何兴辉 郑文振 雷骏轩 刘换章 马泽粦

【摘要】 目的 探讨加味玉屏风敷脐联合推拿治疗婴幼儿湿疹的临床疗效。方法 将收治的48例湿疹患儿按就诊顺序分为对照组和试验组各24例。对照组给予推拿治疗，试验组在对照组的基础上合以加味玉屏风敷脐治疗。治疗两个疗程共10天后，随访四周，观察比较两组患儿治疗总显效率、湿疹面积及严重度指数评分（EASI）、复发率。结果 治疗结束后试验组治疗总显效率为91.7%，高于对照组的66.7%，差异有统计学意义（Z=-2.618，P=0.009）。治疗10天后，试验组EASI评分（1.41±0.42）分，低于对照组（2.28±0.62）分，差异有统计学意义（t=-5.653，P<0.001）;治疗28天后，试验组EASI评分（0.79±0.25）分，低于对照组（1.12±0.49）分，差异有统计学意义（t=-2.959，P=0.005）。停药四周后，试验组复发率8.3%，低于对照组的20.8%，但差异无统计学意义（χ2=0.669，P=0.413）。结论 加味玉屏风敷脐联合推拿治疗婴幼儿湿疹能在一定程度上提高临床治疗效果，值得进一步研究与推广应用。

【关键词】 婴幼儿;湿疹;加味玉屏风敷脐;推拿

中图分类号：R758.23   文献标志码：A   DOI：10.3969/j.issn.1003-1383.2020.07.005

【Abstract】 Objective To explore the clinical efficacy of modified Yupingfeng application on navel combined with massage in the treatment of infantile eczema.Methods 48 children with infantile eczema admitted to hospital were divided into control group and experimental group with 24 cases in each group by visiting sequence.The control group were treated with massage，and the experimental group were treated with modified Yupingfeng application on navel on the basis of the control group.After two treatment courses（10 days），the patients were followed up for four weeks to compare the total marked improvement rate，the score of eczema area and severity index（EASI） and the recurrence rate.Results The total marked improvement rate of treatment in the experimental group was 91.7%，higher than that（66.7%） in the control group，and the difference was statistically significant（Z=-2.618，P=0.009）.10 days after treatment，the EASI score of the experimental group（1.41±0.42） was lower than that of the control group（2.28±0.62），and the difference was statistically significant（t=-5.653，P<0.001）.28 days after treatment，the EASI score of the experimental group（0.79±0.25） was lower than that of the control group （1.12±0.49），and the difference was statistically significant（t=-2.959，P=0.005）.Four weeks after drug withdrawal，the recurrence rate of the experimental group（8.3%） was lower than that of the control group（20.8%），but the difference between the two groups was not statistically significant（χ2=0.669，P=0.413）.Conclusion Modified Yupingfeng application on navel combined with massage in the treatment of infant eczema can improve the clinical effect to a certain extent，which is worthy of further promotion and application.

【Key words】 infant;eczema;modified Yupingfeng application on navel;massage

嬰幼儿湿疹是一种常见的过敏性皮肤病，表现为红斑、丘疹、渗出或脱屑，多发于头面部、躯干和四肢[1]，其病因及发病机制尚不清楚，多认为属遗传和环境相互作用并通过免疫反应途径发病[2]。目前，西医治疗婴幼儿湿疹的常用药物为糖皮质激素乳膏[3]，虽然含激素类药物起效快，但停药后易复发，且激素类药物易导致激素依赖性皮炎、毛细血管扩张、皮肤屏障功能受损等不良反应，故不适合婴幼儿长期大量使用。最近文献报道中药敷脐疗法和推拿已被广泛应用于小儿疾病，属中医外治法之一，前者通过脐部吸收药物作用于经络，后者通过刺激穴位及特定部位以达到治疗疾病的目的[4～5]。中药外治法和推拿治疗湿疹安全有效，不良反应少，但应用于儿童患者的研究报道比较少。……