目的 观察龙牡加味汤治疗中重度特应性皮炎(AD)风湿蕴热证的临床疗效及安全性.方法 64例中重度特应性皮炎风湿蕴热证患者随机分为治疗组和对照组各32例.治疗组给予龙牡加味汤口服加冷湿敷,对照组给予氯雷他定口服加糖皮质激素外用.两组疗程均为8周.观察两组患者治疗前后的AD指数(SCORAD)评分(包括皮疹面积、皮疹严重程度、瘙痒指数与睡眠干扰度),判定临床疗效;对临床痊愈及显效患者随访2个月观察其复发情况;并记录两组患者不良反应.结果 治疗组脱落1例,对照组脱落2例.治疗组31例中临床痊愈1例,显效12例,有效15例,无效3例,总有效率90.32％;对照组30例中临床痊愈0例,显效9例,有效14例,无效7例,总有效率76.67％.两组临床总有效率比较差异具有统计意义(P＜0.05).两组患者治疗后皮疹面积、皮疹严重程度、瘙痒指数与睡眠干扰度评分及SCORDA总积分均较本组治疗前显著降低(P＜0.05),且治疗后治疗组患者SCORAD总积分、皮疹面积和皮疹严重度评分均显著低于对照组(P＜0.05).治疗组临床痊愈及显效患者共13例,其中复发2例(15.38％),对照组9例患者中复发5例(55.56％),两组复发率比较差异具有统计学意义(P＜0.05).两组均未出现明显的不良反应.结论 龙牡加味汤在治疗中重度特应性皮炎风湿蕴热证有较好的临床疗效,可明显降低复发率,且安全性好.

黄尧洲教授认为，银屑病的根本病因为素有血热，主要发病诱因为感受外邪。银屑病的治疗应兼顾血热和外邪两方面，治疗过程中顾护正气，灵活选择清轻升散的药物，散表不伤正，标本兼顾；清热凉血药物的选择兼顾凉血、化瘀、收敛等方面，一药数用，随证加减，取得了较好的临床疗效。

目的 探讨镇心安神法治疗特应性皮炎(AD)的临床疗效.方法 选取作者所在5家医院收治的AD患者210例,随机分为试验组和对照组,各105例.试验组患者按辨证分型予中药镇心安神法治疗;对照组患者予氯雷他定片口服及丁酸氢化可的松乳膏外用.两组均持续治疗8周.结果 试验组脱落9例,对照组脱落8例、剔除1例.试验组总有效率为88.54％,与对照组的83.33％无显著差异(P>0.05);两组患者病变范围、皮疹严重程度、瘙痒指数与影响睡眠程度、特应性皮炎指数(SCORAD)评分、生活质量评分均无显著差异(P>0.05);试验组复发率为22.22％,显著低于对照组的54.17％(P<0.05);两组均未出现与药物相关的严重不良反应(P>0.05).结论 镇心安神法治疗AD,具有较好的近期和远期疗效,且能降低复发率.

目的 观察镇心安神方对1-氯-2,4-二硝基苯(DNCB)致敏诱导特应性皮炎(AD)小鼠皮肤组织瞬时电压感受受体(TR Ps)表达的影响.方法 SPF级雌性BALB/c小鼠24只随机分为4组(正常对照组、模型组、阳性对照组及中药组),每组6只,采用DNCB诱发皮炎法制备AD模型,自造模后第14天起,中药组每天按镇心安神方生药量为18,18 g/kg颗粒水溶液灌胃,阳性对照组每天给予西替利嗪1.3mg/kg灌胃,模型组及正常对照组每天给予0.1 mL/10 g生理盐水灌胃.连续灌胃14天.于造模第1、4、14、28天分别观模型小鼠皮损评分和搔抓频率变化,HE染色观察皮损组织病理学变化,蛋白免疫印迹法(Western Blot)和实时荧光定量技术(RT-PCR)检测皮损中TRPV1、TRPA1、TRPM8蛋白及mRNA相对表达量.结果 与正常对照组比较,造模第14天各组小鼠搔抓次数明显增加(P＜0.01),出现红斑、水肿、糜烂、结痂、干燥等AD样表现,皮肤组织病理学表现为表皮增生明显,棘层肥厚,海绵水肿,真皮层大量炎性细胞浸润;与模型组比较,造模第28天中药组及阳性对照组搔抓次数及皮损评分均降低(P＜0.05).与正常对照组比较,模型组TRPA1、TRPV1、TRPM8蛋白及mRNA表达均升高(P＜0.01);与模型组比较,中药组、阳性对照组TRPA1、TRPV1、TRPM8蛋白及mRNA表达均降低(P＜0.01),中药组TRPA1表达高于阳性对照组,差异有统计学意义(P＜0.05).结论 镇心安神方可以改善模型小鼠AD样皮损及瘙痒,抑制TRPs表达可能是其作用机制,值得深入探索.

