CAJ | 학술논문

目的：探讨消银2号方治疗寻常型银屑病患者最佳的洗浴温度和时间。方法选取120例符合寻常型银屑病诊断标准的住院患者纳入试验。按随机序列表分为4组，每组30例。采用2×2析因设计将4组患者分别使用消银2号方剂药浴的4种治疗方案，试验1组（ A1 B1）采用42℃药浴30 min；试验2组（ A1 B2）采用42℃药浴20 min；试验3组（ A2 B1）采用38℃药浴30 min；试验4组（ A2 B2）采用38℃药浴20 min。分别在入院时和出院时采用银屑病皮损面积及严重程度量表（ PASI评分表）、生活质量指数（ DLQI）、焦虑自评量表（ SAS）对患者状况进行评定。结果120例寻常型银屑病患者治疗后PASI评分、DLQI指数、SAS评分分别为（11．33±5．68），（4．78±3．50），（24．23±6．72）分，低于治疗前的（25．51±10．26），（11．60±5．70），（42．37±8．40）分，差异有统计学意义（t 分别为23．105，17．174，40．558；P＜0．01）。试验1组患者治疗前后PASI评分差值为（16．59±6．46）分，高于其他3组，差异有统计学意义（F＝4．242，P＜0．01）；DLQI指数差值和SAS评分差值分别为（8．27±5．15），（19．93±4．73）分，高于试验4组的（5．47±3．25），（16．30±4．82）分，差异有统计学意义（P＜0．05）。在PASI、DLQI、SAS三方面，消银2号方洗浴时间因素的主效应及时间与温度的交互作用差异无统计学意义（ P ＞0．05），仅温度的主效应差异有统计学意义（ F分别为11．380，6．335，9．168；P＜0．01）。结论银屑病皮损面积及严重程度的改善、生活质量改善、焦虑状况改善三方面，温度对药浴的影响效果大于时间。考虑到时间因素对患者的经济和治疗时间的影响等问题，42℃联合20 min中药洗浴的方案更为合理，值得临床推广。
목적：탐토소은2호방치료심상형은설병환자최가적세욕온도화시간。방법선취120례부합심상형은설병진단표준적주원환자납입시험。안수궤서렬표분위4조，매조30례。채용2×2석인설계장4조환자분별사용소은2호방제약욕적4충치료방안，시험1조（ A1 B1）채용42℃약욕30 min；시험2조（ A1 B2）채용42℃약욕20 min；시험3조（ A2 B1）채용38℃약욕30 min；시험4조（ A2 B2）채용38℃약욕20 min。분별재입원시화출원시채용은설병피손면적급엄중정도량표（ PASI평분표）、생활질량지수（ DLQI）、초필자평량표（ SAS）대환자상황진행평정。결과120례심상형은설병환자치료후PASI평분、DLQI지수、SAS평분분별위（11．33±5．68），（4．78±3．50），（24．23±6．72）분，저우치료전적（25．51±10．26），（11．60±5．70），（42．37±8．40）분，차이유통계학의의（t 분별위23．105，17．174，40．558；P＜0．01）。시험1조환자치료전후PASI평분차치위（16．59±6．46）분，고우기타3조，차이유통계학의의（F＝4．242，P＜0．01）；DLQI지수차치화SAS평분차치분별위（8．27±5．15），（19．93±4．73）분，고우시험4조적（5．47±3．25），（16．30±4．82）분，차이유통계학의의（P＜0．05）。재PASI、DLQI、SAS삼방면，소은2호방세욕시간인소적주효응급시간여온도적교호작용차이무통계학의의（ P ＞0．05），부온도적주효응차이유통계학의의（ F분별위11．380，6．335，9．168；P＜0．01）。결론은설병피손면적급엄중정도적개선、생활질량개선、초필상황개선삼방면，온도대약욕적영향효과대우시간。고필도시간인소대환자적경제화치료시간적영향등문제，42℃연합20 min중약세욕적방안경위합리，치득림상추엄。
Objective By applying the factorial design to ascertain the best temperature and time of bathing using Xiaoyin Prescription 2 in treating patients with psoriasis vulgaris .Methods According to the inclusion criteria 120 cases with psoriasis vulgaris were selected .They were randomly divided into 4 treatment groups with 30 people for each group .Group 1 ( A1 B1 ) was treated with 42℃bathing for 30 minutes;Groups 2 ( A1 B2 ) was treated with 42℃bathing for 20 minutes;Groups 3 ( A2 B1 ) was treated with 38℃bathing for 30 minutes;Groups 4 (A2B2) was treated with 38℃bathing for 20 minutes.All of the patients were investigated by the Psoriasis Area and Severity Index ( PASI ) , Dermatology Life Quality Index ( DLQI ) and Self Rating Anxiety Scale (SAS).Results The PASI score, DLQI index and SAS score of the 120 patients were (11.33 ± 5.68), (4.78 ±3.50), (24.23 ±6.72), respectively, after the treatment, and (25.51 ±10.26), (11.60 ± 5.70), (42.37 ±8.40), respectively, before the treatment, which were significantly different (t=23.105, 17.174, 40.558, respectively;P<0.01).For Group 1, the PASI score difference before and after treatment was (16.59 ±6.46) that was significantly higher than the other three groups (F=4.242,P<0.01).The score difference of DLQI and SAS were (8.27 ±5.15), (19.93 ±4.73), higher than Group 4 whose score were (5.47 ±3.25), (16.30 ±4.82).The differences were significant (P <0.05).There was no significant interaction for time and temperature and no significant main effect of time factor ( P>0.05 ) .Only the main effect of temperature was statistically significant ( F =11.380, 6.335, 9.168, respectively; P <0.01 ). Conclusions The main effect of bathing temperature to treat patients with psoriasis vulgaris is higher than the bathing time in PASI, DLQI and SAS.Taking into account the time factor and expenditure for the patients , a herbal bathing temperature of 42 ℃ for 20 minutes is more reasonable and is worthy of promoting in clinical situations .