| Vulvar lichen sclerosus(VLS)is a common non-neoplastic disease of the skin of the vulva in women.The main symptoms of this disease are long-term recurring vulvar itching,vulvar skin chapped pain,vulvar skin hypopigmentation or even whitening,and vulvar tissue atrophy and adhesion,etc.,and with current clinical methods,the disease cannot be completely cured.Curative effect.Therefore,patients with this disease are not only suffering from the physical pain,but also constantly under pressure psychologically.Topical application of glucocorticoid and vitamin E to the affected area is a common drug treatment method for female vulvar lichen sclerosus,but the treatment effect is not good for the symptoms of chapped vulva in patients with VLS.Teacher Wang Guiping found in many years of clinical work that it was used in conjunction with patients with chapped After Danggui Buxue Decoction was used for sitz bath treatment,the healing effect of the chapped symptoms was better,and the recurrence was relieved.The purpose of this paper is to explore the difference between the two treatment methods,and to provide reference for clinical research and individualized treatment of female vulvar lichen sclerosus symptoms.OBJECTIVE: This study mainly observes the effect of Danggui Buxue Decoction Sitz Bath on the clinical symptoms,signs and psychological status of patients with VLS,objective to evaluate the clinical efficacy of Danggui Buxue Decoction hip bath in the treatment of VLS,to explore its clinical basis for the treatment of VLS,and to clarify the mechanism of traditional Chinese medicine in the treatment of VLS disease,so as to provide a better method for the traditional Chinese medicine treatment of cracking disease of VLS.Materials and Methods:1 Research objectThis trial uses the principle of randomization and control to collect cases of lichen sclerosus of the vulva in the gynecological clinic of the Affiliated Hospital of Tianjin Academy of Traditional Chinese Medicine from December 2019 to November 2020.After passing the inclusion and exclusion criteria and TCM Qi blood loss After the standard of syndrome differentiation,the 60 patients who were finally screened out to meet the requirements were divided into a treatment group and a control group by random and controlled methods,with 30 cases in each group.2 Research methodsMethods: 60 patients were randomly divided into treatment group(30 cases)and control group(30 cases).The treatment group was given Danggui Buxue Decoction granules.Specific method: Mix the Danggui Buxue Tang Xifang granules in a ratio of 1:20 in boiling water,and wait until the water temperature is appropriate(similar to body temperature or slightly higher than body temperature to avoid excessive water temperature aggravating the irritation of the affected area or causing burns),Fully soak the affected area of the vulva in the medicinal solution for 20 minutes;after taking a bath,gently rub the vulva to dry it,and then evenly apply 0.5‰ triamcinolone acetonide cream and vitamin E cream.The dosage should cover the affected area evenly.The control group was given 0.5‰ triamcinolone acetonide cream +vitamin E cream,usage: the same as the treatment group.1 month and 1 course of treatment,after 3 courses of treatment,observe the changes before and after the curative effect evaluation index.The above-mentioned drugs are provided by Xinlu Pharmacy and Western Pharmacy of Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital.Vulvar pruritus was observed and recorded before and after treatment,vulvar pain(chapped condition),pigment changes in vulvar skin lesions,and mental state.3 Observation indicators and evaluationObservation indicators: Visual analogue scale(VAS)was used to evaluate the degree of skin itching and vulvar pain(chapped condition)in the affected area before and after treatment.Evaluate the therapeutic effects of itching,pain,hypopigmentation,etc.before and after treatment(that is,the changes in frequency of attacks,range of lesions,etc.)by means of scoring.Self rating Anxiety Scale(SAS)and self rating Depression Scale(SDS)were used to evaluate the psychological status of patients before and after treatment.The curative effects of the two methods were compared and analyzed.4 Statistical methods(1)Spss23.0 software was used to analyze the data.(2)The measurement data conforming to the normal distribution are expressed by "mean ±standard deviation(x ±s)".The paired measurement data is paired t test,and the comparison of the two independent samples is conducted by independent sample t test.The measurement data are normal distribution by t test,and non parameter rank sum test is used for data that do not conform to normal distribution.There was significant difference between P < 0.05.Result:1.After 3 courses of treatment,the total effective rate in the treatment group was 96.7%,and the total effective rate in the control group was 46.7%.According to statistical analysis,P<0.05,which is statistically significant.It shows that the curative effect of the treatment group on the treatment of VLS is better than that of the control group.2.The two groups improved in vulvar pruritus,vulvar pain(chapped condition),skin pigment loss in the affected area of vulva and symptoms of traditional Chinese medicine.The curative effect of the treatment group was better than that of the control group(P < 0.05);However,in terms of hypopigmentation of vulvar skin and mucosa and TCM symptoms,the curative effect of the treatment group was not significantly better than that of the control group(P > 0.05).3.The psychological state of the two groups were improved,but the treatment effect was not significantly better than that of the control group(P > 0.05).4.There were no obvious adverse reactions during the treatment and follow-up.Conclusion:1.For VLS patients with vulvar skin chapped symptoms,the use of Danggui Buxue Decoction to wash the sitz bath can significantly improve the symptoms of chapped and itching,and the method is safe and reliable.2.Danggui Buxue Decoction can improve vulvar hypopigmentation,Qi and blood deficiency and other TCM symptoms of VLS patients,but the curative effect is not significantly better than that of the control group.3.The two treatment methods can regulate the psychological state of patients,but the difference is not significant. |
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