Clinical Study Of Zhixuan External Washing Formula Combined With Itraconazole In The Treatment Of Tinea Manus And Pedis

ObjectiveTo observe the efficacy and safety of Zhixuan external washing formula combined with itraconazole in the treatment of tinea manus and pedis of blister scale type and immersion erosion type,and to explore its mechanism of action.Methods90 patients with tinea manus and pedis of blister scale type and immersion erosion type were randomly divided into 3 groups,30 cases in each group.The traditional Chinese medicine group was treated with Zhixuan external washing formula,20 minutes each time,twice a day;The western medicine group was treated with oral itraconazole capsules,200 mg once a day,during or after meals;The integrated traditional Chinese and Western medicine group was treated with Zhixuan waixi decoction combined with oral itraconazole capsule.The course of treatment of the three groups was 2 weeks.Before treatment,1 week after treatment,2 weeks after treatment and 2 weeks after drug withdrawal,according to the clinical symptoms and signs such as erythema,blisters,scales,exudation,erosion,area,pain and pruritus,the patients were scored according to the 4-level scoring method.The scores of all the subjects at each observation time point were recorded,and the cure rate,clinical observation scores before and after treatment,clinical observation scores before and after treatment were compared among the three groups To evaluate the efficacy and safety of each group in the treatment of tinea manus and pedis,and to explore its mechanism of action.The data of this study were analyzed by spss25.0 statistical software.ResultsThe average score of each group before and after treatment were different(P<0.05),which showed that the three groups had significant effect after treatment.There were significant differences in the curative effect results(the number of cured,markedly effective,improved,invalid),cure rate,clinical observation score after 1 week of treatment and after 2 weeks of treatment,and total curative effect index among the three groups(P<0.05).There was no significant difference between the traditional Chinese medicine group and the western medicine group,but there was significant difference between the traditional Chinese medicine group and the western medicine group.It is suggested that the clinical effect of the integrated traditional Chinese and Western medicine group is better than that of the traditional Chinese medicine group and the western medicine group.After one week of treatment,there were significant differences in erythema,scale,exudation,area and itching degree among the three groups(P<0.05);After 2 weeks of treatment,there were significant differences in scale and area among the three groups(P<0.05).It is suggested that the integrated traditional Chinese and Western medicine group is better than the western medicine group and the traditional Chinese medicine group in relieving erythema,scale,exudation,area and itching degree after one week of treatment,and is better than the western medicine group and the traditional Chinese medicine group in improving scale and area degree after two weeks of treatment.There was no significant difference in the fungal clearance rate and recurrence rate among the three groups(P>0.05).The three groups had less adverse reactions and higher safety.Conclusion1.The clinical and mycological effects of Zhixuan waixi prescription in the treatment of tinea manus and pedis are clear,which can have the same curative effect as itraconazole,with less adverse reactions and high safety,and is worthy of clinical application.2.Zhixuan external washing formula combined with itraconazole in the treatment of tinea manus and pedis has clear curative effect,and its clinical curative effect is better than that of Zhixuan external washing formula alone or itraconazole alone.The treatment of tinea manus and tinea pedis with the combination of traditional Chinese and Western medicine has the advantages of rapid onset,significant curative effect and less adverse reactions,which is worthy of clinical application.