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The Clinical Research on Treating Chronic Urticaria According to Liver Channel with TCM

Author: ChenWenZeng
Tutor: ChenHanZhang
School: Guangzhou University of Traditional Chinese Medicine
Course: Surgery of Chinese Medicine
Keywords: Chronic Urticaria Differentiation Treatment liver Channel Clinical Research
CLC: R275
Type: PhD thesis
Year: 2007
Downloads: 394
Quote: 4
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Chronic urticaria is a common skin disease in clinic, has high incidence,Its pathogeny is complex, tend to break out repeatedly, touching to heal whilebeing difficult, bring great harm to the patients, as aresult, It’s a greattask for us to prevention and cure chronic urticaria. Chinese Medicine forthe Treatment of CU has well-resporsive, and has the unique and obviousadvantages, and is an effective way to prevent CU from recurrence. My tutorProf. Chen Hanzhang, who engages in Clinical Working of department ofdermatology more than thirty years, has accumulated a wealth of experiencein treatment of CU with TCM, brings forward treating chronic urticariaaccording to liver Channel, and acquire notable clinical efficacy. Under theguidance of TCM theory, it is helpful to diagnosis and treat of by furtherstudy in the therapy methods.ObjectiveThis research aim to probe into the new way of Chinese DifferentialTreatment of CU by study Prof. Chen Hanzhang’s Clinical Experience in TreatingCU, and supplies scientific therapy according for clinical treatment.①Study on Clinical Effects of treating CU according to liver channel withTCM.②Study on Variation of immunoglobulin IgA, IgM, IgG, IgE in CU patients beforeand after therapy.③Study on Variation of the lymphocyte transfermation rate in CU patientsbefore and after therapy.④Study on relapse condition after 2 months follow-up.MethodThe research is prospective study, a self controlled study before and after treatment.By collects the medical literature, we comprehend chinese and westernmedicines Current Situation, and affirm that treating CU according to liverchannel with TCM does not exist.All cases are from outpatient dermatological clinic of GuangzhouUniversity of Traditional Chinese Medicine. 96 patients were divided into 4groups according to liver channel with TCM, and were delivered correspondingtreatments: patients with Liver-Qi Stagnation Syndrome, to Relieving thedepressed liver and regulating Qi Therapy, Xiaochaihutang and Shengjiangsan;Blood Vacuity Win-dryness Syndrome, Blood-nourishing and Wind-expellingTherapy, Dangguiyinzi; Cold-heat Complication Syndrome, consonance cold andheat Therapy, Wumeiwan; Blood-Stasis Obstruction Syndrome, regulate qi andinvigorate the blood Therapy, Tongjingzhuyutang.Respectively, study on elinical effects of treating CU according to liverchannel with TCM, Variation of immunoglobulin IgA, IgM, IgG, IgE in CU patientsbefore and after therapy, Variation of the lymphocyte transfermation rate inCU patients before and after therapy, relapse condition after 2 monthsfollow-up. According to european research standend of MILOR, symptoms andsigns were observed and scored in order to grade illness severity, includesnumbers of wheal, degree of pruritus and size, quantity frequency and lastingtime of wheal. On the basis of the symptom total integral before and aftertherapy, we calculate SSRI in order to determine the elinical effects. At thesame time, safety of the therapy is observed, including general medicalexamination, routine blood and urine examinations, liver and renal functionexaminations. And adverse reaction should be observed during treatment inevery group.SPSS software is used to make analysis of the data gained from the research.the calculating materials, counting materials and grading materials wereanalyzed by t test, X2 test and Riddit analysis respectively. Descriptivelevels(P) less than 0.05 were considered significant.Results1. Cases According to selection and Exclusive criteria, 96 outpatients withCU were included. Fifty-one were male and forty-five were female; the rangeof disease course was from 6 weeks to 306 weeks, average 152.34±28.46 weeks;age arranges from 18 to 63 year old, average 35.13±12.34 years old; totle average scores before treatment was 9.26±2.37. The patient’ s generalclinical data was quite equal in the 4 groups before treatment (P>0.05).2. comparison of the clinic effect In 4 groups, post-treatment effetionwas obviously satisfied. The total efficency in patients with Liver-QiStagnation Syndrome(A groups) was highest(88.46%), and in Blood VacuityWin-dryness Syndrome(B groups) was lowest(80.00%). There was no significantdifference in four groups(P>0.05).3. Comparison of integrals before and after treatment The severity degreescore of 4 groups were obviously decreased after the treatment than that beforethe treatment. There was significant difference in 4 groups(P<0.05).4. Comparison of relapsement rate After 2 months follow-up, 10 cases recur,including 5 patients with Liver-Qi Stagnation Syndrome(A group), 2 patientswith Blood Vacuity Win-dryness Syndrome(B group), 2 patients with Cold-heatComplication Syndrome(C group), 1 patients with Blood-Stasis ObstructionSyndrome(D group). There was no significant difference in 4 groups(P>0.05).5. Comparison of abnormal increase of serum immunoglobulins. All abnormal casesare abnormal increase, no abnormal descend. After therapy the cases of abnormalincrease of IgE was reduced as compared with that before treatment(P<0.05);There was no significant difference of IgA, IgM, IgG in 4 groups(P>0.05).6. Comparison of serum immunoglobulins After treatment IgE value weresignificantly decreased than before treatment in 4 groups(P<0.05). There wasno significant difference of IgA, IgM, IgG before and after treatment in 4groups(P>0.05).7. The changese of the lymphocyte transfermation rate before treatment thelymphocyte transfermation rate were lower than that After treatment indifferent degree. The difference was significant (P<0.05).8. Evaluation on the Safety. All patients were normal before and aftertreatment. Occult blood had been found in urine of 5 female patients. Thenthe intermenstrual bleeding had been proved later by theirself. Andcounterchecks of that were all resumed after menstruation. So we think thatwas due to contaminated specimen of Urine by menstruation. 9 patients withBlood-Stasis Obstruction Syndrome were taking chinese drugs when menstrualperiod, and then amount of menstruation increased, period prolonged. No otherdiscomfort were observed. And No adverse effect on liver and kidney functionwas found. Conclusion1. In all 4 groups, post-treatment effetion was obviously satisfied bytreating CU according to liver channel with TCM. The severity degree scoreof 4 groups, such as numbers of wheal, degree of pruritus and size, quantityfrequency and lasting time of wheal, were obviously decreased after thetreatment than that before the treatment, the short and long term effects areobvious, and the relapsement rate is low. No toxic side effect had been found.Because its high security and well-resporsive, It’s worthy of clinicapplication.2. It show that all abnormal cases are abnormal increase, no abnormal descend.After therapy the cases of abnormal increase of IgE was reduced as comparedwith that before treatment. After treatment IgE value were significantlydecreased than before treatment in 4 groups. There was no significantdifference of IgA, IgM, IgG before and after treatment in 4 groups. It showthat take effect by adjusting levels of IgE in chronic urticaria patients.According to Detection and Comparison of the lymphocyte transfermation rate,we found before treatment they were lower than that After treatment indifferent degree. And it show that reinforce the autoimmunity has somepositive effect to the treatment of CU.

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