基于双重差分法模型分析清热散结方治疗痤疮的动态效果

陈彩飞; 曹毅; 位磊; 傅宏阳

doi:10.16766/j.cnki.issn.1674-4152.004264

基于双重差分法模型分析清热散结方治疗痤疮的动态效果

doi: 10.16766/j.cnki.issn.1674-4152.004264

陈彩飞¹,
曹毅^2, ,,
位磊²,
傅宏阳²

1.
绍兴市中医院皮肤科，浙江绍兴 312000
2.
浙江省中医院皮肤科，浙江杭州 310006

基金项目:

浙江省中医药科技计划项目 2025ZF031

详细信息

通讯作者:
曹毅, E-mail：caoyi1965@163.com

中图分类号: R758.73 R243
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- 文章访问数: 5
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出版历程
- 收稿日期: 2025-03-14
- 网络出版日期: 2026-01-07

Dynamic effect of Qingre Sanjie Recipe on acne based on a DID model

1.
Department of Dermatology, Shaoxing Hospital of Traditional Chinese Medicine, Shaoxing, Zhejiang 312000, China

摘要

摘要: 目的寻常痤疮(瘀热互结证)是皮肤科常见炎症性疾病，影响患者形象，现有治疗效果局限。本研究应用(difference-in-differences，DID)模型分析清热散结方的动态效果，以期为建立基于证候分型的痤疮中西医结合诊疗方案提供循证依据。方法纳入2023年9月—2024年9月绍兴市中医院收治的92例寻常痤疮(瘀热互结证)患者，采用随机数字表法分为对照组(n=46)和观察组(n=46)。对照组给予多西环素胶囊联合夫西地酸乳膏治疗，观察组在对照组的基础上给予清热散结方治疗。比较2组患者临床疗效、中医证候评分、炎症-氧化情况及不良反应。结果观察组临床总有效率显著高于对照组[95.65%(44/46) vs. 82.61%(38/46)，χ²=4.039，P=0.044]。清热散结方与寻常痤疮患者中医证候评分降低显著相关(P < 0.05)。治疗后，2组患者肿瘤坏死因子-α(TNF-α)、白细胞介素-17(IL-17)均下降，超氧化物歧化酶(SOD)均上升，且观察组患者TNF-α、IL-17低于对照组，SOD高于对照组(P＜0.05)。对照组与观察组不良反应发生率比较差异无统计学意义[6.52%(3/46) vs. 13.04%(6/46)，χ²=0.493，P=0.483]。结论清热散结方用于寻常痤疮(瘀热互结证)患者，临床疗效显著，可调节炎症-氧化因子水平，降低中医证候评分，并具有一定的安全性。
- 痤疮 /
- 双重差分法 /
- 清热散结方 /
- 瘀热互结证 /
- 超氧化物歧化酶
Abstract: Objective Acne vulgaris (stagnation of blood-heat syndrome) is a common inflammatory dermatological condition that affects patients ' appearance, and the efficacy of current treatments is limited. This study applied a difference-in-differences (DID) model to analyze the dynamic effect of the Qingre Sanjie Recipe, aiming to provide evidence-based basis for an integrated traditional Chinese and western medicine diagnosis and treatment of acne based on syndrome classification. Methods A total of 92 patients with acne vulgaris (stagnation of blood-heat syndrome) admitted to our hospital from September 2023 to September 2024 were randomly divided into a control group (n=46) and an observation group (n=46). The control group received doxycycline capsules combined with fusidic acid cream, while the observation group was supplemented with Qingre Sanjie Recipe on the basis of the control group. The clinical efficacy, traditional Chinese medicine (TCM) syndrome score, inflammation-oxidation, and adverse reactions were compared between the two groups. Results The total clinical effective rate in the observation group was significantly higher than that in the control group [95.65% (44/46) vs. 82.61% (38/46), χ²=4.039, P=0.044]. Qingre Sanjie Recipe was significantly related to the decrease of TCM syndrome score of acne vulgaris patients (P < 0.05). After treatment, the levels of tumor necrosis factor-α (TNF-α) and interleukin-17 (IL-17) decreased, while the levels of superoxide dismutase (SOD) increased. The levels of TNF-α and IL-17 in the observation group were lower than those in the control group, while the levels of SOD were higher than those in the control group (P < 0.05). There was no significant difference in the incidence of adverse reactions between the control group and the observation group [6.52% (3/46) vs. 13.04% (6/46), χ²=0.493, P=0.483]. Conclusion The Qingre Sanjie Recipe is effective in treating acne vulgaris (stagnation of blood-heat syndrome), and it can regulate inflammatory-oxidative factors, reduce the score of TCM syndromes, and demonstrates safety.
- Acne /
- Difference-in-differences /
- Qingre Sanjie Recipe /
- Stasis-heat syndrome /
- Superoxide dismutase

