蛇床子散熏洗结合口服中药治疗外阴色素减退性疾病临床观察

Clinical observation on the treatment of vulvar white lesion with common cnidium fruit powder combined with oral taking Chinese medicine

关键词:  蛇床子散加减方  中药熏洗  中药内服  外阴色素减退性疾病

Key words:  common cnidium fruit powder  traditional Chinese medicine fumigation  oral medicinal herbs  vulvar white lesion

摘要:

[目的] 观察蛇床子散加减方局部熏洗外阴结合口服中药治疗外阴色素减退性疾病的临床疗效。[方法] 临床观察40例中医辨证为肝肾阴虚的围绝经期外阴色素减退性疾病患者，按就诊先后顺序将患者随机分组：治疗组采用补益肝肾中药内服配合蛇床子散加减局部熏洗外阴的方法治疗，于经前期每日早晚分次口服外用，每4周为1个疗程，经期停用。连续治疗3个疗程。对照组予西药曲安奈德软膏局部用药3个月。分别在6个月、12个月时随访，观察其近期疗效、远期疗效及治疗前后的临床症状评分。[结果] 治愈12例（30%），显效22例（55%），好转4例（10%），无效2例（5%），近期总有效率95%。随访12个月，有效34例，复发6例，远期总有效率85%。对照组治愈10例（25%），显效17例（42.5%），好转6例（15%），无效7例（17.5%），近期总有效率82.5%。随访12个月，有效25例，复发15例，远期总有效率62.5%。两组近期有效率无统计学差异，远期有效率对比有统计学差异，治疗组远期有效率明显高于对照组。两组治疗前后临床症状均显著改善，且治疗组症状改善优于对照组，差异有统计学意义。[结论] 蛇床子散加减方熏洗外阴配合中药内服补肝益肾，是一种疗效确切，安全无创的治疗方法，值得临床进一步推广应用。

Abstract:

[Objective] To observe the clinical curative effect of cnidium fruit powder fumigation and washing of vulva in combination with oral taking Chinese medicine in treating vulvar white lesion. [Methods] Clinical observation of 80 cases of perimenopausal vulvar hypopigmentation patients with syndrome of liver-kidney yin deficiency based on traditional Chinese medicine. The patients were randomly divided into groups according to the order of treatment:the treatment group used tonifying liver and kidney herbs orally and cnidium fruit powder fumigation and washing of vulva. The vulva washing method is applied daily in the morning and evening in the premenstrual period. It is a course of treatment every 4 weeks,and is discontinued during menstruation. 3 consecutive courses of treatment. The control group was given topical application of western medicine triamcinolone ointment for 3 months. Follow-up was performed at 6 months and 12 months to observe the short-term effect,long-term effect,and clinical symptom score before and after treatment. [Results] The treatment group was cured in 12 cases (30%),markedly effective in 22 cases (55%),improved in 4 cases (10%),and ineffective in 2 cases (5%). The recent total effective rate was 95%,and the follow-up was 12 months. There were 34 cases and 6 cases of recurrence. The total long-term effective rate was 85%. The control group was cured in 10 cases (25%),markedly effective in 17 cases (42.5%),improved in 6 cases (15%),ineffective in 7 cases (17.5%),and the total effective rate in the near future was 82.5%. Followed up for 12 months,25 cases were effective,15 cases recurred,and the total long-term effective rate was 62.5%. There was no statistical difference in the near-term efficiency between the two groups,and there was a statistical difference between the long-term efficiency. The long-term efficiency in the treatment group was significantly higher than that in the control group.The clinical symptoms before and after treatment were significant,the difference was statistically significant,and the improvement of symptoms in the treatment group was better than that in the control group. [Conclusion] Cnidium fruit powder Fumigation and Washing of Vulva combined with traditional Chinese medicine orally tonifying liver and kidney,is an accurate,safe and non-invasive treatment method,which is worthy of further clinical application.