Effect of Qibai Tazi Decoction Combined with Comprehensive Nursing Based on 5E Concept on the Clinical Efficacy and Inflammatory Factors of Jellyfish Acute Dermatitis
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摘要:
目的 探讨芪柏塌渍方外敷联合基于“5E”理念的综合护理对海蜇蜇伤性急性皮炎疗效和血清炎症因子的影响。 方法 将秦皇岛市中医医院急诊科、皮肤科2018年6月—2019年9月就诊的120例海蜇蜇伤急性皮炎患者按照随机数字表法分为标准组(60例)和“5E”组(60例)。2组患者均给予芪柏塌渍方外敷, 标准组给予标准化护理管理, “5E”组给予“5E”综合护理干预。1周后对2组患者起效、疼痛时间、皮损消退、肿胀消退时间, 组胺、致痛物质, IL-6、IL-8、IL-10, 表皮含水量和油脂量及依从率进行比较, 进而评价2组效果。 结果 “5E”组起效时间快于标准组(P＜0.05), 且疼痛时间、皮损消退时间及肿胀时间均短于标准组(均P＜0.05)。治疗后2组组胺及致痛物质较治疗前均有所下降, 组内比较差异有统计学意义(均P＜0.01), “5E”组效果明显优于标准组(P＜0.05)。治疗前2组IL-6、IL-8、IL-10表达量比较差异无统计学意义, 治疗后2组IL-6、IL-8表达量降低, IL-10表达量升高, 组内比较差异有统计学意义(均P＜0.05), 且“5E”组IL-6、IL-8低于标准组, IL-10表达高于标准组(均P＜0.05)。治疗前2组表皮含水量及油脂量比较差异无统计学意义, 治疗后2组表皮含水量和油脂量升高, 组内比较差异有统计学意义(均P＜0.01), 且“5E”组表皮含水量及油脂量改善情况优于标准组(P＜0.05)。 结论 芪柏塌渍方外敷联合“5E”综合护理可以提高临床疗效, 改善皮肤过敏状态及炎症应答, 改善局部皮肤状态。 Abstract:Objective To explore the effect of external application of Qibai Tazi Decoction combined with comprehensive nursing based on 5E concept on the curative effect and serum inflammatory factors of jellyfish acute dermatitis. Methods A total of 157 patients with acute dermatitis were divided into standard group (79 cases) and 5E group (78 cases). Both groups were given external application of Qibai Tazi Decoction, standard group was given standardized nursing management, and 5E group was given 5E comprehensive nursing intervention. Three days later, the efficacy, pain time, skin lesions, swelling time, histamine, pain causing substances, IL-6, IL-8, IL-10, water content and oil content in epidermis of the two groups were compared, and then the effect of the two groups was evaluated. Results The onset time of 5E group was faster than that of the standard group (P < 0.05). After treatment, histamine and pain causing substance in the two groups decreased compared with that before treatment (P < 0.01). The effect of 5E group was significantly better than that of the standard group (all P < 0.05). The expressions of IL-6, IL-8 and IL-10 in the two groups increased before and after treatment. The expressions of IL-6 and IL-8 in the two groups decreased and the expression of IL-10 increased (all P < 0.05). The 5E effect of the two groups was better than that of the standard group (P < 0.05). There was interaction effect between the two groups at the time point (all P < 0.05). The water content and oil content of epidermis in the two groups decreased before treatment, and the above indexes increased in the two groups after treatment (all P < 0.01), and the improvement of 5E was better than that in the standard group (P < 0.05). Conclusion The external application of Qibai Tazi Decoction combined with 5E comprehensive nursing can improve the clinical effect, the allergic state and inflammatory response of skin, and the local skin state. -
表 1 2组急性皮炎患者一般资料比较
组别 例数 性别(例) 年龄(x±s，岁) 病程(x±s，h) 皮损程度(例) 男性 女性 轻度 中度 标准组 60 32 28 35.45±5.27 4.85±0.24 31 29 “5E”组 60 29 31 35.27±5.28 4.92±0.25 28 32 统计量 0.300a 0.187b 1.565b 0.300a P值 0.584 0.852 0.120 0.584 注：a为χ2值，b为t值。 
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表 2 2组急性皮炎患者临床症状消退时间比较(x ±s)
组别 例数 起效时间(min) 疼痛时间(d) 皮损消退时间(d) 肿胀时间(d) “5E”组 60 4.33±1.14 2.48±0.57 2.78±0.57 3.14±1.03 标准组 60 6.32±1.65 4.41±0.75 5.29±0.68 5.80±0.69 t值 6.150 8.576 8.609 9.701 P值 < 0.001 < 0.001 < 0.001 < 0.001
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表 3 2组急性皮炎患者2组患者致敏物质比较(x ±s)
组别 例数 组胺(ng/mL) t值 P值 致痛物质(pg/mL) t值 P值 治疗前 治疗后 治疗前 治疗后 标准组 60 12.48±2.23 9.79±2.20 7.621 < 0.001 113.16±15.54 75.17±8.02 16.827 < 0.001 “5E”组 60 12.73±2.58 5.66±2.10 16.46 < 0.001 112.10±14.89 51.28±10.13 26.159 < 0.001 t值 0.567 10.518 0.381 14.322 P值 0.285 < 0.001 0.351 < 0.001
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表 4 2组急性皮炎患者炎症因子比较(x ±s，pg/mL)
组别 例数 IL-6 t值 P值 IL-8 t值 P值 IL-10 t值 P值 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 标准组 60 57.46±9.01 38.63±9.58 11.090 < 0.001 86.58±7.67 55.47±7.92 21.856 < 0.001 12.03±2.67 19.33±5.37 9.428 < 0.001 “5E”组 60 58.78±9.85 21.14±6.37 24.855 < 0.001 86.34±8.05 40.21±5.37 26.159 < 0.001 11.67±2.99 33.53±5.38 27.510 < 0.001 t值 0.765 11.776 0.167 12.352 0.696 14.470 P值 0.221 < 0.001 0.433 < 0.001 0.243 < 0.001
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表 5 2组急性皮炎患者表皮含水量及油脂量比较(x ±s)
组别 例数 表皮含水量(%) t值 P值 油脂含量(μg/cm2) t值 P值 治疗前 治疗后 治疗前 治疗后 标准组 60 17.25±3.46 24.58±7.61 12.029 < 0.001 82.52±7.14 94.58±8.35 8.500 < 0.001 “5E”组 60 17.66±3.60 35.82±7.21 17.455 < 0.001 82.60±7.18 113.23±11.29 17.732 < 0.001 t值 0.636 8.305 0.061 10.288 P值 0.262 < 0.001 0.475 < 0.001
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表 6 2组急性皮炎患者依从性比较[例(%)]
组别 例数 遵医治疗 定期复查 按时用药 “5E”组 60 60(100.00) 52(86.67) 58(96.67) 标准组 60 49(81.67) 40(66.67) 49(81.67) χ2值 5.392 9.229 9.942 P值 0.019 0.008 0.006
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