萆薢滲濕湯聯(lián)合哌拉西林鈉他唑巴坦鈉治療下肢丹毒的療效及對血清細胞因子的影響

滕林　孫鳳娟　回雪穎

摘要 目的：探討萆薢滲濕湯聯(lián)合哌拉西林鈉他唑巴坦鈉治療下肢丹毒的療效，檢測其對血清指標(biāo)的影響及治療安全性。方法：選取2016年5月至2018年10月黑龍江中醫(yī)藥大學(xué)附屬第二醫(yī)院收治的下肢丹毒患者82例作為研究對象，按照隨機數(shù)表法分為對照組和觀察組，每組41例。對照組接受哌拉西林鈉他唑巴坦鈉治療，觀察組在哌拉西林鈉他唑巴坦鈉治療基礎(chǔ)上加入萆薢滲濕湯進行聯(lián)合治療，持續(xù)治療2周。比較2組患者的治療效果、癥狀體征積分值、血清學(xué)指標(biāo)[一氧化氮（NO）、白細胞介素1β（IL-1β）、白細胞介素-6（IL-6）、腫瘤壞死因子α（TNF-α）]及藥物不良反應(yīng)發(fā)生率的差異。結(jié)果：治療后，觀察組患者的治療有效率高于對照組患者;膚色、腫脹程度、膚溫、自覺疼痛等癥狀體征積分值低于對照組患者;血清NO、IL-1β、IL-1β、IL-6、TNF-α的含量低于對照組患者（P<0.05）。治療期間，2組患者皮疹瘙癢、惡心嘔吐、便秘腹瀉等不良反應(yīng)發(fā)生率的差異無統(tǒng)計學(xué)意義（P>0.05）。結(jié)論：萆薢滲濕湯治療下肢丹毒的效果卓著，且具有良好的用藥安全性。

關(guān)鍵詞 下肢丹毒;萆薢滲濕湯;哌拉西林鈉他唑巴坦鈉;一氧化氮;炎性反應(yīng)

Efficacy of BiXie Dampness-Percolating Decoction Combined with Piperacillin Sodium and Tazobactam Sodium in Leg Erysipelas and Their Influence on Serum Cytokines

Teng Lin1，Sun Fengjuan1，Hui Xueying2

（1 Heilongjiang University of Traditional Chinese Medicine，Harbin150040，China; 2The Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine Peripheral vascular disease，Harbin 150040，China）

Abstract Objective：To investigate the efficacy of Xueyushi Decoction combined with piperacillin sodium and tazobactam sodium in the treatment of erysipelas of lower extremities，and to detect its influence on serum indexes and treatment safety.Methods：From May 2016 to Oct 2018，82 patients with erysipelas of lower extremities were divided into control group and combination group by random number table.The control group received piperacillin sodium and tazobactam sodium，and the combination group received Xuoshi Decoction on the basis of piperacillin sodium and tazobactam sodium for 2 weeks.The therapeutic effect，symptom and sign integral value，serological indexes [nitric oxide（NO），interleukin-1 beta（IL-1 beta），interleukin-6（IL-6），tumor necrosis factor-alpha（TNF-alpha）] and the incidence of adverse drug reactions were compared between the two groups.Results：After treatment，the effective rate of treatment in the combined group was higher than that in the control group;the scores of symptoms and signs such as skin color，swelling degree，skin temperature and conscious pain were lower than those in the control group; the levels of serum NO，IL-1beta，IL-1beta，IL-6 and TNF-alpha were lower than those in the control group（P<0.05）.During the treatment period，there was no significant difference in the incidence of adverse reactions such as rash pruritus，nausea and vomitin g、constipation and diarrhea between the two groups（P>0.05）.Conclusion：Xuanxueshi Decoction is effective in treating erysipelas of lower limbs and has good medication safety.

Key Words Leg erysipelas;BiXie Dampness-Percolating Decoction;Piperacillin Sodium and Tazobactam Sodium;NO;Inflammatory reaction

中圖分類號：R275.9文獻標(biāo)識碼：Adoi：10.3969/j.issn.1673-7202.2019.09.047

丹毒是一種皮膚急性感染性疾病，以局部皮膚突然發(fā)紅、顏色鮮艷并稍隆起、按壓后褪色為主要臨床表現(xiàn)，多伴有燒灼樣痛、嚴(yán)重的紅腫處可伴紫斑甚至膿皰，下肢是該病最常發(fā)生的部位[1-2]。最新研究指出丹毒是一種β-溶血性鏈球菌感染導(dǎo)致的網(wǎng)狀淋巴管炎，哌拉西林鈉他唑巴坦鈉是一種半合成青霉素類抗生素[3]，靜脈滴注可在短時間內(nèi)改善全身癥狀，但療效存在局限性、治療后復(fù)發(fā)率較高。……