中西医结合治疗胸背部痤疮的效果观察及综合护理干预

李欢梅; 唐艳丽; 钟红丽; 沈惠良

doi:10.16766/j.cnki.issn.1674-4152.003009

中西医结合治疗胸背部痤疮的效果观察及综合护理干预

doi: 10.16766/j.cnki.issn.1674-4152.003009

1.
浙江省皮肤病医院美容理疗科，浙江湖州 313200
2.
浙江省皮肤病医院皮肤科

基金项目:

浙江省医药卫生科技计划项目 2018KY357

详细信息

通讯作者:
李欢梅，E-mail：LHM20220723@126.com

中图分类号: R473.75 R758.733
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- 文章访问数: 209
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- PDF下载量: 10
- 被引次数: 0
出版历程
- 收稿日期: 2023-01-06

Observation study on the efficacy of integrated traditional Chinese and Western medicine in the treatment of chest and back acne and comprehensive nursing intervention

1.
Department of Beauty and Physiotherapy, Zhejiang Dermatology Hospital, Huzhou, Zhejiang 313200, China

摘要

摘要: 目的分析中西医结合治疗胸背部痤疮的临床效果，探讨适用于中西医结合治疗的综合护理干预，改善胸背部痤疮患者临床症状和心理状态。方法选取2020年4月—2021年11月浙江省皮肤病医院美容理疗科收治的80例胸背部痤疮患者，根据随机数字表法将其分为对照组和观察组, 每组各40例。对照组患者采用红蓝光治疗，并给予常规护理干预，观察组在对照组基础上实施中药外治(消痤散)并给予患者综合护理干预。比较2组患者临床疗效及不良反应发生率、治疗前后痤疮综合分级系统(GAGS)评分，并比较2组患者治疗前后心理状态评分。结果观察组患者临床总有效率为65.0%(26/40)，高于对照组[42.5%(17/40)]，差异有统计学意义(P < 0.05)。2组患者治疗期间不良反应发生率比较差异无统计学意义(P>0.05)；治疗后, 观察组GAGS评分为6.13(2.06，10.71)分，显著低于对照组[8.86(3.91，13.25)分, P < 0.05]；观察组患者焦虑、抑郁自评量表评分分别为(40.73±3.89)分、(41.03±4.22)分均低于对照组[(46.38±5.41)分、(46.83±5.69)分, 均P < 0.05]。结论红蓝光结合消痤散治疗胸背部痤疮并配合综合护理干预临床效果显著且安全性较高，能有效减轻患者皮损情况、改善患者不良情绪，值得临床应用。
- 红蓝光治疗 /
- 消痤散 /
- 胸背部痤疮 /
- 综合护理
Abstract: Objective To analyze the clinical effects of combining Chinese and Western medicine in the treatment of acne on the chest and back, and to explore comprehensive nursing interventions applicable to the combined treatment of Chinese and Western medicine, to improve the clinical symptoms and psychological status of patients with acne on the chest and back. Methods A total of 80 patients with acne on chest and back who were treated in the Department of Beauty and Physiotherapy, Zhejiang Dermatology Hospital from April 2020 to November 2021 were selected as the research samples. They were divided into control group and observation group, with 40 cases in each group according to the random number table method. The patients in the control group were treated with red and blue light and received routine nursing intervention. The patients in the observation group were treated with traditional Chinese medicine (Xiaocuo Powder) and received comprehensive nursing intervention on the basis of the control group. The clinical efficacy and incidence of adverse reactions, the global acne grading system (GAGS) score and the psychological status score before and after treatment were compared between two groups. Results The overall clinical effective rate of patients in the observation group was 65.0% (26/40), which was higher than that in the control group (42.5%, 17/40), and the difference was statistically significant (P < 0.05). The difference in the incidence of adverse reactions between the two groups was not statistically significant (P>0.05); after treatment, the GAGS score of the observation group was 6.13 (2.06, 10.71) points, which was significantly lower than that in the control group [8.86 (3.91, 13.25) points, P < 0.05]; The self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores in the observation group were (40.73±3.89) points and (41.03±4.22) points, respectively, which were lower than those in the control group (46.38±5.41) points and (46.83±5.69) points, both P < 0.05. Conclusion The combination of red and blue light with Xiaocuo Powder in the treatment of chest and back acne combined with comprehensive nursing intervention has a significant clinical effect and high safety. It can effectively reduce patients ' skin damage and improve patients ' bad mood, which is worthy of clinical application.
- Red and blue light therapy /
- Xiaocuo Powder /
- Acne on chest and back /
- Comprehensive nursing
利益冲突 无

