摘要
目的:观察改良(优化组方比例)颠倒散外敷治疗热毒痰瘀型寻常痤疮的临床疗效及在体抑菌影响。方法:采用随机、单盲、平行、对照研究方法。将符合入选标准的72例患者采用随机数字表法分为试验组37例及对照组35例。两组患者均内服自拟经验方“消痤汤”(免煎颗粒)配合针清术治疗,试验组另予改良颠倒散(大黄∶硫黄=2∶1)外用,对照组予颠倒散原方(大黄∶硫磺=1∶1)外用,疗程均为4周。比较两组患者的临床疗效及治疗前后皮损评分、VISIA(红色区、紫质)的绝对分值、汉密尔顿抑郁量表24项(Hamilton Depression Rating Scale 24 Items,HAMD-24)评分、皮损内常见病原菌计数及不良反应发生情况。结果:试验组、对照组的总有效率分别为72.97%(27/37)、74.29%(26/35),(P>0.05);两组治疗后的皮损评分、VISIA(红色区、紫质)的绝对分值、HAMD-24评分、皮损内常见病原菌计数较治疗前均下降(P<0.05),且二者改善程度相当(P>0.05);试验组、对照组的不良反应发生率分别为8.11%(3/37)、29.73%(11/37)(P<0.05)。结论:外敷改良颠倒散治疗热毒痰瘀型寻常痤疮疗效确切,且疗效与颠倒散原方对比相当,但其安全性较原方高,且能改善患者的抑郁状态;其作用机制可能与抑菌/杀菌、减轻炎症反应及清除皮脂堆积有关,值得进一步探索及推广。
Objective:To observe the clinical efficacy of modified Diandao San(改良颠倒散)(optimized proportion of prescription)on acne vulgaris with heat-toxin-phlegm-stasis syndrome and its antibacterial effect in vivo.Methods:In this study,a randomized,single-blind,parallel-controlled trial design was adopted,and seventy-two acne patients who met the inclusion criteria were divided into the test group(37 cases)and the control group(35 cases)by random number table method.They were all treated once a night for 4 weeks and took orally the self-made empirical prescription,“the Xiaocuo decoction(消座汤)”(free decoction granules)plus acne removal;the test group received modified Diandao San(Rhubarb 2:1 Sulfur)externally while the control group received the original prescription of Diandao San(Rhubarb 1:1 Sulfur).The clinical efficacy and skin lesion scores before and after treatment,the absolute scores of VISIA(red area,purple),the HAMD-24 score,the count of common pathogenic bacteria in skin lesions and the occurrence of adverse reactions in the two groups were compared.Results:The total effective rates in the test group and the control group were 72.97%(27/37)and 74.29%(26/35)respectively(P>0.05);After treatment,the skin lesion scores,the absolute scores of VISIA(red area,purple),the HAMD-24 score and the counts of common pathogens in the skin lesions were lower than those before treatment(P<0.05),and the improvement degree in the two groups was equivalent(P>0.05).The incidence of adverse reactions in the test group and the control group were 8.11%(3/37)and 29.73%(11/37),respectively(P<0.05).Conclusions:External application of modified Diandao San has a definite effect in the treatment of acne vulgaris with heat-toxin-phlegm-stasis syndrome.And the curative effect is comparable to that of the original prescription of Diandao San,but its safety is higher than the original prescription of Diandao San,and it can relieve the patient’s depression.Its mechanism of action may be related to bacteriostasis/sterilization,relief of inflammation,and to the removal of sebum accumulation,which is worthy of further exploration and promotion.
作者
何明
王文娇
唐挺
HE Ming;WANG Wenjiao;TANG Ting
出处
《中医临床研究》
2022年第30期132-135,共4页
Clinical Journal Of Chinese Medicine
基金
贵阳市科学技术局,科技基金资助项目(2019926)
贵州省科学技术厅,科学技术基金资助项目(黔科合基础-ZK[2021]一般511)
贾敏全国名老中医药专家传承工作室项目,国中医药人教函[2022]75号
“贵州省卫健委:省级中医临床研究基地建设项目”。
关键词
改良颠倒散
寻常痤疮
常见病原菌
疗效
不良反应
Modified Diandao San
Acne vulgaris
Common pathogens
Efficacy
Adverse reaction
