导赤散联合窄谱强脉冲光治疗寻常痤疮（心经积热证）临床研究

doi:10.3760/cma.j.cn441417-20241220-10027

摘要/Abstract

摘要：

目的　探讨导赤散联合窄谱强脉冲光对心经积热证寻常痤疮的治疗效果。方法　选取2022年1月至2024年7月长安医院收治的126例寻常痤疮患者为前瞻性研究对象，采用抽签法随机将患者分为导赤散组、窄谱强脉冲光组、联合组，每组42例。导赤散组男15例、女27例，年龄（23.67±4.66）岁，病程（1.48±0.31）年，给予导赤散治疗；窄谱强脉冲光组男18例、女24例，年龄（22.19±3.52）岁，病程（1.43±0.36）年，给予窄谱强脉冲光治疗；联合组男16例、女26例，年龄（22.52±3.49）岁，病程（1.57±0.38）年，给予导赤散联合窄谱强脉冲光治疗。均持续治疗3个月。比较3组治疗前后的中医症状评分、皮损评分、炎症因子［肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）、白细胞介素-12（interleukin-12，IL-12）、白细胞介素-17（interleukin-17，IL-17）］，以及临床疗效和不良反应。统计学方法采用单因素方差分析、t检验、χ2检验。结果　治疗前，3组中医症状评分、皮损评分和TNF-α、IL-12、IL-17水平比较，差异均无统计学意义（F=0.530、0.158、0.432、0.968、0.142，均P>0.05）；治疗3个月后，3组的中医症状评分［（7.88±1.57）分、（7.36±1.44）分、（4.81±0.98）分］、皮损评分［（10.38±2.34）分、（9.52±2.08）分、（6.05±0.98）分］、TNF-α［（33.16±4.41）μg/L、（34.53±4.78）μg/L、（27.84±3.66）μg/L］、IL-12［（30.34±3.85）μg/L、（29.22±3.34）μg/L、（23.65±3.09）μg/L］、IL-17［（1.42±0.26）μg/L、（1.37±0.25）μg/L、（0.92±0.18）μg/L］均较治疗前降低（均P<0.001），且组间比较差异均有统计学意义（均P<0.001），联合组上述指标均低于导赤散组（均P<0.001）和窄谱强脉冲光组（均P<0.001）。导赤散组、窄谱强脉冲光组、联合组的治疗总有效率分别为69.05%（29/42）、73.81%（31/42）、92.86%（39/42）］，联合组高于导赤散组和窄谱强脉冲光组，差异有统计学意义（χ2=7.919， P=0.0219）。3组不良反应发生率分别为2.38%（1/42）、7.14%（3/42）、9.52%（4/42），差异无统计学意义（χ2=1.869，P>0.05）。结论　导赤散联合窄谱强脉冲光治疗心经积热证寻常痤疮能够促进症状缓解和皮损消退，抑制炎症反应，疗效高且安全性好。

关键词:

寻常痤疮； , , 心经积热证； , , 导赤散； , , 窄谱强脉冲光

Abstract:

Objective　To explore the effect of Daochi San combined with narrow-spectrum intense pulsed light for patients with acne vulgaris of heart meridian heat accumulation syndrome. Method　A total of 126 patients with acne vulgaris admitted to Chang 'an Hospital from January 2022 to July 2024 were selected as the prospective research subjects, and were divided into a Daochi San group, narrow-spectrum intense pulsed light group, and a combination group by lottery, with 42 patients in each group. There were 15 males and 27 females in the Daochi San group, with an age of (23.67±4.66) years and a disease course of (1.48±0.31) years. There were 18 males and 24 females in the narrow-spectrum intense pulsed light group, with an age of (22.19±3.52) years and a disease course of (1.43±0.36) years. There were 16 males and 26 females in the combination group, with an age of (22.52±3.49) years and a disease course of (1.57±0.38) years. The Daochi San group were treated with the Daochi San, the narrow-spectrum intense pulsed light group narrow-spectrum intense pulsed light, and the combination group with Daochi San and narrow-spectrum intense pulsed light, for 3 months. The study evaluated traditional Chinese medicine symptom scores, skin lesion severity, serum inflammatory factor levels [tumor necrosis factor-α (TNF-α), interleukin-12 (IL-12), and interleukin-17 (IL-17)] before and after treatment, clinical efficacy, and adverse reaction incidence.One-way analysis of variance, t test, and χ² test were used for the statistical analysis. Results　Before the treatment, there were no statistical differences in the scores of traditional Chinese medicine symptoms and skin lesions and levels of TNF-α, IL-12, and IL-17 between the 3 groups (all P>0.05). After the treatment, the scores of traditional Chinese medicine symptoms (7.88±1.57, 7.36±1.44, and 4.81±0.98) and skin lesion (10.38±2.34, 9.52±2.08, and 6.05±0.98) and levels of TNF-α [(33.16±4.41) μg/L, (34.53±4.78) μg/L, and (27.84±3.66) μg/L], IL-12 [(30.34±3.85) μg/L, (29.22±3.34) μg/L, and (23.65±3.09) μg/L], and IL-17 [(1.42±0.26) μg/L, (1.37±0.25) μg/L, and (0.92±0.18) μg/L] decreased in the three groups (all P<0.001), and there were statistical differences between the 3 groups ( all P<0.001); those in the combination group were lower than those in the Daochi San group (all P<0.001) and those in the narrow-spectrum intense pulsed light group (all P<0.001). The total effective rates of the Daochi San group, the narrow-spectrum intense pulsed light group, and the combination group were 69.05% (29/42), 73.81% (31/42), and 92.86% (39/42), the combination group was higher than those in the Daochi San group and the narrow-spectrum intense pulsed light group (χ²=7.919，P=0.0219). The incidence rates of adverse reactions in the Daochi San group, the narrow-spectrum intense pulsed light group, and the combination group were 2.38% (1/42), 7.14% (3/42), and 9.52% (4/42), respectively, with no statistical difference (χ²=1.869, P>0.05). Conclusion　Daochi San combined with narrow-spectrum intense pulsed light for patients with acne vulgaris of heart meridian heat accumulation syndrome can promote symptom relief and skin lesion regression, inhibit inflammatory reactions, with high efficacy and good safety.

Key words: Acne vulgaris, Heart meridian heat accumulation syndrome, Daochi San, Narrow-spectrum intense pulsed light

王少博李伟赵婵刘燕. 导赤散联合窄谱强脉冲光治疗寻常痤疮（心经积热证）临床研究 [J]. 国际医药卫生导报, 2025, 31(10): 1713-1718.

Wang Shaobo, Li Wei, Zhao Chan, Liu Yan.

Daochi San combined with narrow-spectrum intense pulsed light for patients with acne vulgaris of heart meridian heat accumulation syndrome [J]. International Medicine and Health Guidance News, 2025, 31(10): 1713-1718.

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