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辨病辨证中药雾化透皮法为主治疗系统性硬皮病临床研究

发表时间:2018-08-01浏览次数:

  辨病辨证中药雾化透皮法为主治疗系统性硬皮病临床研究

  XITONGXINGYINGPIBING(SSc)SHIYIZHONGQUANSHENXINGJIEDIZUZHIBING,BINGYINQIJINBUMING,ZHILIAOSHIFENKUNNAN。CAIYONGHUAHENGZHONGYAOQILIAOYIBINGJIEHELINCHUANGBIANBINGBIANZHENGZHONGYAOWUHUATOUPIFAWEIZHUZHILIAOSScLINCHUANGYANJIU75LI,XIANBAOGAORUXIA:

  1、临床资料

  1.1XIYIZHENDUANBIAOZHUN:ANRIBENHOUSHENGSHENG(1973NIAN)XITONGXINGYINGPIBINGDEZHENDUANBIAOZHUN,ZHONGYIBIANZHENGBIAOZHUN:CANZHAO《ZHONGXIYIJIEHEZHILIAOFENGSHILEIJIBING》HE《SHIYONGZHONGYIFENGSHIBINGXUE》,BINGJIEHELINCHUANGCHANGJIANZHENGHOUFENWEIFENGSHIHANQINXI、FEIWEIBUXUANZHENG,YANGXUHANNING、TANYUHUJIEZHENG,QIXUELIANGXU、JINGLUOSHIRONGZHENGSANXING。

网上扎金花平台   1.2PAICHUBINGLIBIAOZHUN:SUIWEISSc,DANYOUDUOZHONGZHONGXIYAOWUGUOMINTIZHIZHE、JINGSHENBING、GANYAN、FEIJIEHEHUODONGQI、YANZHONGXINXUEGUANJIBING、ZHONGLIUBUZUOWEIZHILIAOYANJIUDEDUIXIANG。

  1.3YIBANZILIAO:75LISScSUIJIFENWEI3ZU,ZHONGYAOQILIAOYIWUHUATOUPIZU(JIANCHENG“JIAZU”)20LI,NAN3LI,NV17LI,NIANLING20-56SUI,PINGJUN35±8SUI;BINGCHENG1.5-23NIAN,PINGJUN6.3±2.4NIAN;BINGQI:SHUIZHONGQI6LI,YINGHUAQI12LI,WEISUOQI2LI;ZHONGYIZHENGXING:FENGSHIHANQINXI、FEIWEIBUXUANZHENG5LI,YANGXUHANNING、TANYUHUJIEZHENG13LI;QIXUELIANGXU、JINGLUOSHIRONGZHENG2LI。NEIZHIZU(JIANCHENG“YIZU”)20LI,NAN4LI,NV16LI,NIANLING20-57SUI,PINGJUN35±9SUI;BINGCHENG2-25NIAN,PINGJUN8.5±5.9NIAN;BINGQI:SHUIZHONGQI5LI,YINGHUAQI11LI,WEISUOQI4LI,ZHONGYIZHENGXING:FENGSHIHANQINXI、FEIWEIBUXUANZHENG5LI;YANGXUHANNING、TANYUHUJIEZHENG11LI;QIXUELIANGXU、JINGLUOSHIRONGZHENG4LI。ZHONGYAOQILIAOYIWUHUATOUPIZUONEIZHIZU(JIANCHENG“BINGZU”)35LI,NAN7LI,NV28LI,NIANLING20-58SUI36±8.9SUI;BINGCHENG9GEYUE-5.6NIAN;BINGQI:SHUIZHONGQI10LI,YINGHUAQI19LI,WEISUOQI6LI。ZHONGYIZHENGXING:FENGSHIHANQINXI、FEIWEIBUXUANZHENG9LI;YANGXUHANNING、TANYUHUJIEZHENG20LI;QIXUELIANGXU、JINGLUOSHIRONGZHENG6LI。75LIHUANZHELIAOQIANJUNJINGGUOZHONGYI、XIYI、ZHONGXIYIJIEHEDENGDUOZHONGLIAOFAZHILIAOWUXIAOERLAIBENBUJIESHOUZHILIAO。3ZUNIANLING、BINGCHENG、BINGQI、ZHENGXINGDENGZILIAOJINGTONGJIXUECHULIWUXIANZHUXINGCHAYI(P>0.05)。