目的:观察分析点舌丸联合丹参酮胶囊治疗肺经风热型痤疮的临床疗效.方法:选取2015年6月-2017年6月期间于本院就诊的120例肺经风热型痤疮患者作为研究对象,应用随机数表法分为对照组和观察组,各60例.对照组患者应用丹参酮胶囊口服联合维A酸乳膏局部治疗,观察组患者在此基础上联合应用点舌丸口服治疗.评估两组临床疗效及药物安全性,并观察两组患者皮肤状态改善情况及治疗后复发情况.结果:治疗后,观察组治疗总有效率93.33％(56/60)高于对照组的75.00％(45/60),差异有统计学意义(P＜0.05);治疗期间观察组不良反应发生率15.00％(9/60)与对照组13.33％ (8/60)相比,差异无统计学意义(P＞0.05);治疗前,两组患者脸部皮肤pH、油脂程度、皮肤水分含量对比,差异无统计学意义(P＞0.05);治疗后,观察组患者脸部皮肤pH、油脂程度低于对照组,皮肤水分含量高于对照组,差异有统计学意义(P＜0.05);治疗后8周及16周后,观察组痤疮复发率[3.33％ (2/60),8.33％(5/60)]均低于对照组的[13.33％(8/60),23.33％(14/60)],差异有统计学意义(P＜0.05).结论:联合应用点舌丸与丹参酮胶囊治疗肺经风热型痤疮疗效显著,安全性高,可有效改善患者皮肤状态,降低痤疮复发几率,预后良好.

目的:通过非靶向代谢组学方法研究手工与机器煎煮对八珍汤中化学成分的影响,寻找这2种不同煎药方式之间的差异性化学成分.方法:以规范化手工煎药与机器煎药2种方式对八珍汤进行煎煮,利用正交偏最小二乘法-判别分析(OPLS-DA)等多元统计方法,结合变量重要性投影(VIP)值及t检验分析2种煎药方式对该复方中化学成分的影响.通过UPLC-LTQ-Orbitrap MS对差异性化合物进行分析,流动相乙腈(A)-0.1％甲酸水溶液(B)梯度洗脱(0～3 min,5％A;3～7 min,5％ ～8％A;7～9 min,8％～15％A;9～17 min,15％ ～25％A;17 ～27 min,25％～35％A;27 ～29 min,35％ ～40％A;29～35 min,40％ ～95％ A),柱温30℃,流速0.4 mL·min-1;采用电喷雾离子源和正、负离子模式,扫描范围m/z 50～1 500.结果:在正、负离子监测模式下,共发现87个差异性成分,通过质谱数据结合文献报道,共识别并鉴定了其中的40个成分,包括洋川芎内酯A,甘草素,阿魏酸等.结论:手工与机器煎药获得的八珍汤煎煮液在色泽及化学成分上存在着较为明显的差异.若将二者的优点结合起来,在保持手工煎药优势的基础上,借鉴机器煎药包装药液的方式,建立规范的煎药流程,将使中药汤剂的药效得到最大程度上的发挥.

