| Chronic urticaria is a common pruritic and allergic skin diseases.Due to the change of people's living environment,life style,eating habits and other reasons,the incidence of this disease has gradually increased year by year.Chronic urticaria with complex causes is difficult to treat.Its long course,repeatedly manifests and unbearable itching which affect the patients'work and study seriously,bring great pain to the patients.At present,western medicine with symptom control as the main method has no specific treatment.The treatment of traditional Chinese medicine is still based on syndrome differentiation,such as syndrome differentiation of eight principles,syndrome differentiation of etiology,defense-qi-nutrient-blood differentiation,viscera syndrome differentiation,six-channel differentiation and so on.There are different ideas of syndrome differentiation and different prescriptions for treatment,however there is no universally recognized standard for diagnosis and treatment of TCM at present for chronic urticaria.In addition,some patients with chronic urticaria have the characteristics of periodic attack,and the symptoms disappear in the remission period,which results in the situation with no symptoms to be identified.In this case,treatment based on syndrome differentiation is easy to miss the opportunity to consolidate the curative effect.Constitution differentiation is the premise of syndrome differentiation,and can improve its accuracy.Therefore combining treatment of both in order to improve the therapeutic effect of chronic urticaria.Meanwhile,quantification of TCM constitution determination provides an objective and standardized method for clinical research.The tunability of constitution provides the methodological guidance for the clinical practice of constitution differentiation treatment.The study is a clinical observation and study,through the method of combination of constitution differentiation treatment and syndrome differentiation treatment for chronic urticaria,to preliminarily evaluate the intervention effect and effectiveness of constitutional treatment in improving patients'condition,shortening the course of disease,improving curative effect and reducing recurrence,so as to provide ideas for further research and standardization of traditional Chinese medicine treatment of chronic urticaria.Objective:The aim of this study is to observe and evaluate the intervention effect of the combination of syndrome differentiation and constitutional treatment on improving patients' condition,shortening the course of disease,improving curative effect,slowing down recurrence and so on,and to discuss the clinical curative effect of constitution differentiation treatment for chronic urticaria.Methods:According to the inclusion and exclusion criteria of this subject,100 outpatients with chronic urticaria belonged to wind-dampness-heat syndrome were randomly divided into control group and treatment group.The control group was given Xiaofeng powder in the form of decoction-free granules to remove wind,clear heat and relieve itching and calamine lotion for external use.The treatment group was given the above medicines with the prescription for constitutional treatment.Statistical analysis was carried out by SPSS17.0 statistical software.Measurements were expressed by mean +standard deviation.Pearson chi-square test,continuity correction or Fisher's exact test were used for comparison of rates between the two groups,and t test was used for comparison of mean between the two groups.When the data were non-normal distribution,non-parametric rank sum test was used.Analysis of variance of random blocks was applied to non-experimental factors,and the Friedman rank sum test was used for those with variance inhomogeneity,with P<0.05 as the significant test standard.The main outcome measures were comprehensive curative effect,itching degree,rash area,TCM syndrome score and dermatology life quality index.Results:(1)The dermatology life quality index,curative effect score and TCM syndrome score of the treatment group and the control group decreased significantly after treatment(P<0.05).The effective rate of clinical comprehensive effect of the former was 63.5%and that of the latter was 39.6%.Compared with the control group,the decline of dermatology life quality index,curative effect evaluation and TCM syndrome of the treatment group was larger significantly(p<0.05).The effective rate of rash area and the comprehensive curative effect in the treatment group were significantly better than those in the control group(P<0.05).(2)The recurrence rate decreased from 31.3%and 23.1%to 25.0%and 11.5%respectively at the 4th and 8th weeks of follow-up after treatment,and the effective rates of pruritus degree of the 4th and comprehensive effect of the 8th in the follow-up were significantly higher than those in the control group(P<0.05).(3)Compared with the control group,the difference of TCM syndrome score decrease was larger in the treatment group(P<0.05).In the treatment group,the degree of each clinical index of qi-stagnation constitution were more than those of non-qi-stagnation(P<0.05).Conclusion:Constitutional treatment can improve the clinical effect and prognosis.The combined treatment of constitution and syndrome differentiation is superior to simple syndrome differentiation treatment in improving clinical indicators.Different constitution types may affect the clinical efficacy.Qi-stagnation constitution and special constitution may have more advantages in constitutional treatment. |
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