二妙汤加味内服结合外洗治疗湿热浸淫型小儿湿疹72例临床观察

Treatment of 72 cases of infantile eczema with dampness-heat immersion syndrome by internal and external washing with Ermiao Decoction

关键词:  湿疹  小儿  湿热浸淫证  二妙汤  内服  外洗  临床观察

Key words:  eczema  child  damp-heat immersion syndrome  Ermiao Decoction  take orally  external washing  clinical observation

摘要:

[目的] 探讨二妙汤加味内服结合外洗治疗湿热浸淫型小儿湿疹的临床疗效。[方法] 选取2018年6-9月天津市西青区妇幼保健和计划生育服务中心就诊的湿热浸淫型湿疹患儿72例，随机分为治疗组（36例）、对照组（36例）。对照组给予丁酸氢化可的松乳膏外涂，治疗组给予二妙汤加味内服加外洗治疗。两组均连续治疗4周，观测4周后临床疗效、症状积分改变情况、瘙痒疗效，并随访6个月，观察复发率以了解远期疗效。[结果] 治疗组湿疹面积及严重度指数（EASI）疗效评分总有效率为94.44%，高于对照组的88.89%。治疗组患儿治疗后皮疹形态较前明显好转，面积较前减小，且治疗组皮疹形态降幅优于对照组，两组比较差异有统计学意义（P<0.05）。治疗组治疗后瘙痒程度愈显率为94.44%，高于对照组的77.78%，差异有统计学意义（P<0.05）。治疗组复发率为27.78%，低于对照组的78.79%，差异有统计学意义（P<0.01）。[结论] 二妙汤加味内服结合外洗治疗湿热浸淫型小儿湿疹疗效显著，优于单纯西药组，不仅改善症状积分、瘙痒程度，随访复发率也明显低于单纯西药局部用药，远期疗效优势明显。

Abstract:

[Objective] To investigate the clinical effect of Ermiao Decoction on treating infantile eczema with dampness-heat immersion syndrome.[Methods] From June 2018 to September 2018, the 72 children with damp-heat immersion eczema in Xiqing Maternal and Child Health Care and Family Planning Service Center of Tianjin were selected and randomly divided into treatment group (n=36) and control group (n=36). The control group was externally coated with hydrocortisone butyrate cream, and the treatment group was orally treated with Ermiao Decoction plus external washing. Both groups were treated continuously for 4 weeks, and the clinical efficacy, symptom score changes and pruritus efficacy were observed after 4 weeks, and the recurrence rate was observed for 6 months to understand the long-term efficacy.[Results] The total effective rate of EASI (eczema area and severity index score) in the treatment group was 94.44%, which was higher than 88.89% in the control group. After treatment, the skin rash morphology in the treatment group was significantly improved and the area was decreased, and the reduction of skin rash morphology in the treatment group was better than that in the control group, with statistical significance(P<0.05). The effective rate of pruritus in the treatment group was 94.44%, which was significantly higher than that in the control group (77.78%), and the difference was statistically significant (P<0.05). The recurrence rate of the treatment group was 27.78%, significantly lower than that of the control group (78.89%), and the difference was statistically significant(P<0.01).[Conclusion] Ermiao Decoction has a significant effect on the treatment of infantile eczema with damp-heat immersion syndrome by oral administration and external washing, which was higher than that of the western medicine group. It not only improved the symptom score and pruritued degree, but also significantly reduced the recurrence rate during follow-up.