  2、治疗与观察方法

网上扎金花平台   2.1YIQI:HH-QLXINGHUAHENGZHONGYAOQILIAOYI(SUYAOGUANXIE(ZHUN)ZI2001DI2260349HAO,SUYAOGUANXIESHENGCHANXU20010352HAO。ZHUANLIHAO:ZL:97327964.8HE98218369.0)。

  2.2YAOWUZUCHENG:ZHONGYAOQILIAOYIWUHUATOUPIZU:YONGYAOYIJULINCHUANGZHENGXINGXUANYONGZINIDE930HAOFANGJI(YOUFUZI、XIXIN、GUIZHI、MAHUANG、ZAOJIAOCI、JIXUETENG、LUODEDA、SANGYE、HUANGQI、RUXIANG、WUSHAOSHEDENGZUCHENG,MEIDAIHANSHENGYAO390KE,SHIYONGYUFENGSHIHANQINXI、FEIWEIBUXUANZHENG);931HAOFANGJI(YOUXIANLINGPI、SHECHUANGZI、FUZI、GUIZHI、LUODEDA、WUSHAOSHE、HUANGQI、FULING、TAOJINNIANG、ZAOJIAOCI、DANCAN、BAIJIEZIDENGZUCHENG,MEIDAIHANSHENGYAO380KE,SHIYONGYUYANGXUHANNING、TANYUHUJIEZHENG);932HAOFANGJI(YOUHUANGQI、DANGGUI、SHUDIHUANG、ZHISHOUWU、BAISHAO、LUODEDA、DANCAN、ZAOJIAOCI、NANXING、WUSHAOSHEDENGZUCHENG,MEIDAIHANSHENGYAO380KE,SHIYONGYUQIXUELIANGXU、JINGLUOSHIRONGZHENG)。NEIZHIZU:YIJUSHANGSHUZHENGXINGZINIDEWAIZHIFANGJI930、931、932HAO3ZUFANGJIJICHUSHANGANNEIFUYONGLIANGFAFENBIEJIANZHUNONGSUOTIQUCHENGKOUFUYIN(3ZUNEIFUYINMEIHAOSHENGFENBIEHANYUANSHENGYAO0.89g、0.76g、0.81g),MEIPING200ml。

网上扎金花平台   2.3SHIYONGFANGFA:JIA、BINGZUYIJUZHENGXINGXUANYONG930HAO、931HAO、932HAOFANGYAO,YONGQILIAOYIWUHUATOUPIZHILIAO,ZHILIAOWENDUYIBANKONGZHIZAI40-45℃ZHINEI(DUIQIXUELIANGXUZHENGHUANZHECANGWENKAISHIZHILIAOQIAN5CIYINGKONGZHIZAI38-39℃ZHINEI,SHIJIANKONGZHIZAI20FENZHONGZUOYOU)MEIRI1CI,MEICIZHILIAO20-30FENZHONG,ZHILIAO5CI,XIUXI2TIAN;YIZUYIJUZHENGXINGFENBIEXUANYONG930、931、932HAOKOUFUYIN,MEICI100ml,MEIRI2CI,CANHOUYIXIAOSHIFUYONG;BINGZUCHUYONGJIAZUFANGFABINGZUOYIANYIZUGEZHENGXINGNEIFUYINBINGYONG。3ZUJUNWEI3GEYUEWEI1LIAOCHENG,DUIZHANGQIFUYONGZAITILEIYAOYISHIBUNENGTINGFU,YINGZHUJIANCHETING,QITAYAOWUHELIAOFAQUANBUTINGYONG。

