复方参蓉汤加减治疗脾肾两虚型斑秃的临床疗效观察

马颖，纳猛，杨恩品

1. 云南省开远市人民医院皮肤科，云南开远 661000；2. 云南中医药大学第一附属医院，云南昆明 650021

Clinical observation of compound shenrong decoction in treating alopecia areata withdefi ciency of spleen and kidney

MA Ying ,NA Meng ,YANG En-pin

1.Department of Dermatology Kaiyuan People‘s Hospital of Yunnan,Kaiyuan,Yunnan 661000,China;2.The First Affi liated Hospitalof Yunnan University of Traditional Chinese Medicine,Kunming,Yunnan 650021,China

摘要	[目的] 观察复方参蓉汤对脾肾两虚型斑秃的疗效及安全性，为健脾益肾法治疗脾肾两虚型斑秃提供临床依据。方法将同期收治的 66 例脾肾两虚型斑秃患者 61 例随机分为两组，试验组 31 例、对照组 30 例。试验组口服复方参蓉汤，对照组口服健脾益肾颗粒；两组均外擦0.1%他克莫司软膏。疗程共12周，患者每周复诊1次，在治疗前及每4周末记录患者皮损积分，在治疗前及治疗结束时检测血清 CD 4 + 、CD 8 + T 淋巴细胞的水平、皮肤镜下靶皮损改变并进行数据分析。结果治疗后，试验组总有效率为 90.32%；对照组为 76.67%，两组比较，差异有统计学意义（P ＜ 0.05）；两组 SALT 评分、中医证候评分、终毛数密度、DLQI 评分，较治疗前有显著差异（P ＜ 0.05），组间比较，试验组优于对照组。试验组不良反应发生率、复发率显著低于对照组，差异有统计学意义（P ＜ 0.05）。结论复方参蓉汤汤治疗脾肾两虚型斑秃疗效确切，较健脾益肾颗粒有明显优势。皮肤镜在毛发性疾病的诊断、鉴别、判定疗效方面显示了良好的应用前景。
关键词	斑秃 ; 复方参蓉汤 ; 脾肾两虚 ; 临床观察
Abstract：	To observe the effi cacy and safety of compound Shenrong decoction on alopecia areata with defi ciency of spleen and kid-ney, and to provide clinical basis for strengthening spleenand enriching kidney in the treatment of alopecia areata with defi ciency of spleen andkidney.Methods 66 patients with alopecia areata with defi ciency of both spleen and kidney were randomly divided into two groups. A total of 61 effective cas-es were obtained, including 31 cases in experimental group and 30 cases in control group.The experimental group was given compound Shengrong de-coction orally.The control group received Jianpi Yishen Granules orally.Both groups were applied 0.1% tacrolimus ointment.The treatment course was 12weeks, patients were visited once a week, and the skin lesion scores were recorded before treatment and every 4 weekends. The serum CD 4 + and CD 8 + Tlymphocyte levels were detected before and at the end of treatment, and the changes of target skin lesions under dermoscopic conditions were analyzed.Results After treatment, the total effective rate of the experimental group was 90.32%.The control group was 76.67%, and the difference between thetwo groups was statistically signifi cant (P ＜ 0.05); Salt score, TCM syndrome score, fi nal hair density and DLQI score were signifi cantly different be-tween the two groups (P ＜ 0.05), the experimental group was better than the control group.The incidence of adverse reactions and recurrence rate in thetrial group were signifi cantly lower than those in the control group, and the difference was statistically signifi cant (P ＜ 0.05). Conclusion CompoundShenrong Decoction has defi nite curative effect on alopecia areata with defi ciency of spleen and kidney, and has obvious advantages over Jianpi YishenGranules. Dermatoscopy has a promising application prospect in the diagnosis, differentiation and curative effect determination of hair diseases.
Keywords	Alopecia areata ; Compound shenrong decoction ; Spleen and kidney defi ciency ; Observation of curative effect
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