Abstract:

Objective　To explore the effect of fumigation with Shire Duqing decoction combined with diphenyl cream for patients with perianal eczema. Methods　One hundred and ninety-six patients with perianal eczema treated at Xi'an Daxing Hospital from January 2022 to July 2023 selected for the randomized controlled trial, and were divided into an observation group and a control group by the random number table method, with 98 cases in each group. There were 51 males and 47 females in the control group; they were (39.15±5.26) years old; their disease course was (5.78±1.62) weeks. There were 46 males and 52 females in the observation group; they were (37.82±5.08) years old; their disease course was (5.41±1.38) weeks. The control group were treated with diphenyl cream. The observation group were treated with diphenyl cream and fumigation with Shire Duqing decoction. After 3 weeks' treatment, the severities of eczema, scores of traditional Chinese medicine syndromes, levels of inflammation and immune factors [interleukin-4 (IL-4), interferon gamma (INF-γ), and immunoglobulin E (IgE)], quality of life and psychological resilience, efficacies, adverse reactions, and recurrence rates were compared between the two groups. χ² and t tests were used. Results　The treatment effective rate of the observation group was higher than that of the control group [94.90% (93/98) vs. 83.67% (82/98)], with a statistical difference (χ²=6.453, P=0.011). After the treatment, the scores of anal itching, eczema area, perianal exudate, main symptoms, and secondary syndromes, the levels of IL-4, INF-γ, and IgE, and the scores of Dermatology Life Quality Index (DLQI) and Connor-Davidson Resilience Scale (CD-RISC) in the observation group were better than those in the control group [1.44±0.31 vs. 1.61±0.33, 1.47±0.21 vs. 1.59±0.34, 1.39±0.29 vs. 1.52±0.41, 6.21±1.83 vs. 7.59±1.73, 2.57±0.43 vs. 3.16±0.51, 2.07±0.35 vs. 2.41±0.29, (30.62±4.83) ng/L vs. (34.91±5.27) ng/L, (35.14±5.71) ng/L vs. (32.56±4.95) ng/L, (561.34±79.62) U/ml vs. (584.28±61.37) U/ml, 6.04±1.51 vs. 7.72±1.39, and 67.34±7.21 vs. 62.48±6.05], with statistical differences (all P<0.05). The recurrence rate of the observation group was lower than that of the control group [14.29% (14/98) vs. 29.59% (29/98)], with a statistical difference (χ²=6.703, P=0.010). No serious adverse reactions were observed in both groups. Conclusion　Shire Duqing decoction combined with diphenyl cream for patients with perianal eczema can alleviate their symptoms, such as itching and skin lesions, inhibit inflammatory reactions, improve therapeutic effect, and reduce the recurrence rate.

Key words:

Perianal eczema, Shire Duqing decoction, Fumigation, Inflammation

摘要：

目的　探讨湿热毒清汤加减熏洗联合地苯乳膏治疗肛周湿疹患者的效果。方法　选取2022年1月至2023年7月西安大兴医院收治的196例肛周湿疹患者进行随机对照试验。采用随机数字表法将其分为观察组和对照组，各98例。对照组男51例，女47例，年龄（39.15±5.26）岁，病程（5.78±1.62）周。观察组男46例，女52例，年龄（37.82±5.08）岁，病程（5.41±1.38）周。对照组采用地苯乳膏治疗，观察组采用地苯乳膏联合湿热毒清汤加减熏洗治疗。治疗3周后，比较两组湿疹严重程度、中医证候积分、炎症及免疫因子［白细胞介素4（interleukin-4，IL-4）、干扰素γ（interferon gamma，INF-γ）、免疫球蛋白E（immunoglobulin E，IgE）］、生活质量及心理弹性、疗效、不良反应及复发率。采用χ²检验、t检验进行统计分析。结果　观察组治疗有效率高于对照组［94.90%（93/98）比83.67%（82/98）］，差异有统计学意义（χ²=6.453，P=0.011）。治疗后，观察组肛门瘙痒评分、湿疹面积评分、肛周渗液评分、主证评分、次证评分、舌脉评分，IL-4、INF-γ、IgE水平，皮肤病生活质量指数（Dermatology Life Quality Index，DLQI）评分、心理弹性量表（Connor-Davidson Resilience Scale，CD-RISC）评分均优于对照组［（1.44±0.31）分比（1.61±0.33）分、（1.47±0.21）分比（1.59±0.34）分、（1.39±0.29）分比（1.52±0.41）分、（6.21±1.83）分比（7.59±1.73）分、（2.57±0.43）分比（3.16±0.51）分、（2.07±0.35）分比（2.41±0.29）分、（30.62±4.83）ng/L比（34.91±5.27）ng/L、（35.14±5.71）ng/L比（32.56±4.95）ng/L、（561.34±79.62）U/ml比（584.28±61.37）U/ml、（6.04±1.51）分比（7.72±1.39）分、（67.34±7.21）分比（62.48±6.05）分］，差异有统计学意义（均P<0.05）。观察组复发率为14.29%（14/98），低于对照组的29.59%（29/98），差异有统计学意义（χ²=6.703，P=0.010）。两组均未见严重不良反应。结论　湿热毒清汤加减熏洗联合地苯乳膏治疗肛周湿疹患者有助于缓解瘙痒、皮损等症状，抑制炎症反应，提升疗效，降低复发率。

关键词:

肛周湿疹, 湿热毒清汤, 熏洗, 炎症