  2.4GUANCHAFANGFA

  2.4.1LINCHUANGZHUYAOZHENGZHUANG、TIZHENG:PIFUDANXING,ZHIDUANJINGLUAN,ZHIJIEZHONGTONG,GONGNENGQUSHENZHANGAI,ZHIDUANNILENG、MAMU、CHENZHONGDENGZHISHUQINGKUANG,MEI15TIANJILU1CI。

网上扎金花平台   2.4.2SHIYANSHIJIANCHA:XUECHEN(ESRmm/h,ZHANGGUANFA),KANGHEKANGTI(ANA)JIANJIEMIANYIYINGGUANGFA,KANGScL-70ZISHENKANGTI(MIANYIYINGGUANGFA),LEIFENGSHIYINZIDIDU(RFJIAORUNINGJISHIYANFA),GANSHENGONGNENGCHANGGUI(ReitmanFA),XUECHANGGUIJIXINDIANTU、XIONGPIAN、SHIDAOBEIJIANDENGJIANCHA,LIAOQIAN、ZHILIAO3GEYUEGEJIANCHAYICI。

  2.4.3ZHONGYIZHENGHOU:ZHUZHENGQINGKUANGJIFENFA,GENJU3ZHENGXINGZHONGZHUYAOZHENGHOU,YIJUZHENGZHUANG、TIZHENGCHENGDUBUTONG,YOUQINGZHIZHONGAN0、2、4、6DE4DENGFENFENZHIHUAFEN,MEIXIANG15TIANJILUYICI。

  2.5TONGJIXUEFANGFA:LIAOXIAOBIJIAOYONGRiditFENXI,JISHUZILIAOBIJIAOYONGXJIANYAN,JILIANGZILIAODEBIJIAOYONGPEIDUItJIANYAN。

  3、疗效标准与结果

网上扎金花平台   3.1LIAOXIAOPINGDINGBIAOZHUN:JINQIKONGZHI:HUANZHEZISHENPINGGUHEYISHENGPINGJIABINGQINGXIANZHUGAISHAN,ZHUYAOLIHUAGUANCEZHIBIAO,ZHENGTIGAISHANLVDA85%YISHANG;XIANXIAO:HUANZHEZISHENPINGGUHEYISHENGPINGJIABINGQINGMINGXIANGAISHAN,ZHUYAOLIHUAJIANCHAZHIBIAO、GUANCEZHIBIAOZHENGTIGAISHANLV>65%;HAOZHUAN:HUANZHEZISHENPINGGUHEYISHENGPINGJIABINGQINGGAISHAN,ZHUYAOLIHUAZHIBIAOYOUSUOGAISHAN,GUANCEZHIBIAOZHENGTIGAISHANLVZAI30-64%ZHINEI;WUXIAO:HUANZHEZISHENPINGGUJIYISHENGPINGJIABINGQINGJILIHUAZHIBIAOGAISHANYULIAOQIANXIANGBIJIAOBUMINGXIAN,GUANCEZHIBIAOZHENGTIGAISHANLV<30%。ZHUYAOZHENGZHUANGJITIZHENGPINGJIAFENWEI4JI:GAISHANLVDA85-100%ZHEWEIKONGZHI;GAISHANLVDA65-80%ZHEWEIXIANXIAO;GAISHANLVDA30-64%ZHEWEIHAOZHUAN;GAISHANLV<30%ZHEWEIWUXIAO。ZHONGYIZHUZHENGLIAOXIAOPINGDINGFEN4JI,ZHILIAOHOUZHUZHENGJIFENJIAOLIAOQIANJIANSHAO90-100%ZHEWEIKONGZHI;ZHILIAOHOUZHUZHENGJIFENJIAOLIAOQIANJIANSHAO70-89%WEIXIANXIAO;ZHILIAOHOUZHUZHENGJIFENJIAOLIAOQIANJIANSHAO35%-69%WEIHAOZHUAN;ZHILIAOHOUZHUZHENGJIFENJIAOLIAOQIANJIANSHAO<35%WEIWUXIAO。