Erysipelas is an acute inflammation of skin,subcutaneous lymph duct and peripheral soft tissue through minor trauma or invasion of potential focal bacteria under some inducing factors.It is commonly used by beta hemolytic streptococcus.Erysipelas is located at epidermis and it is related to the external stimuli and the body constitution of pa-tient.The retention of blood heat on the skin combined with the invasion of wind,head and damp pathogens results in the interaction of heat and toxin at the skin.Finally,the disease occurs.This disease is the deficiency in the root and the excess in symptom.The improper treatment may lead to interaction of phlegm,heat and stasis,persistent sickness or repeated at-tacks.In the treatment of erysipelas,Prof.Huang Yaozhou uses the bitter and cold drugs of the large dose,combined with the therapy for clearing heat,eliminating damp,activating blood circulation and resolving stasis.In the herbal medicine,the drugs of bitter in taste and cold in nature are used to achieve the quick effects and avoid the evolution of disease.

通过对古典医籍以及近20年来发表文献的检索研究,采用Microsoft Office 2007 Excel电子表对文献进行信息的提取与整理,并对研究结果进行描述性分析,来阐述火针疗法治疗痤疮的研究进展.结果发现目前已有少数随机对照试验证实了火针疗法治疗痤疮的疗效,从已有研究可知火针治疗痤疮的安全性及患者的耐受性均已得到肯定.因此认为,火针疗法治疗痤疮,不仅能够减少皮损,缓解临床症状,且安全性高、复发率低.

Objective:To investigate the effect of Shufeng Jiedu Decoction on clinical efficacy,sequelae of neuralgia and inflammatory cytokines in herpes zoster.Methods:According to the random number table,130 cases of herpes zoster were divided into the control group and the observation group.Two groups of patients took oral famciclovir tablets,vitamin B1 tablets,mecobalamin tablets,and painful oral administration of ibuprofen sustained-release tablets.The observation group were added oral administration of Shufeng Jiedu Decoction,continuous treatment for 1 month.Blister time,scab time,pain loss time and the levels of interleukin-6(IL-6),interleukin-2(IL-2) and interleukin-10 (IL-10) in the serum of the two groups before and after treatment were observed.The patients were followed up for 6 months after the treatment.The incidence of sequelae of neuralgia and the degree of pain were observed,and the incidence of adverse reactions was recorded.Results:Blister time,scab time,pain loss time were significantly shorter in the observation group than those in the control group after treatment (P＜ 0.05).Before treatment,the levels of IL-6,IL-2 and IL-10 in the two groups were not significantly different (P＞ 0.05).After treatment,the levels of IL-6 and IL-10 were decreased in both groups;IL-2 increased,and the improvement rate of the observation group was better than that of the control group (P＜ 0.05).The incidence of sequelae neuralgia in the observation group was 9.23％,lower than that in the control group 23.08％(P＜ 0.05),and VAS score of sequelae neuralgia in the observation group was lower than that of the control group (P ＜ 0.05).Conclusion:Shufeng Jiedu Decoction has an obvious curative effect on herpes zoster,which can significantly shorten the course of the patients and may play a role by inhibiting the expression of IL-6 and IL-10 and promoting the expression of IL-2,and the adverse reaction is small,with high security,worthy of clinical application.

银屑病，俗名“牛皮癣”，是皮肤科常见的慢性复发性炎症性皮肤病，因病程长、反复发作、无特效疗法，肉眼可见红斑鳞屑，自觉瘙痒不适，受到歧视等，给患者带来极大的生理及心理的痛苦。中医学称银屑病为“白疕”，因其“肤如疹疥，色白而痒，搔起白皮”而得名。因为治疗周期长，需要反复治疗，治疗方法的安全性更显重要。中医药治疗以其安全、有效受到患者及皮肤科学界的认可。但是中医药治疗存在着辨证方法众多，不够规范，难于掌握等问题。

特应性皮炎（AD）又称遗传过敏性湿疹或异位性皮炎，是一种常见的慢性复发性、瘙痒性、炎症性皮肤病。一般自婴幼儿期起病，病情迁延反复，部分可持续至成年期，且80% AD儿童日后可发展成为过敏性鼻炎或哮喘。近年来，AD发病率呈逐年上升趋势，严重影响着患者的生活质量。由于其复发率高，需要长期反复治疗，给家庭和社会都带来了较大的经济负担。

