
| Clinical Observation on Modified Danggui Sini Plus Wuyu Shengjiang Decoction Combined with Desloratadine Tablet in the Treatment of Chronic Urticaria Patients |
| 投稿时间：2018-12-10 |
| DOI：10.3969/j.issn.1673-7202.2020.02.025 |
| 中文关键词: 慢性荨麻疹 当归四逆加吴萸生姜汤 枸地氯雷他定片 IgE IL-13 TSP-1 D-二聚体 临床研究 |
| English Keywords:Chronic urticaria Danggui Sini Plus Wuyu Shengjiang Decoction Desloratadine tablet IgE IL-13 TSP-1 D-dimer Clinical research |
| 基金项目:沈阳市卫计局科研项目(2016688) |
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| 中文摘要: |
| 目的:观察用当归四逆加吴萸生姜汤加味联合枸地氯雷他定片治疗慢性荨麻疹患者的临床效果及对血清总IgE、白细胞介素-13(IL-13)、凝血酶敏感蛋白-1(TSP-1)、D-二聚体水平的影响。方法:选取2017年6月至2018年4月沈阳市第七人民医院皮肤科门诊收治的慢性荨麻疹患者110例作为研究对象,按照随机数字表法分为对照组和观察组,每组55例。对照组患者给予枸地氯雷他定片口服;观察组患者则在对照组基础上加用当归四逆加吴萸生姜汤加味而成的汤剂内服,2组患者均连续治疗1个月为疗程。通过观察2组患者的风团发作情况、中医证候积分变化比较2组患者的临床疗效,治疗前后采用皮肤病生命质量指数(DLQI)量表评价生命质量,测定血清总IgE、白细胞介素-13(IL-13)、凝血酶敏感蛋白-1(TSP-1)、Ｄ-二聚体水平,随访半年,统计治愈患者的复发率,统计治疗过程中的不良反应。结果:对照组的临床有效率74.55%明显低于观察组的90.91%(P<0.05);观察组患者治疗后的风团发作情况明显改善,风团数目、风团最大直径、风团发作频率、持续时间等评分较对照组明显下降(P<0.05);中医证候积分、生命质量DLQI评分均明显低于对照组(P<0.05);血清总IgE水平呈明显下降趋势(P<0.05),同一时间点组间比较,以观察组明显低于对照组(P<0.05）;观察组患者的血清中IL-13、D-二聚体水平均较对照组有所降低(P<0.05),TSP-1水平则有所升高(P<0.05）(P<0.05);随访半年,观察组复发率12.5%明显低于对照组的复发率30%(P<0.05);观察组患者治疗过程中不良反应率为7.27%,低于对照组的不良反应率21.82%(P<0.05)。结论:当归四逆加吴萸生姜汤加味联合枸地氯雷他定片利于减轻慢性荨麻疹患者的风团发作程度,缓解临床症状,提高生命质量,其起效可能与调整血清中IL-13、TSP-1、D-二聚体水平以降低IgE的异常分泌、改善血管通透性、机体凝血状态等途径有关,值得临床进一步探究。 |
| English Summary: |
| To observe the clinical effect of modified Danggui Sini Plus Wuyu Shengjiang Decoction combined with desloratadine tablet in the treatment of chronic urticaria patients and its influence on serum IgE, IL-13, TSP-1 and D-dimer levels.Methods:A total of 110 patients with chronic urticaria admitted to the outpatient department of dermatology of Shenyang Seventh People's Hospital were selected as the research objects, and were divided into a control group(n=55 cases)and an observation group(n=55 cases)by random number table method.Patients in the control group were given desloratadine tablets orally; The observation group was treated with modified Danggui Sini Plus Wuyu Shengjiang Decoction combined with desloratadine tablet, and the 2 groups were treated for 1 month as one treatment course.The clinical efficacy of the 2 groups was compared by observing the urticaria attack situation and the change of TCM syndrome integral of the 2 groups.The quality of life was evaluated by dermatology life quality index(dermatology life quality index, DLQI)scale before and after treatment.The serum total IgE, IL-13,TSP-1 and D-dimer levels were monitored, and the recurrence rate of cured patients follow-up for half a year was analyzed and adverse reactions in the treatment process were counted.Results:The clinical effective rate of 74.55% in the control group was significantly lower than 90.91% in the observation group(P<0.05).The patients in the observation group showed more obvious improvement in the incidence of air mass，and the number, maximum diameter, frequency and duration of air mass were significantly decreased compared with those in the control group(P<0.05).TCM syndrome score and DLQI score of quality of life were significantly lower than those of the control group(P<0.05).The serum total IgE level showed a significant downward trend(P<0.05), and was significantly lower in the observation group than in the control group(P<0.05).The serum levels of IL-13 and D-dimer in the observation group were decreased than those in the control group(P<0.05), while the levels of TSP-1 were increased than those in the control group(P<0.05).Follow-up for half a year, the recurrence rate of 12.5% in the observation group was significantly lower than 30% in the control group(P<0.05).The rate of adverse reactions in the treatment of patients in the observation group was 7.27%, which was lower than 21.82% in the control group(P<0.05).Conclusion:The treatment plan of treating chronic urticaria patients with modified Danggui Sini Plus Wuyu Shengjiang Decoction combined with desloratadine tablet is to reduce the air mass attack rate of the patients with chronic urticaria, relieve the clinical symptoms and improve quality of life.Its effect may be related to adjusting the serum IL-13, TSP-1, D-dimer levels to reduce the abnormal secretion of IgE, improve the way such as vascular permeability and the body's blood coagulation state, which is worthy of clinical promotion. |
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