清心镇肝汤治疗特应性皮炎心肝火旺证的临床观察*

作者：张 玲1，陈 露2，徐 佳3

单位：1.北京中医医院怀柔医院，北京 101400； 2.苏州市吴江区中医医院，江苏 苏州 215221； 3.首都医科大学附属北京中医医院，北京 100010

引用：引用：张玲，陈露，徐佳.清心镇肝汤治疗特应性皮炎心肝火旺证的临床观察[J].中医药导报,2025,31(12):133-137,162.

DOI：10.13862/j.cn43-1446/r.2025.12.021

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摘要：目的：评价清心镇肝汤治疗特应性皮炎心肝火旺证的临床疗效及安全性。方法：将66例特应性皮炎心肝火旺证患者随机分为治疗组与对照组，每组33例。治疗组予清心镇肝汤颗粒口服，2次/d；对照组予依巴斯汀片口服，1次/d。两组均外用糠酸莫米松乳膏，1次/d。疗程均为4周。评价患者治疗前后特应性皮炎积分指数（SCORAD）评分、中医证候评分，检测血清免疫球蛋白E（IgE）及白细胞介素-31（IL-31）水平，并评价有效率及安全性。结果：治疗组1例、对照组3例因疗效欠佳、皮损加重而脱落。治疗组32例完成研究，对照组30例完成研究。治疗组总有效率为84.38%（27/32），高于对照组[70.00%（21/30）]（P＜0.01）。两组患者治疗后SCORAD总分、皮损范围评分、皮损严重程度评分、瘙痒程度评分、影响睡眠程度评分均较治疗前下降（P<0.01），且治疗组均低于对照组（P<0.05）。两组患者治疗后中医证候评分均降低（P＜0.01或P＜0.05），且治疗组低于对照组（P＜0.01）。两组患者治疗后血清IgE、IL-31水平均较治疗前下降（P＜0.01或P＜0.05），且治疗组低于对照组（P＜0.05）。结论：清心镇肝汤治疗特应性皮炎心肝火旺证患者有较好的临床疗效，能降低血清IgE及IL-31水平，减轻患者皮损，缓解瘙痒症状。

关键词：特应性皮炎；心肝火旺证；清心镇肝汤；依巴斯汀；免疫球蛋白E；白细胞介素-31

Abstract：

Objective: To evaluate the clinical efficacy and safety of Qingxin Zhen'gan Decoction (清心镇肝汤) in treating atopic dermatitis (AD) with heart-liver fire hyperactivity syndrome. Methods: 66 AD patients with this syndrome were randomly divided into a treatment group and a control group, 33 cases in each. The treatment group received oral Qingxin Zhen'gan Decoction granules twice daily; the control group received oral ebastine once daily. Both groups applied mometasone furoate ointment once daily. The treatment course was 4 weeks. SCORAD index, TCM syndrome scores, serum IgE and IL-31 levels were evaluated, along with efficacy and safety. Results: One patient in the treatment group and three in the control group withdrew from the study due to poor efficacy and worsening skin lesions. Consequently, 32 patients in the treatment group and 30 in the control group completed the study. The total effective rate was significantly higher in the treatment [84.38%(27/32)] group compared to the control group [70.00%(21/30)] (P<0.01). After treatment, scores for the total SCORAD index, extent of skin lesions, severity of skin lesions, pruritus intensity, and sleep disturbance all showed a significant decrease from baseline in both groups (P<0.01). Furthermore, post-treatment scores for the total SCORAD index, lesion severity, pruritus, and sleep disturbance in the treatment group were significantly lower than those in the control group (P<0.05). Traditional Chinese Medicine (TCM) syndrome scores decreased significantly in both groups after treatment (P<0.01 or P<0.05), with the treatment group exhibiting significantly lower post-treatment TCM syndrome scores than the control group (P<0.01). Serum levels of immunoglobulin E (IgE) and interleukin-31 (IL-31) were significantly reduced from pre-treatment levels in both groups after therapy (P<0.01 or P<0.05). Additionally, the post-treatment serum IgE level in the treatment group was significantly lower than that in the control group (P<0.05). Conclusion: Qingxin Zhen'gan Decoction shows good clinical efficacy in treating AD with heart-liver fire hyperactivity syndrome, reducing serum IgE and IL-31 levels, alleviating skin lesions and itching symptoms.

Key words：atopic dermatitis; heart-liver fire hyperactivity syndrome; Qingxin Zhen'gan Decoction; ebastine; ebastiimmunoglobulin E; interleukin-31

发布时间：2025-12-31

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