高存志 翁志洁 王岩 杨晓丽

    [摘要]目的：研究清热除湿汤加减联合放血拔罐对急性湿疹皮损疗效及血清T淋巴细胞亚群、Th2相关细胞因子水平的影响。方法：选择秦皇岛市中医医院收治的96例急性湿疹患者作为研究对象，将其随机分为观察组(48例)和对照组(48例)。两组采取常规西医治疗，观察组清热除湿汤联合放血拔罐治疗，对照组放血拔罐治疗。观察两组治疗3周后临床疗效、比较治疗前后CD3+、CD4+、CD8+、CD4+/CD8+、IL-4、IL-5、IL-13、IL-31水平。以ROC曲线及非条件Logistic逐步回归分析急性湿疹短期疗效的影响因素。结果：治疗后，两组瘙痒、皮损面积、皮损形态评分均较治疗前降低，且观察组更低(P<0.05);治疗后，观察组CD4+水平高于对照组，CD8+、IL-4、IL-31水平低于对照组(P<0.05);经ROC分析，CD4+、CD8+、IL-4、IL-31预测急性湿疹皮损短期疗效曲线下面积为分别为0.776、0.790、0.819、0.691;经Logistic回归性分析显示CD4+≥34.114%、CD8+<26.825%、IL-4<12.525 pg/ml、IL-31<22.040 pg/ml是治疗湿疹取得较好短期疗效的独立影响因素。结论：清热除湿汤联合放血拔罐治疗湿疹能促进细胞免疫平衡恢复，减轻炎症反应，具有推广价值。

    [关键词]急性湿疹;清热除湿汤;放血拔罐;免疫细胞;炎性因子

    [中图分类号]R758.23? ? [文獻标志码]B? ? [文章编号]1008-6455(2022)06-0110-05

    Clinical Application of Qingre Chushi Decoction Combined with Blood-letting Cupping in the Treatment of Acute Eczema

    GAO Cunzhi1，WENG Zhijie2，WANG Yan3，YANG Xiaoli1

    (1.Department of Dermatology; 2.Department of Outpatient; 3.Department of Blood Transfusion， Qinhuangdao Hospital of Traditional Chinese Medicine，Qinhuangdao 066000，Hebei，China)

    Abstract： Objective To study the effect of Qingre Chushi decoction combined with blood-letting cupping on acute Eczema and the levels of T lymphocyte and TH2 related cytokines. Methods 96 patients with acute eczema in Qinhuangdao Hospital of traditional Chinese medicine were randomly divided into observation group (48 cases) and control group (48 cases). Two groups were treated with conventional Western medicine ......