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表 1 2组胸背部痤疮患者一般资料比较

Table 1. Comparison of general data of patients with acne on the chest and back in 2 groups

组别	例数	性别(例)		年龄(x±s，岁)	病程时间(x±s，月)	位置(例)
组别	例数	男性	女性	年龄(x±s，岁)	病程时间(x±s，月)	胸部	背部	胸+背部
对照组	40	24	16	22.78±8.29	12.11±5.05	3	31	6
观察组	40	19	21	21.25±7.14	12.09±4.81	2	34	4
统计量		1.257^a		0.884^b	0.018^b	0.739^b
P值		0.262		0.379	0.986	0.691
注：^a为χ²值，^b为t值。

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表 2 2组胸背部痤疮患者治疗效果比较

Table 2. Comparison of treatment results between 2 groups of patients with acne on the chest and back

组别	例数	治愈(例)	显效(例)	好转(例)	无效(例)	总有效[例(%)]
对照组	40	5	12	20	3	17(42.5)
观察组	40	10	16	14	0	26(65.0)
注：2组总有效率比较，χ²=4.073，P=0.044。

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表 3 2组胸背部痤疮患者治疗前后GAGS评分比较[M(P₂₅, P₇₅)，分]

Table 3. Comparison of GAGS scores before and after treatment in 2 groups of patients with chest and back acne [M(P₂₅, P₇₅), score]

组别	例数	治疗前	治疗后	Z值	P值
对照组	40	16.21(13.18，20.56)	8.86(3.91，13.25)	9.150	< 0.001
观察组	40	16.37(13.55，20.86)	6.13(2.06，10.71)	10.763	< 0.001
Z值		0.836	3.114
P值		0.405	0.027

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表 4 2组胸背部痤疮患者治疗前后焦虑、抑郁情绪比较(x±s，分)

Table 4. Comparison of anxiety and depression in 2 groups of patients with chest and back acne before and after treatment(x±s, score)

组别	例数	SAS		t值	P值	SDS		t值	P值
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
对照组	40	54.98±5.77	46.38±5.41	6.756	< 0.001	54.18±5.79	46.83±5.69	5.159	< 0.001
观察组	40	56.13±5.72	40.73±3.89	12.015	< 0.001	55.38±5.71	41.03±4.22	11.665	< 0.001
t值		0.895	5.123			0.933	5.178
P值		0.373	< 0.001			0.354	< 0.001

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参考文献(20)

