多糖药膳粥辅助治疗血虚风燥型成人特应性皮炎的临床观察研究OA
Clinical observational study on polysaccharide medicated congee as an adjunctive treatment for adult atopic dermatitis of the blood deficiency and wind-dryness type
目的 探究多糖药膳粥辅助治疗血虚风燥型成人特应性皮炎(AD)的临床疗效及安全性.方法 选取 110 例血虚风燥型成人AD患者,按随机数字表法分为对照组与研究组,每组 55 例.对照组采用常规西医治疗方案,并予外观、口感与多糖药膳粥一致但不含活性成分的安慰剂粥干预;研究组则在对照组治疗的基础上加用多糖药膳粥辅助治疗.两组均连续治疗 8 w.观察指标包括临床疗效、中医证候积分、皮肤屏障功能指标、血清炎症因子水平、特应性皮炎生活质量量表(ADQoL)评分及不良反应发生率.结果 研究组的治疗总有效率高于对照组,差异有统计学意义(P<0.05).经治疗,两组患者的中医证候积分(包括皮肤瘙痒、干燥脱屑、红斑丘疹、抓痕结痂等)均较治疗前显著降低(P<0.05),且研究组的降低幅度大于对照组(P<0.05).在皮肤屏障功能方面,两组患者的经皮水分流失水平均较治疗前降低,角质层含水量水平较治疗前升高(P<0.05),且研究组的改善效果均优于对照组(P<0.05).经治疗,两组患者的白细胞介素(IL)-4、IL-13 及肿瘤坏死因子(TNF)-α水平均较治疗前下降(P<0.05),其中研究组的下降更为明显(P<0.05).两组患者的特应性皮炎生活质量量表评分均较治疗前提高(P<0.05),且研究组高于对照组(P<0.05).两组不良反应发生率的差异无统计学意义(P>0.05).相关性分析显示,患者治疗前血清IL-4、IL-13、TNF-α水平与中医证候总积分均呈显著正相关(P<0.01);治疗 8 w后,上述三项炎症因子水平的下降幅度与中医证候总积分的下降幅度亦呈显著正相关(P<0.01).结论 多糖药膳粥辅助常规西医治疗血虚风燥型成人AD,能显著提高临床疗效且安全性良好.
Objective To investigate the clinical efficacy and safety of polysaccharide medicated congee as an adjunctive treatment for adult atopic dermatitis(AD)of the blood deficiency and wind-dryness type.Methods A total of 110 adult patients with AD of the blood deficiency and wind-dryness type were enrolled and randomized using a random number table into a control group and a study group,with 55 cases in each group.The control group received a conventional Western medicine regimen and a placebo congee intervention that was consistent with the polysaccharide medicated congee in appearance and taste but contained no active ingredients.The study group received polysaccharide medicated congee as an adjunctive treatment on the basis of the control group regimen.Both groups were treated continuously for 8 weeks.Outcome measures included clinical efficacy,Chinese medicine syndrome score,skin barrier function index,serum inflammatory cytokine level,Atopic Dermatitis Quality of Life(ADQoL)score,and incidence of adverse reactions.Results The total response rate in the study group was higher than that in the control group,and the difference was statistically significant(P<0.05).After treatment,Chinese medicine syndrome scores(including pruritus,dryness and desquamation,erythema and papules,excoriation and crusting,etc.)were significantly reduced in both groups compared with baseline,with a greater reduction in the study group than in the control group(P<0.05).Regarding skin barrier function,transepidermal water loss decreased and stratum corneum hydration increased in both groups compared with baseline,and the improvements were greater in the study group than in the control group(P<0.05).After treatment,levels of interleukin(IL)-4,IL-13,and tumor necrosis factor(TNF)-α decreased in both groups compared with baseline,with more pronounced decreases in the study group(P<0.05).ADQoL scores improved in both groups compared with baseline,and the study group had better scores than the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Correlation analysis showed that baseline serum IL-4,IL-13,and TNF-α levels were significantly positively correlated with the total Chinese medicine syndrome score(P<0.01).After 8 weeks of treatment,the magnitude of decrease in these three inflammatory cytokines was also significantly positively correlated with the magnitude of decrease in the total Chinese medicine syndrome score(P<0.01).Conclusion Polysaccharide medicated congee as an adjunct to conventional Western medicine treatment for adult AD of the blood deficiency and wind-dryness type can significantly improve clinical efficacy with a favorable safety profile.
戴婧;彭友华;曾碧君
湖南中医药大学第二附属医院皮肤科,湖南 长沙 410005湖南航天医院医疗美容科,湖南 长沙 410000湖南中医药大学第二附属医院皮肤科,湖南 长沙 410005
医药卫生
多糖药膳粥血虚风燥型成人特应性皮炎皮肤屏障功能炎症因子
polysaccharide medicated congeeblood deficiency and wind-dryness typeadult atopic dermatitisskin barrier functioninflammatory cytokines
《药食同源杂志》 2026 (2)
122-129,8
湖南省自然科学基金项目(2025-KY-009-01).
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