李远志 岳朝驰 龙庆

摘要： 目的 观察苦黄燥湿汤坐浴治疗肛周湿疹的临床疗效及对Th1/Th2相关因子的影响。方法 将100例肛周湿疹患者随机分为治疗组和对照组各50例，对照组采用外搽曲安奈德益康唑乳膏治疗，治疗组在对照组基础上加用苦黄燥湿汤坐浴，治疗3周后比较2组的临床疗效、瘙痒程度、IFN-γ、IL-2、IL-4等相关因子的改变情况，3个月后随访比较2组的复发情况。结果 治疗组在临床疗效、瘙痒程度评分及复发率方面均优于对照组（P<0.05），且治疗组患者治疗后的Th1相关因子（IFN-γ、IL-2）上升幅度及Th2相关因子（IL-4）下降幅度均优于对照组（P<0.05）。结论 苦黄燥湿汤可有效改善肛周湿疹患者Th1/Th2相关因子的失衡和炎症状态，起到良好的治疗效果。

关键词： 苦黄燥湿汤;肛周湿疹;Th1/Th2

中图分类号：R758.23   文献标志码：B   文章编号：1007-2349（2021）08-0057-03

Study on the Curative Effect of Kuhuang Zaoshi Decoction on Perianal Eczemaand its Influence on Th1/Th2 Related Factors

LI Yuan-zhi， YUE Chao-chi， LONG Qing

（Clinical School of Southwest Medical University/The Affiliated Hospital of Southwest Medical University， Luzhou 646000， China）

【Abstract】Objective： To observe the clinical effect of Kuhuang Zaoshi Decoction in the treatment of perianal eczema and its influence on Th1/Th2 related factors. Methods： 100 patients with perianal eczema were randomly divided into a treatment group and a control group， 50 cases each group. The control group was treated with triamcinolone acetonide and econazole cream and the treatment group was treated with Kuhuang Zaoshi Decoction sitting bath on the basis of the control group. After 3-week treatment， the clinical effect， pruritus degree， IFN-γ， IL-2 and IL-4 related factors of the two groups were compared， and the recurrence of the two groups were followed up and compared 3 months later. Results： The treatment group was better than the control group in terms of clinical effect， pruritus score and recurrence rate （P<0.05）. The increase of Th1 related factors （IFN-γ， IL-2） and the decrease of Th2 related factors （IL-4） in the treatment group after treatment were better than that of the control group （P<0.05）. Conclusion： Kuhuang Zaoshi Decoction can effectively improve the Th1/Th2 related factor imbalance and inflammation in patients with perianal eczema and has a good curative effect.

【Key words】Kuhuang Zaoshi Decoction; Perianal Eczema; Th1/Th2

肛周濕疹是一种常见的肛门皮肤疾病，其发病原因主要是由于肛门周围皮肤黏膜的过敏性炎症，且多继发于多种肛肠疾病如混合痔、肛瘘、肛裂等，具有病情顽固反复、缠绵不愈等特点，严重影响着患者的生活质量[1]。研究表明，Ⅰ型和Ⅳ型变态反应是肛周湿疹发病的重要机制，而Th1/Th2功能失衡又在相关变态反应中起着重要作用，因此研究Th1/Th2相关因子的变化有助于肛周湿疹的治疗。目前临床上多采用糖皮质激素类药物治疗肛周湿疹，疗效欠佳且容易出现色素沉着、依赖性、复发率高等问题。中医学认为肛周湿疹多由于湿热蕴脾，脾失运化以致湿热邪气下注经络，浸淫腠理肌肤所致，故常以清热燥湿、祛风止痒之法治疗[2]。因此，本研究采用经验方苦黄燥湿汤坐浴治疗湿热下注型肛周湿疹患者，观察其治疗疗效，并检测Th1/Th2平衡相关因子，为肛周湿疹的临床治疗及基础研究提供参考。……