ObjectiveTo evaluate the clinical curative effect and security by performing the clinical study ofYinggencao formula in treatment of psoriasis vulgaris with blood-heat TCM syndrome.MethodsA total of 75 patients, diagnosed with Psoriasis Vulgaris Blood-heat RCM syndrome, were randomizedly divided into the treatmeat group with 39 patients and the control group with 36. The treatment group tookYinggencao formula twice daily, while the control group tookQingdai capsules three times daily. All the patients were treated 12 weeks. PASI scores were used as the main outcome and to estimate the curative effect rates.ResultsThe PASI scores of patients in the treatment group (6.97 ± 2.02vs. 16.88 ± 2.91;t=14.380,P=0.009) and the control group (13.14 ± 3.18vs. 17.49 ± 2.32;t=7.780,P=0.013) after treatment showed significantly lower than the scores before. The PASI scores showed significant difference between the two groups after the treatment (P=0.027). The total effective rate of treatment group was significantly higher than the control group (76.9%vs. 61.1%;χ2=5.120, P<0.05).Conclusions TheYinggencao formula therapy showed better effect thanQingdai capsules therapy in treatment of psoriasis vulgaris with blood-heat TCM syndrome.

Objective:To evaluate the clinical efficacy and safety of Chinese herbal medicine in the treatment of psoriasis vulgaris.Methods:Mild psoriasis patients were differentiated into blood-heat syndrome group,blood-dryness syndrome group and blood-stasis syndrome group,120 patients were recruited in each group,and randomized 2:1 to receive Chinese herbs or placebo.The primary endpoint was the proportion of patients achieving improvement in Psoriasis Area and Severity Index(PASI 75) at week 8.Results:Three-hundred and fifty cases were analyzed.The total effective rate of Chinese herbs prescription in blood-heat syndrome group was 69.23%,blood-dryness was 67.09% and blood-stasis group was 56.41%,and only in blood-dryness group it was higher than placebo statistically(P0.05).No severe side-effect occurred in all patients.Conclusion:Chinese herbs in treating mild psoriasis are effective and safe,but the effects are distinct in different syndrome.

Objective To evaluate the clinical efficacy and safety of traditional Chinese medicine on internal and external treatment of acne.Methods 128 patients in Dermatology Department of Xiyuan Hospital CACMS from May 2012 to March 2013 were collected and randomly divided into Chinese medicine group and western medicine group.The patients of Chinese medicine group were divided into invasion of the Lung by Wind-Heat syndrome and damp-heat oflmg and stomach syndrome,respectively taking acne liquid 1 or 2 orally and using the herb mask once a week.The western medicine group took Roxithromycin Capsules orally and smeared 0.3％ Viaminate and Vitamin E Cream.The treatment period lasted for 6 weeks,and collected the photograph of the target lesion before and after research every 2 week and evaluated the efficacy.Result The total efficacy rate were 90.77％ (59/65) and 74.60％ (47/63) for Chinese medicine group and western medicine group respectively,with significant difference between them(x2=11.83,P＜0.05).The efficacy rates were 87.50％ and 93.94％ for invasion of the Lung by Wind-Heat syndrome and damp-heat of lung and stomach syndrome respectively,with no significant difference between them(x2=0.416,P＞0.05).The TCM symptom scores after treatment [Chinese medicine group (4.36 ± 2.45),western medicine group (8.62± 2.49)] had significant difference in two groups respectively compared with before treatment[Chinese medicine group(15.33±6.08),western medicine group(14.34±5.29),P＜0.05].The difference of TCM symptom scores after treatment between the two groups also had a significant difference (P＜0.05).The TCM symptom scores after treatment of invasion of the Lung by Wind-Heat syndrome group and damp-heat of lung and stomach syndrome group were (4.50±3.01) and (4.24±1.83),which had a significant difference compared with before treatment respectively[(15.37±7.03)and(15.29±5.13),P＜0.05].Conclusion The TCM internal and external treatment on acne could reduce the number of lesions and improve TCM symptom scores.The effect of treating invasion of the Lung by Wind-Heat syndrome and damp-heat of lung and stomach syndrome with TCM was almost equal.