[1]	骆华芳, 刘振强. 丹参酮胶囊联合常规西医治疗寻常型痤疮的疗效分析[J]. 中华全科医学, 2021, 19(11): 1858-1860, 1867. doi: 10.16766/j.cnki.issn.1674-4152.002185 LUO H F, LIU Z Q, Analysis of the efficacy of tanshinone capsule combined with conventional western medicine in the treatment of acne vulgaris[J]. Chinese Journal of General Practice, 2021, 19(11): 1858-1860, 1867. doi: 10.16766/j.cnki.issn.1674-4152.002185
[2]	KHARAZI L, DADKHAHFAR S, RAHIMI H, et al. The efficacy of blue light versus the combination of blue and red light therapy in the treatment of acne vulgaris[J]. Photodermatol Photoimmunol Photomed, 2021, 37(6): 564-566. doi: 10.1111/phpp.12702
[3]	NITAYAVARDHANA S, MANUSKIATTI W, CEMBRANO K A G, et al. A comparative study between once-weekly and alternating twice-weekly regimen using blue (470 nm) and red (640 nm) Light combination LED phototherapy for moderate-to-severe acne vulgaris[J]. Lasers Surg Med, 2021, 53(8): 1080-1085. doi: 10.1002/lsm.23388
[4]	LI W H, FASSIH A, BINNER C, et al. Low-level red LED light inhibits hyperkeratinization and inflammation induced by unsaturated fatty acid in an in vitro model mimicking acne[J]. Lasers Surg Med, 2018, 50(2): 158-165. doi: 10.1002/lsm.22747
[5]	赵冰清, 韩维鑫, 党艳茹, 等. 强脉冲激光联合红蓝光照射治疗痤疮后红斑临床观察[J]. 山东医药, 2021, 61(15): 72-74. doi: 10.3969/j.issn.1002-266X.2021.15.018 ZHAO B Q, HAN W X, DANG Y R, et al, Clinical observation of intense pulse laser combined with red and blue light irradiation in the treatment of erythema after acne[J]. Shandong Medical Journal, 2021, 61(15): 72-74. doi: 10.3969/j.issn.1002-266X.2021.15.018
[6]	任俊荣, 张理涛. 中医特色疗法治疗痤疮临床研究进展[J]. 中国中西医结合皮肤性病学杂志, 2021, 20(3): 325-328. doi: 10.3969/j.issn.1672-0709.2021.03.030 REN J R, ZHANG L T. Progress in clinical research on the treatment of acne with traditional Chinese medicine[J]. Chinese Journal of Integrated Traditional and Western Medicine Dermatology, 2021, 20(3): 325-328. doi: 10.3969/j.issn.1672-0709.2021.03.030
[7]	中国痤疮治疗指南专家组. 中国痤疮治疗指南(2019修订版)[J]. 临床皮肤科杂志, 2019, 48(9): 583-588. https://www.cnki.com.cn/Article/CJFDTOTAL-LCPF201909023.htm China acne treatment guide expert group. China acne treatment guide (2019 revision)[J]. Journal of Clinical Dermatology, 2019, 48(9): 583-588. https://www.cnki.com.cn/Article/CJFDTOTAL-LCPF201909023.htm
[8]	张天博, 白彦萍. 寻常痤疮的中医证候研究进展[J]. 江苏中医药, 2018, 50(12): 83-86. doi: 10.3969/j.issn.1672-397X.2018.12.032 ZHANG T B, BAI Y P. Research progress in TCM syndromes of acne vulgaris[J]. Jiangsu Traditional Chinese Medicine, 2018, 50(12): 83-86. doi: 10.3969/j.issn.1672-397X.2018.12.032
[9]	廖丽君. 痤疮严重度分级及其治疗研究进展[J]. 世界最新医学信息文摘(连续型电子期刊), 2015(18): 51-51, 43. doi: 10.3969/j.issn.1671-3141.2015.18.035 LIAO L J. Research progress in acne severity classification and treatment[J]. World's Latest Medical Information Abstract (Continuous Electronic Journal), 2015(18): 51-51, 43. doi: 10.3969/j.issn.1671-3141.2015.18.035
[10]	刘根起, 陈树民. 痤疮综合分级系统和皮损计数法的一致性评价[J]. 中华皮肤科杂志, 2004, 37(7): 403-405. doi: 10.3760/j.issn:0412-4030.2004.07.008 LIU G Q, CHEN S M. Consistency evaluation of acne comprehensive grading system and skin lesion counting method[J]. Chinese Journal of Dermatology, 2004, 37(7): 403-405. doi: 10.3760/j.issn:0412-4030.2004.07.008
