摘要
目的探讨中药当归四逆汤对慢性荨麻疹患者血清炎性反应、免疫机制与临床疗效及生活质量影响。方法选择2017年12月至2018年10月诊断慢性荨麻疹180例,随机数字表法分为中药组与对照组。对照组患者给予咪唑斯汀缓释片10mg/(次·d),中药组在对照组基础上给予加用当归四逆汤口服治疗,治疗时间8周。治疗前后,流式细胞仪检测外周静脉血CD4+T淋巴细胞亚群、计算Th1/Th2、Th17/Treg比值变化。免疫比浊法检测血清超敏C反应蛋白、酶联免疫吸附法检测血IL-17,免疫化学法检测血浆D-二聚体,比较2组患者荨麻疹严重程度评分(UAS7)、皮肤病生活质量指数评分(DLQI)变化与临床疗效。结果治疗后,2组患者外周血Th1/Th2升高,Th17/Treg比值降低,血清hs-CRP、IL-17、D-二聚体水平下降,症状严重程度评分降低、皮肤病生活质量指数评分改善、临床疗效提高。其中,中药组改善幅度优于对照组,组内前后比较与治疗后组间比较差异有统计学意义(P<0.05)。结论中药当归四逆汤可以显著减轻慢性荨麻疹患者临床症状,改善患者生活质量,提高临床疗效。分析机制与其下调体内炎性反应、纠正凝血机制紊乱与免疫失衡有关。
Objective To investigate the effect of Danggui Sini Decoction on serum inflammatory response,immune mechanism,clinical efficacy and quality of life in patients with chronic urticaria.Methods 180 cases of chronic urticaria diagnosed from December 2017 to October 2018 were selected and randomly divided into Chinese medicine group and control group.The patients in the control group were given mizolastine sustained-release tablets 10 mg/time/day,while the patients in the Chinese medicine group were given Danggui Sini Decoction on the basis of the control group for eight weeks.Before and after treatment,CD4+T lymphocyte subsets in peripheral venous blood were detected by flow cytometry,and the ratio of Th1/Th2 and Th17/Treg was calculated.Immunoturbidimetry was used to detect serum hypersensitive C-reactive protein,enzyme-linked immunosorbent assay was used to detect serum IL-17,and immunochemistry was used to detect plasma D-dimer.The changes of urticaria severity score(UAS7),dermatosis quality of life index(DLQI)and clinical efficacy were compared between the two groups.Results After treatment,Th1/Th2 in peripheral blood increased,Th17/Treg ratio decreased,serum hs-CRP,IL-17 and D-dimer levels decreased,symptom severity score decreased,skin disease quality of life index score improved and clinical efficacy improved in both groups.Among them,the improvement of the Chinese medicine group was better than that of the control group,and there was significant difference between the two groups before and after treatment(P<0.05).Conclusion Danggui Sini Decoction can significantly alleviate the clinical symptoms of chronic urticaria patients,improve the quality of life of patients,and improve the clinical efficacy.The mechanism of analysis is related to down-regulation of inflammatory reaction,correction of coagulation disorder and immune imbalance.
作者
陈坚
CHEN Jian(Shandong Yankuang New Mileage General Hospital,Zoucheng 273500,China)
出处
《中国医药指南》
2019年第15期24-25,共2页
Guide of China Medicine
关键词
荨麻疹
超敏C反应蛋白
血浆D-二聚体
慢性
中药
疗效
Urticaria
Hypersensitive C-reactive protein
Plasma D-dimer
Chronic
Traditional Chinese medicine
Curative effect
