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中藥治療異位性皮膚炎病患之療效評估及免疫學研究 鄭慧滿中國醫藥學 |
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| 異位性皮膚炎是一常見的慢性搔癢性皮膚病，罹患率約2-15%，近年有日益增多的趨勢，部分病人病灶範圍廣泛，呈乾燥脫屑、苔蘚化，搔癢不已，病情頑固，對一般性治療（如：外用類固醇藥膏，口服抗組織胺）反應欠佳，病患深受其擾，不僅影響生活、求學、工作、睡眠、情緒，甚至波及家人，使社會付出極大的成本。近年來，吾人從治療異位性皮膚炎病人的經驗中，發現以養血清熱利濕袪風中藥，治療嚴重異位性皮膚炎病患，療效良好，我們曾經進行隨機雙盲治療組與安慰劑組交叉研究試驗〈Double-blind, Placebo-control, cross-over design study〉，評估中藥的臨床療效，研究對象為慢性、病情嚴重、病灶呈非滲出性且以苔蘚化為主、對一般性治療反應欠佳的異位性皮膚炎病人，結果顯示第8週時治療組病灶分數變化顯著低於對照組，兩者差異達到統計之顯著水準(p<0.05)，病患於治療前後進行肝腎功能、血液常規檢查及早晨8時Cortisol值之測量，治療前後並無明顯異常變化。這個前驅試驗顯示中藥可作為治療頑固異位性皮膚炎的另一種治療選擇。故吾人從使用養血清熱利濕袪風中藥治療異位性皮膚炎的臨床經驗中，選擇常用的消風散進行隨機雙盲臨床試驗，預計蒐集治療組80例及對照組病例40例，觀察12週，評估臨床療效及藥物安全性評估，並進一步探討中藥治療異位性皮膚炎病人之相關免疫學變化，分析病人服用中藥前後血清IgE， 嗜伊紅球（eosinophil），細胞間白質（IL-2、IL-4、IL-5、IL-10、IL-13、IFN-α、IFN-γ），可溶性細胞間白質2受體（Soluble Interleukin 2 Receptor）， 可溶性血管細胞粘結分子（Soluble Vascular Cellular Adhesion Molecule），嗜伊紅球陽離子蛋白質（eosinophil cationic protein，ECP）等變化及單核球上CD23的表達，希望建立相關血中濃度指標等指標性評估項目及了解中藥治療異位性皮膚炎的作用機轉。 | |
| 關鍵字：異位性皮膚炎，中藥，免疫學 |
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Efficacy and The immunologic study of Atopic dermatitis patients treated with Traditional Chinese medicine H.M. ChangChina medical college |
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| Atopic Dermatitis is a common chronic pruritic disease. Recent studies suggest an overall cumulative prevalence ranges 2-15%. It is generally agreed that the reported prevalence of atopic dermatitis has been increasing 2-3 times over the last 30 years. Severe and widespread atopic dermatitis often fails to respond adequately to currently available therapy, e.g., Topical steroid and oral antihistamin. These individuals frequently endure great suffering due to extreme pruritus. Following the observations of substantial benefit among patients receiving oral treatment with traditional Chinese herbs, we undertook a pilet study using double-blind, Placebo-control, cross-over design to assess the efficacy, and safety of traditional Chinese herbs for widespread non-exudative atopic dermatitis. The results reveal that the differences of the lesion score change during 8-week period between active treatment group and placebo group are statistically significant ( p<0.05). The patients reported | |
| 關鍵字：Atopic Dermatitis；Trditional Chinese medicine；Cytokine |