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图 1 清热散结方治疗影响中医证候评分的平衡趋势

Figure 1. Parallel trends in the effect of Qingre Sanjie recipe treatment on TCM syndrome scores

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表 1 2组寻常痤疮(瘀热互结证)患者总有效率比较[例(%)]

Table 1. Comparison of overall clinical efficacy between the two groups of patients with acne vulgaris (blood-heat stagnation syndrome)[cases(%)]

组别	例数	治愈	显效	有效	无效	总有效
对照组	46	5(10.87)	16(34.78)	17(36.96)	8(17.39)	38(82.61)
观察组	46	14(30.43)	19(41.30)	11(23.91)	2(4.35)	44(95.65)
注：2组总有效率比较，χ²=4.039，P=0.044。

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表 2 患者中医证候评分比较(x±s，分)

Table 2. Comparison of TCM syndrome scores between the two groups of patients with acne vulgaris (blood-heat stagnation syndrome)(x±s, points)

组别	例数	治疗前	治疗1周	治疗2周	治疗4周	治疗8周
对照组	46	10.51±2.87	10.20±2.83	9.56±2.74	8.94±2.41^ab	7.95±2.01^abcd
观察组	46	11.02±2.95	10.25±2.90	9.15±2.67^a	7.50±2.34^abc	4.58±1.63^abcd
F值		0.840	0.084	0.727	2.907	8.832
P值		0.403	0.933	0.469	0.005	＜0.001
注：与同组治疗前比较，^aP＜0.05;与同组治疗后1周比较，^bP < 0.05;与同组治疗后2周比较，^cP < 0.05;与同组治疗后4周比较，^dP < 0.05。

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表 3 清热散结方治疗影响寻常痤疮(瘀热互结证)患者中医证候评分的结果

Table 3. Results of the effect of Qingre Sanjie recipe on TCM syndrome scores in patients with acne vulgaris (blood-heat stagnation syndrome)

变量	β	SE	t值	P值	95% CI
时间	-0.320	0.050	-6.400	＜0.001	-0.420~-0.220
治疗	0.510	0.200	2.550	0.012	0.110~0.910
交互作用	0.485	0.150	3.230	0.072	-0.190~1.160

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表 4 2组寻常痤疮(瘀热互结证)患者治疗前后炎症-氧化情况比较(x±s)

Table 4. Comparison of inflammation oxidation status before and after treatment between the two groups of patients with acne vulgaris (blood-heat stagnation syndrome, x±s)

组别	例数	TNF-α(ng/L)		IL-17(ng/L)		SOD(U/mL)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	46	42.15±4.86	34.22±4.40^b	33.85±3.39	23.57±2.64^b	38.76±4.58	52.33±2.50^b
观察组	46	42.78±4.94	28.05±3.96^b	33.94±3.26	19.46±2.63^b	38.65±5.04	66.74±4.68^b
统计量		0.617^a	7.069^c	0.130^a	7.480^c	0.110^a	18.420^c
P值		0.539	＜0.001	0.897	＜0.001	0.913	＜0.001
注：^a为t值，^c为F值; 与同组治疗前比较，^bP＜0.05。

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