当归饮子加减联合盐酸西替利嗪治疗老年皮肤瘙痒症的疗效观察及其对IgE、IL-4、IL-2、TNF-α、IFN-γ的影响OA
Observation on the Curative Effect of Modified Danggui Decoction(当归饮子)Combined with Cetirizine Hydrochloride in Treating Pruritus in Elderly Patients and Effects on Serum IgE,IL-4,IL-2,TNF-α,IFN-γ
目的:观察当归饮子加减联合盐酸西替利嗪治疗老年血虚风燥型皮肤瘙痒症的疗效及其对血清IgE、IL-4、IL-2、TNF-α和IFN-γ的影响.方法:选取老年皮肤瘙痒症患者 70 例,按照随机数字表法分为对照组与观察组各35 例.试验期间对照组剔除 3 例,脱落 1 例,观察组剔除 1 例,最终完成研究对照组31 例、观察组34 例.对照组给予口服盐酸西替利嗪片治疗,观察组在对照组基础上给予当归饮子加减治疗,2 组均连续用药6 周后评估总疗效,并于治疗前及治疗6 周后评估瘙痒严重程度(改良Duo氏瘙痒评分)、睡眠质量[匹兹堡睡眠质量指数(PSQI)评分],检测实验室指标血清IgE、IL-4、IL-2、TNF-α和IFN-γ水平;同时记录不良反应及复发情况.结果:用药6 周后,观察组总有效率为 88.24%,高于对照组的 64.51%(P<0.05);2 组患者改良Duo氏瘙痒评分、PSQI 评分均降低,且观察组改良Duo氏瘙痒评分、PSQI 评分较对照组降幅更明显(P<0.05);2 组患者血清IgE、IL-4、TNF-α水平下降,观察组血清IgE、IL-4、TNF-α水平较对照组降幅更明显(P<0.05),2 组患者血清IL-2、IFN-γ水平较治疗前比较均无显著性差异(P>0.05).不良反应发生率观察组为 8.82%,对照组为 9.68%,差异无统计学意义(P>0.05).随访 3 个月,观察组复发率 10.00%,低于对照组 35.00%,差异有统计学意义(P<0.05).结论:以当归饮子加减联合盐酸西替利嗪治疗老年皮肤瘙痒症患者疗效显著,可有效减轻患者瘙痒症状,调节患者机体免疫功能,减轻患者机体炎症反应,提升患者睡眠质量,且药物不良反应少,并能降低复发率,值得推广应用.
Objective:To evaluate the efficacy of modified Danggui Decoction combined with Cetirizine Hydrochloride tablets in treating pruritus in elderly patients with blood deficiency and wind-dryness syndrome and its effects on serum IgE,IL-4,IL-2,TNF-α,IFN-γlevels.Methods:70 elderly patients with pruritus were selected and divided into a control group and an observation group(35 cases each)according to a random number table.During the trial,3 cases were excluded and 1 case dropped out in the control group,while 1 case was excluded in the observation group.Finally,31 cases in the control group and 34 cases in the observation group completed the study.The control group received oral Cetirizine Hydrochloride tablets.The observation group received modified Danggui Decoction in addition to the control group's treatment.After 6 weeks of continuous medication,the total effect was evaluated,pruritus severity(modified Duo's pruritus score),sleep quality[Pittsburgh Sleep Quality Index(PSQI)score],and laboratory indicators(IL-2,IL-4,TNF-α,IFN-γ and IgE were assessed before treatment and after 6 weeks of treatment.Adverse reactions and recurrence were also recorded.Results:After 6 weeks of medication,the total effective rate in the observation group was 88.24%,which was higher than 64.51%in the control group(P<0.05).The modified Duo's pruritus scores and PSQI scores decreased in both groups,and the decreases in the observation group were more significant those in the control group(P<0.05).Serum IgE,IL-4,and TNF-α levels decreased in both groups,and the decreases in the observation group were more significant than those in the control group(P<0.05).However,there were no significant differences in serum IL-2 and IFN-γ levels before and after treatment in either group(P>0.05).The incidence of adverse reactions was 8.82%in the observation group and 9.68%in the control group,with no statistically significant difference(P>0.05).After 3 months of follow-up,the recurrence rate in the observation group was 10.00%,which was lower than 35.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion:The combination therapy of modified Danggui Decoction with Cetirizine Hydrochloride tablets demonstrates significant efficacy in treating elderly patients with pruritus.It effectively alleviates itching symptoms,regulates immune function,reduces inflammatory responses,and improves sleep quality.With minimal adverse drug reactions and a reduced recurrence rate,this approach warrants wider application.
宋志华;江渊
浙江大学医学院附属金华医院,金华市中心医院皮肤科·浙江 金华 321000浙江大学医学院附属金华医院,金华市中心医院皮肤科·浙江 金华 321000
皮肤瘙痒症当归饮子加减盐酸西替利嗪IgEIL-4IL-2TNF-αIFN-γ复发率
pruritusmodified Danggui DecoctionCetirizine HydrochlorideIgEIL-4IL-2TNF-αIFN-γrecurrence rate
《中国中医药科技》 2026 (3)
213-216,4
浙江省金华市科技计划项目(2023-4-081)
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