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Objective:To evaluate the efficacy of Qufeng Zhiyang Decoction combined with Fuzhiqing Ointment in the treatment of chronic perianal eczema.Methods:Randomized controlled trial. A total of 122 patients with chronic perianal eczema in Meishan People's Hospital from January 2020 to May 2021 were selected as the observation objects and divided into 2 groups according to random number table method, with 61 cases in each group. The conventional group was treated with Fuzhiqing Ointment. The study group was treated with Qufeng Zhiyang Decoction. The treatment for both groups lasted for two weeks. TCM symptom score was recored before and after treatment; the degree of skin lesions was evaluated by the area and Eczema Area and Severity Index (EASI); the quality of life of patients was evaluated by the quality of life index of dermatosis (DLQI); the number of Treg and Th17 cells was measured by flow cytometry; the ratio of Th17/Treg cells was calculated; the levels of TNF-α, IL-10 and IL-6 were detected by ELISA. The adverse reactions were recorded and the clinical efficacy was evaluated. The patients were followed up for 3 months and the recurrence was recorded.Results:The total effective rate of the study group was 86.89% (53/61) and that of the conventional group was 72.13% (44/61), with statistical significance ( χ2=4.08, P=0.044). After treatment, the scores of pruritus, spurt water, erythema and burning, upset and thirsty, yellow urine and dry urine in the study group were lower than those in the conventional group ( t values were 19.64, 49.13, 19.64, 33.14, 24.61, P<0.01); EASI and DLQI scores were lower than those in the conventional group ( t values were -6.52 and -29.33, P<0.01). After treatment, Treg cells [(6.58±0.78) % vs. (5.49±0.81) %, t=7.57] in the study group was higher than that of the conventional group ( P<0.01), Th17 cells [(1.03±0.28) % vs. (1.27±0.39) %, t=-3.90] and Th17/Treg ratio [(0.15±0.07) vs. (0.23±0.05), t=7.68] were lower than those in the conventional group ( P<0.01). After treatment, the level of IL-10 in the study group was higher than that of the conventional group ( t=-16.97, P<0.01), and the levels of IL-6 and TNF-α were lower than those in the conventional group ( t values were -21.48 and -25.59, P<0.01). During treatment, the incidence of adverse reactions was 6.56% (4/61) in the study group and 9.84% (6/61) in the conventional group, without statistical significance in the incidence of adverse reactions between the two groups ( χ2=0.44, P=0.509). During the follow-up period, the recurrence rate was 15.09% (8/53) in the study group and 50.00% (22/44) in the conventional group, with statistical significance in the recurrence rate between the two groups ( χ2=14.55, P<0.01). Conclusion:Qufeng Zhiyang Decoction combined with Fuzhiqing Ointment can reduce the levels of inflammatory factors in patients with chronic perianal eczema, maintain Th17/Treg cell immune balance, improve clinical efficacy, and have a low recurrence rate.
RESUMEN
<p><b>OBJECTIVE</b>To observe the differences in the therapeutic effects on chronic perianal eczema between auricular point sticking therapy and auricular sticking pseudo-press therapy on the basis of the treatment with western medication.</p><p><b>METHODS</b>Ninety patients were randomized into an auricular therapy group and an auricular pseudo-press therapy group (pseudo group), 45 cases in each one. The western medication was used in both of the groups. In the auricular therapy group, the auricular sticking method with semen vaccariae was added at Fengxi (SF), Shenshangxian (TG), Duipingjian (AT), Fei (CO), Pi (CO), Gangmen (HX). The patients were advised to press each auricular point every day. In the pseudo group, the plaster was applied to the same auricular points without semen vaccariae used and pressing manipulation given. The auricular sticking therapy was used once every three days in the two groups. The treatment for 2 weeks was as one session and one or two sessions of treatment were given accordingly. The severity of perianal itching, the area of skin lesion, the form of skin lesion and the score of dermatology life quality index (DLQI) and the clinical therapeutic effects were compared before and after treatment in the two groups. The adverse reaction and recurrence rate in 1-year follow-up visit were observed during treatment.</p><p><b>RESULTS</b>After treatment, the itching degree, the area of skin lesion, the form of skin lesion and DLQI score were all reduced apparently as compared with those before treatment in the patients of the two groups (all<0.05). The results in the auricular sticking therapy group were better than those in the pseudo group (all<0.05). The curative and markedly effective rate and the total effective rate in the auricular sticking therapy group were apparently better than those in the pseudo group[52.3% (23/44) vs 19.0% (8/42), 97.7% (43/44) vs 76.2% (32/42), both<0.05]. The recurrence rate in the auricular sticking therapy group was lower apparently than that in the pseudo group[7.0% (3/43) vs 37.5% (12/32),<0.05]. No severe adverse reactions were found during the treatment in the two groups.</p><p><b>CONCLUSIONS</b>The auricular sticking therapy combined with western medication effectively release itching in chronic perianal eczema and local skin lesions, improve the living quality and reduce recurrence rate.</p>