来源：风湿病与关节炎,2019,8（1）:32-35,49.

中药内服、外敷联合青霉素V钾片和双氯芬酸钠缓释片治疗结节性红斑38例临床观察（临床研究）

姜福娜，于文广

　　【摘　要】目的：观察中药内服、外敷联合青霉素V钾片和双氯芬酸钠缓释片治疗结节性红斑的临床疗效。方法：将发病前有咽部感染病史的76例结节性红斑患者随机分为治疗组和对照组，每组38例。对照组给予青霉素V钾片和双氯芬酸钠缓释片口服治疗，治疗组在对照组治疗基础上给予中药煎剂内服，局部外敷。2组均以10 d为1个疗程。观察2组临床疗效，以及治疗前后症状和体征积分、白细胞计数、红细胞沉降率（ESR）、C-反应蛋白（CRP）、抗链球菌溶血素“O”（ASO）的变化，并进行咽拭子培养加药敏试验。结果：治疗组治愈31例，好转6例，未愈1例，总有效率为97.37%；对照组治愈20例，好转12例，未愈6例，总有效率为84.21%。2组比较，差异有统计学意义（P < 0.05）。治疗后，2组斑块、结节、疼痛、压痛积分较治疗前均有改善（P < 0.05），且治疗组优于对照组（P < 0.05）；2组白细胞计数、ESR、CRP、ASO较治疗前均下降（P < 0.05），且治疗组ESR、CRP、ASO优于对照组（P < 0.05）。治疗后，2组咽拭子培养溶血性链球菌均转为阴性。2组除胃部不适外，无重要不良反应发生。结论：中药内服、外敷联合青霉素V钾片和双氯芬酸钠缓释片治疗咽部感染引起结节性红斑，能提高临床疗效。

　　【关键词】　结节性红斑；中药；青霉素V钾片；双氯芬酸钠缓释片；咽部感染；临床疗效

Clinical Observation on 38 Cases of Nodular Erythema Treated by Oral Administration and External Application of Chinese Medicine Combined with Penicillin V Potassium Tablets and Diclofenac Sodium Sustained Release Tablets

JIANG Fu-na,YU Wen-guang

　　【ABSTRACT】Objective:To observe the clinical effect of oral administration and external application of Chinese medicine combined with penicillin V potassium tablets and diclofenac sodium sustained-release tablets in the treatment of nodular erythema.Methods:Seventy-six patients with erythema nodosum who had a history of pharyngeal infection before onset were randomly divided into a treatment group and a control group,38 cases in each group.The control group was given oral administration of penicillin V potassium tablets and diclofenac sodium sustained-release tablets,while the treatment group was given oral administration and topical application of Chinese medicine decoction based on the treatment for the control group.Both groups were treated for 10 days as a course.The clinical efficacy of the two groups were observed,as well as the changes of symptoms and signs integral,white blood cell count,erythrocyte sedimentation rate（ESR）,C-reactive protein（CRP）,anti-streptococcal hemolysin "O"（ASO）before and after treatment.Pharyngeal swab culture and drug sensitivity test were carried out.Results:In the treatment group,31 cases were cured,6 cases were improved,1 case was not cured,and the total effective rate was 97.37%;while in the control group,20 cases were cured,12 cases were improved,6 cases were not cured,and the total effective rate was 84.21%.There was a significant difference between the two groups（P < 0.05）.After treatment,the scores of plaque,nodule,pain and tenderness in the two groups were improved compared with those before treatment（P < 0.05）,and the treatment group was better than the control group（P < 0.05）;the white blood cell count,ESR,CRP and ASO in the two groups were lower than those before treatment（P < 0.05）,and the ESR,CRP and ASO in the treatment group were better than those in the control group（P < 0.05）.After treatment,the cultured streptococcus haemolyticus in pharyngeal swabs of both groups turned negative.Except stomach discomfort,no significant adverse reactions occurred in the two groups.Conclusion:Oral administration and external application of Chinese medicine combined with penicillin V potassium tablets and diclofenac sodium sustained-release tablets can improve the clinical efficacy in the treatment of nodular erythema caused by pharyngeal infection.

　　【Keywords】 erythema nodosum;Chinese medicine;penicillin V potassium tablets;diclofenac sodium sustained-release tablets;pharyngeal infection;clinical efficacy