  3.2JIEGUO

  3.2.1JIA、YI、BING3ZULINCHUANGLIAOXIAOFENXI:JIAZU20LI,QIZHONGXIANXIAOLVYISHANG8LI(40%),ZONGHAOZHUANLVWEI80%;YIZU20LI,XIANXIAOYISHANG6LI(30%),ZONGHAOZHUANLV75%;BINGZU35LI,XIANXIAOYISHANG19LI(54.29%),ZONGHAOZHUAN97.15%,ANRiditJIANYAN,BINGZUYUJIA、YIZUBIJIAO[P<0.05-0.01],YOUXIANZHUXINGCHAYI,JIAZUYUYIZUBIJIAOP>0.05,CHAYIBUMINGXIAN,JIANBIAO1。

  BIAO1.3ZULIAOFADUISScJINQILIAOXIAOFENXI[LI(%)]

  ZUBIELISHUJINKONGXIANXIAOHAOZHUANWUXIAOZONGHAOZHUANLV

网上扎金花平台   JIAZU203(15)5(25)8(40)4(20)16.80*

  YIZU202(10)4(20)9(45)5(25)15(75)

  BINGZU358(22.86)11(31.43)15(42.86)1(2.85)34(97.15)

  ZHU:BINGZUYUJIA、YIZUBIJIAOΔP<0.05-0.01;JIAYUYIZUBIJIAO*P>0.05

  3.2.2ZHILIAOQIANHOUDELINCHUANGZHENGZHUANGJITIZHENGGAISHANQINGKUANG:3ZUYULIAOQIANBIJIAOJUNYOUXIANZHUXINGCHAYI(P<0.05-0.001);JIA

  ZUYUYIZUXIANGBIJIAOCHAYIBUMINGXIAN(P>0.05);BINGZUYUJIA、YIZUXIANGBIJIAO,YOUXIANZHUXINGYIYI(P<0.01)。BIAOMINGWAIZHIZUONEIZHIXIANGJIEHEZHILIAODUIGAISHANLINCHUANGZHENGZHUANGJITIZHENGYOUYUDANCHUNWAIZHI、NEIZHIFA,JIANBIAO2。

网上扎金花平台   BIAO2.3ZUZHILIAOQIANHOULINCHUANGZHENGZHUANGJITIZHENGGAISHANQINGKUANGBIJIAO(X±S)

网上扎金花平台   ZUBIELISHUPIFUYINGHUA、DANLIZHISHUZHIDUANJINGLUANZHISHUPALENGMAMUCHENZHONGZHISHUZHIJIEZHONGTONGZHISHUGONGNENGZHANGAIZHISHU

网上扎金花平台   JIAZU20LIAOQIAN11.84±2.057.86±1.049.53±2.1116.04±5.1310.09±4.65

  LIAOHOU6.15±1.10*△3.53±0.70*△3.73±0.51**△7.58±0.87**△4.57±1.11**△

网上扎金花平台   YIZU20LIAOQIAN12.05±1.888.63±1.167.89±3.4515.11±6.0510.13±3.56

  LIAOHOU7.69±1.37*4.85±2.35*3.60±2.0*9.06±1.16*5.85±1.51*

  BINGZU35LIAOQIAN13.49±3.119.11±1.2310.10±1.7316.55±4.2211.40±3.75

网上扎金花平台   LIAOHOU2.68±1.26***1.67±0.80***1.44±0.5***3.00±1.50***1.69±1.0***

  ZHU:YULIAOQIANBIJIAO,*P<0.05,**P<0.01;***P<0.001;BINGZUYUJIA、YIZUBIJIAO,P<0.01;JIAYUYIZUBIJIAO,△P>0.05。

网上扎金花平台   3.2.3DUILIHUAZHIBIAODEYINGXIANG:3ZUZHILIAOQIANHOUDESHIYANSHIJIANCHA,BAOKUOBAIXIBAO(WBC)、XUEHONGDANBAI(Hb)、ESR、ANA、ENADUOTAIKANGTIPU-KANGDUOTAIKANGTI(SCL-70)DENGXIANGBIJIAO,3ZUZHILIAOQIANHOUXIANGBIJUNYOUFEICHANGXIANZHUXINGYIYI(P<0.05-0.01HUOP<0.001);BINGZUHbYUYIZULIAOHOUBIJIAOCHAYIBUMINGXIAN(P>0.05);BING、YIZUHbLIAOHOUYUJIAZUBIJIAOP<0.05,JIANBIAO3。

