现代中西医治疗淤积性皮炎的研究进展

Research Progress on Modern Chinese and Western Medicine in the Treatment of Stasis Dermatitis

摘要: 淤积性皮炎是一种由下肢慢性静脉功能不全引发的常见炎症性皮肤病，多见于65岁以上的人群，发病率达6.2%，临床主要表现为小腿下1/3处出现丘疹、色素沉着、瘙痒及溃疡，病程迁延反复。目前，本病的西医治疗主要以穿戴压力袜治疗为基础，配合局部应用糖皮质激素、抗感染药和静脉活性药物；中医认为，淤积性皮炎属“湿毒疮”、“臁疮”等范畴，可采用中药内服清热利湿、活血通络、扶正祛邪，配合外治湿敷、熏洗及针刀等疗法；中西医结合通过内服中药联合西医外治，显著提高疗效，改善经皮氧分压及湿疹面积严重指数(EASI)，且安全性良好。未来需深化药理机制研究，优化个体化联合方案，通过多中心、大样本的研究提供循证依据。

Abstract: Stasis dermatitis is a common inflammatory skin disease caused by chronic venous insufficiency of the lower limbs. It is mostly seen in people over 65 years old, with an incidence rate of 6.2%. Its clinical manifestations are papule, pigmentation, pruritus and ulcer at the lower 1/3 of the leg, and the course of the disease is prolonged and repeated. At present, the Western medicine treatment for this disease is mainly based on wearing pressure socks, combined with local application of glucocorticoids, anti-infective drugs, and intravenous active drugs; traditional Chinese medicine believes that stasis dermatitis belongs to the category of “damp toxin sores”, “ulcers”, etc. It can be treated by taking traditional Chinese medicine orally to clear heat and dampness, promote blood circulation and unblock meridians, strengthen the body and dispel evil, combined with external treatment such as wet compress, fumigation and washing, and needle knife therapy; the combination of traditional Chinese medicine and Western medicine, through oral administration of traditional Chinese medicine and external treatment with Western medicine, significantly improves the efficacy, reduces transcutaneous oxygen pressure and the severity index of eczema area (EASI), and has good safety. In the future, it is necessary to deepen pharmacological mechanism research, optimize individualized combination schemes, and provide evidence-based research through multi-center and large sample studies.