赵爱杰 李琳 曹悦玲

[摘要]目的：探讨火针联合卤米松软膏对神经性皮炎患者症状积分及血清炎性因子的影响。方法：选取2017年6月-2019年6月笔者医院收治的106例神经性皮炎患者为研究对象，依据随机数字表法分为研究组与对照组，每组53例。对照组采取卤米松软膏治疗，研究组在对照组基础上联合火针治疗。治疗后，统计两组临床疗效、不良事件发生率及治疗前后临床症状积分、血清炎性因子[白细胞介素-1β（IL-1β）、白细胞介素-4（IL-4）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）]水平、生活质量（DLQI）评分，随访1～6个月，统计两组疾病复发率。结果：治疗后，研究组瘙痒、丘疹、色泽及面积评分均低于对照组（P<0.05）;研究组总有效率94.34%，高于对照组的81.13%（P<0.05）;治疗后，研究组血清IL-1β、IL-4、IL-6、TNF-α水平低于对照组（P<0.05）;两组DLQI评分较治疗前降低，且研究组低于对照组（P<0.05）;两组不良事件发生率对比，差异无统计学意义（P>0.05）;治疗后6个月，研究组疾病复发率3.77%，低于对照组的15.09%（P<0.05）。结论：火针联合卤米松软膏治疗神经性皮炎能從减轻炎症反应方面进一步提高治疗效果，改善临床症状，降低复发率，提升患者生活质量，且不良事件发生率低，安全性高。

[关键词]火针;卤米松软膏;神经性皮炎;症状积分;生活质量;复发率

[中图分类号]R758.3+2    [文献标志码]A    [文章编号]1008-6455（2021）04-0125-04

Effects of Fire Acupuncture Combined with Halomethasone Ointment on Symptom Score and Serum Inflammatory Factors in Patients with Neurodermatitis

ZHAO Ai-jie1，LI Lin2，CAO Yue-ling2

（1.Department of Outpatient;2.Department of Dermatology， Qinhuangdao Hospital of Traditional Chinese Medicine， Qinhuangdao 066000， Hebei，China）

Abstract： Objective To investigate the effects of fire acupuncture combined with halamisone ointment on the symptom score and serum inflammatory factors in patients with neurodermatitis. Methods  A total of 106 patients with neurodermatitis in our hospital from June 2017 to June 2019 were selected and divided into a study group and a control group according to the random number table method， with 53 cases in each group. The control group was treated with halomethasone ointment， and the study group was treated with fire acupuncture on the basis of the control group. The clinical efficacy， incidence of adverse events， clinical symptom scores， serum inflammatory factors [interleukin-1β （IL-1β）， interleukin-4 （IL-4）， interleukin-6 （IL-6）， tumor necrosis factor-α （ TNF-α）] level， quality of life （DLQI） score before and after treatment of the two groups were collected， the follow-up period was 1 to 6 months， and the recurrence rates of the two groups were calculated.  Results  The scores of pruritus， pimples， color and area in the study group after treatment were lower than those in the control group （P<0.05）， the total effective rate of the study group was 94.34% higher than that of the control group 81.13% （P<0.05）.The serum levels of IL-1β， IL-4， IL-6 and TNF-α in the study group were lower than those in the control group after treatment （P<0.05）.After treatment， the DLQI score of the two groups was lower than that before the treatment， and the study group was lower than the control group （P<0.05）.There was no significant difference in the incidence of adverse events between the two groups （P>0.05）.Six months after treatment， the disease recurrence rate in the study group was 3.77%  lower than the control group 15.09% （P<0.05）. Conclusion  Fire acupuncture combined with halomethasone ointment for neurodermatitis can further improve the treatment effect by reducing the inflammatory response， and can improve clinical symptoms， reduce the recurrence rate， improve the quality of life， and has a low incidence of adverse events and high safety.

Key words：fire acupuncture; halamisone ointment; neurodermatitis; symptom score; quality of life; relapse rate

神經性皮炎是青年群体多发慢性炎症性皮肤疾病，常见于前臂、颈后及小腿侧等部位，患病率可达10%以上，主要表现瘙痒、丘疹等，严重者可致皮肤损伤[1]。目前，临床主要予以卤米松软膏外涂治疗，可特异性结合甾体受体，改变与病因相关蛋白质合成，缓解症状，但仍有部分患者效果欠佳，且预后复发率高[2]。近年来，随着中医学的研究深入，其在神经性皮炎中的应用价值被逐渐重视。神经性皮炎属中医“顽癣”、“牛皮癣”等范畴，《外科正宗·顽癣第七十六》记载：“顽癣乃风、热、湿、虫四者为患”，认为风、热、湿邪蕴阻皮肤，致营血失和，肌肤失养，生风化燥乃此病根源所在，治则温通助阳，扶助正气。……