  BIAO3.3ZUZHILIAOQIANHOULIHUAZHIBIAOBIANHUABIJIAO(X±S)

网上扎金花平台   ZUBIELISHUHb(g/L)ESR(mm/h)ANA(YANGXING)SCL-70(YANGXING)

网上扎金花平台   JIAZU20LIAOQIAN80.7±4.0073.50±9.511913

网上扎金花平台   LIAOHOU111.3±2.10*29.1±3.60**2**2**

  YIZU20LIAOQIAN70.6±5.1069.85±10.111814

  LIAOHOU125.2±3.40**△28.47±6.0**2**3**

网上扎金花平台   BINGZU35LIAOQIAN71.6±4.5071.63±8.603331

  LIAOHOU126.7±1.0**△23.35±5.3**1***0***

网上扎金花平台   ZHU:YULIAOQIANBIJIAO,*P<0.05,**P<0.01;***P<0.001;YI、BINGZUYUJIAZUBIJIAO,△P>0.05。

网上扎金花平台   3.2.4BIANZHENGLUNZHIJIEGUOFENXI:BINGZUDUI3ZHENGXINGLIAOXIAOYOUYUJIAZU、YIZU;YIZUDUIQIXUELIANGXU、JINGLUOSHIRONGZHENGDELIAOXIAOYOUYUJIAZU;JIAZUDUIFENGSHIHANQINXI、FEIWEIBUXUANZHENG,YANGXUHANNING、TANYUHUJIEZHENGLIAOXIAOHAOYUYIZU。JIEGUOBIAOMINGZHONGYAOQILIAOYIWUHUATOUPIFAWEIZHU,JIEHENEIZHIBIANZHENGZHILIAODUI3ZHENGXINGLIAOXIAOWEIYOU,JIAZUDUIQIXUELIANGXUZHENGXIAOGUOCHAYUYI、BINGZU,BIAOMINGZHONGYAOQILIAOYIWUHUATOUPIDUITIXUZHEYINGPEIHENEIZHIFADIAOZHI,XIAOGUOYOUYUDANCHUNWAIZHI、NEIZHIFA,JIANBIAO4

  表4.

  3组不同证型治疗结分析[例(%)]

 

  4、讨论与体会

网上扎金花平台   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  BENWENYANJIUJIEGUOBIAOMING:BINGZUZHILIAODUILINCHUANGZHENGZHUANG、TIZHENGDEPIFUDANLI、ZHIDUANJINGLUAN、GUANJIEZHONGTONG、GONGNENGZHANGAI、WEIFENGPALENG、MAMU、SUANCHENDENGZHISHUGAISHANXIANZHU(P<0.01);DUIESR、Hb、ANA、ScL-70DENGJUNYOUXIANZHUDEGAISHANHEDIAOJIEZUOYONG(P<0.01-0.001);LINCHUANGYIZHENGSHIYAO,BIAO4SUOSHI:JIAZUXIANXIAOLVWEI40.00%,ZONGHAOZHUAN80.00%;YIZUXIANXIAOLVWEI30.00%,ZONGHAOZHUAN75.00%;BINGZUXIANXIAOLV54.29%,ZONGHAOZHUAN97.15%。BINGZU3ZHENGXINGLIAOXIAOYOUYUJIA、YIZU(P<0.01),YIZUDUIQIXUELIANGXUZHENGLIAOXIAOYOUYUJIAZU,BIAOMINGDUITIXUZHEYINGPEIHENEIZHIFAXIAOGUOGENGYOUYOUYUEXING。

  江苏省中西医结合风湿病研究中心 张安林 顾宝新等

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