[11]	王征宇, 迟玉芬. 焦虑自评量表(SAS)[J]. 上海精神医学, 1984(2): 73-74. https://www.cnki.com.cn/Article/CJFDTOTAL-JSYI198402008.htm WANG Z Y, CHI Y F. Self-rating anxiety scale (SAS)[J]. Shanghai Psychiatry, 1984(2): 73-74. https://www.cnki.com.cn/Article/CJFDTOTAL-JSYI198402008.htm
[12]	王征宇, 迟玉芬. 抑郁自评量表(SDS)[J]. 上海精神医学, 1984(2): 71-72. https://www.cnki.com.cn/Article/CJFDTOTAL-JSYI198402007.htm WANG Z Y, CHI Y F. Self-rating anxiety scale (SDS)[J]. Shanghai Psychiatry, 1984(2): 71-72. https://www.cnki.com.cn/Article/CJFDTOTAL-JSYI198402007.htm
[13]	LI J H, LI J D, ZHANG L L, et al. Comparison of red light and blue light therapies for mild-to-moderate acne vulgaris: a randomized controlled clinical study[J]. Photodermatol Photoimmunol Photomed, 2022, 38(5): 459-464.
[14]	ZHANG T B, BAI Y P, YANG H Y, et al. Efficacy of modified Qufeng Runmian Powder on acne vulgaris with syndromes of dampness and blood stasis: a multicenter, randomized, double-blind, placebo-controlled clinical trial[J]. Chin J Integr Med, 2020, 26(7): 490-496.
[15]	杨力, 林新瑜. 痤疮与皮肤屏障的研究进展[J]. 中国中西医结合皮肤性病学杂志, 2021, 20(4): 416-419. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXYD202104031.htm YANG L, LIN X Y. Research progress of acne and skin barrier[J]. Chinese Journal of Integrated Traditional and Western Medicine Dermatology, 2021, 20(4): 416-419. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXYD202104031.htm
[16]	云璐, 刘湘, 王根会, 等. 痤疮十味方加减联合阿达帕林凝胶治疗中、重度痤疮临床观察[J]. 河北中医, 2021, 43(11): 1862-1865. https://www.cnki.com.cn/Article/CJFDTOTAL-HBZY202111018.htm YUN L, LIU X, WANG G H, et al, Clinical observation on the treatment of moderate and severe acne with the addition and subtraction of Acne Ten Flavor Recipe combined with Adapalingel[J]. Hebei Traditional Chinese Medicine, 2021, 43(11): 1862-1865. https://www.cnki.com.cn/Article/CJFDTOTAL-HBZY202111018.htm
[17]	北京中西医结合学会医学美容专业委员会. 中西医结合痤疮诊治专家共识[J]. 实用皮肤病学杂志, 2021, 14(5): 257-260. https://www.cnki.com.cn/Article/CJFDTOTAL-SYPF202105001.htm Medical Cosmetology Professional Committee of Beijing Association of Integrated Chinese and Western Medicine. Expert consensus on acne diagnosis and treatment of integrated Chinese and Western medicine[J]. Journal of Practical Dermatology, 2021, 14(5): 257-260. https://www.cnki.com.cn/Article/CJFDTOTAL-SYPF202105001.htm
[18]	徐英, 朱静, 娄青, 等. 皮肤美容护理结合支持性心理干预对女性中重度痤疮患者治疗效果的影响[J]. 中国美容医学, 2022, 31(4): 166-168, 189. https://www.cnki.com.cn/Article/CJFDTOTAL-MRYX202204042.htm XU Y, ZHU J, LOU Q, et al. The effect of skin beauty care combined with supportive psychological intervention on the treatment of female patients with moderate and severe acne[J]. China Cosmetic Medicine, 2022, 31(4): 166-168, 189. https://www.cnki.com.cn/Article/CJFDTOTAL-MRYX202204042.htm
[19]	DUAN P P, YAN C Q, FENG H S, et al. Clinical study on acupuncture treatment of gastrointestinal damp-heat acne[J]. Medicine (Baltimore), 2021, 100(44): e27503. DOI:10.1097/MD.0000000 000027503.
[20]	ZHOU J, LI X X, CHEN H M, et al. Effects and safety of acne vulgaris with external application of herbal medicines: a protocol for systematic review and meta analysis[J]. Medicine (Baltimore), 2021, 100(26): e26408. DOI: 10.1097/MD.0000000000026408.