刘某，男，64岁，2013年4月10日初诊。双小腿起红班、丘疹、伴瘙痒2年余。患者2年前双小腿起红斑、丘疹、水疱，痒，搔破流渗水，曾在某医院就诊，诊断为“急性湿疹”，经治疗后皮损消退，但症状反复发作。近1个月来湿疹急性发作，双小腿起红丘疹密集成片，皮疹抓破后出现糜烂面，渗出多，上覆痂皮，瘙痒剧烈，影响睡眠，烦躁，大便干燥，小便黄。检查：双小腿伸侧起大小不等，面积较大的暗红色斑块，浸润肥厚，境界较清楚，表面有糜烂面，少量渗出液，见到结痂、血痂。部分皮损周围起红丘疹，附着较薄的白色鳞屑。左侧小腿肿胀。舌暗淡苔黄白腻，脉弦滑。西医诊断：慢性湿疹急性发作，中医诊断：湿疮。中医辨证：心火亢盛，下焦湿热，兼感外邪，日久化毒伤阴。治法：镇心安神，健脾除湿，祛风解毒。方药：生龙骨45 g，煅牡蛎30 g，关黄柏20 g，炒苍术15 g，仙鹤草30 g，侧柏炭20 g，防风10 g，炒栀子15 g，茯苓皮30 g，冬瓜皮30 g。共14剂，水煎温服，分2次服，1剂/d，100 mL/d。医嘱：治疗期间不必忌口，注意指甲卫生，控制好双手，尽量不去触碰皮疹处手挠。

黄尧洲教授擅于采用镇心安神法来治疗胆碱能性荨麻疹.他认为胆碱能性荨麻疹的发生与心的功能有密切关系,从“心主血脉”和“心主神明”两个方面结合起来陈述它的发病机制.加味龙牡汤是黄教授治疗胆碱能性荨麻疹的代表方剂,其用药精简,疗效显著.

目的：观察金黄膏对特应性皮炎患者血清肠毒素 B 及相关抗体的影响。方法对符合纳入标准的90例患者随机分为治疗组和对照组，并分别应用金黄膏和凡士林进行分期治疗，治疗前后进行金葡菌血清肠毒素水平检测。结果金黄膏在降低患者血清金葡菌肠毒素 B 及相关抗体方面优于对照组。结论金黄膏可以降低特应性皮炎患者血清肠毒素 B 及相关抗体的水平。

目的 观察加味龙牡二妙汤治疗湿热蕴肤型湿疹的临床疗效及安全性.方法 选取确诊为湿热蕴肤型湿疹的患者70例,按随机方法分为治疗组和对照组,每组35例.对照组应用西替利嗪加外用糖皮质激素治疗,治疗组应用加味龙牡二妙汤加外用中药洗剂治疗,疗程8周.记录两组患者治疗前后皮肤病变面积、皮损严重程度、瘙痒程度及安全性指标.结果 两组患者治疗后治疗组总有效率为97.1％,对照组为82.9％,两组总有效率比较差异无统计学意义(P＞0.05).两组治疗前后湿疹面积及严重度指数评分(EASI)、瘙痒程度评分(VAS)比较差异有统计学意义(P＜0.05);治疗后两组EASI积分,VAS瘙痒程度评分比较差异无统计学意义(P＞0.05).治疗组未发现不良事件,对照组在服药期间有5例出现不良事件.结论 加味龙牡二妙汤治疗湿疹疗效显著,安全性高,值得临床应用.

目的:观察疏风清肺汤联合中药药膜治疗痤疮肺经风热证的临床疗效.方法:将63例痤疮肺经风热证患者随机分为治疗组32例和对照组31例.治疗组予疏风清肺汤联合中药药膜治疗,对照组予丹参酮胶囊内服及外用维胺酯维E乳膏治疗.6周后观察疗效.结果:治疗组总有效率为75.0％,对照组总有效率为58.1％,治疗组疗效优于对照组(P＜0.05);且治疗组在改善皮损变化方面优于对照组(P＜0.01).结论:疏风清肺汤联合中药药膜治疗痤疮肺经风热证疗效显著.

近年来,在皮肤科临床中,大部分痤疮患者都经过数种治疗,但效果不理想.病情反复发作,甚至出现加重的现象.中国中医科学院西苑医院黄尧洲教授行医40余年,对痤疮的治疗有独特的经验,取得良好的效果.根据痤疮临床表现,重度痤疮以肺胃积热、痰湿瘀结为主要病因病机,采用加味芩部丹汤加减治疗,临床效果显著.