探索三種基質調製的如意金黃散藥膏所引發之皮膚過敏現象

Skin Allergic Reactions to the Traditional Chinese Medicine Ru Yi Jin Huang San in Three Different Medium Bases

葉裕祥(Yuh-Hsiang Yeh) ； 陳文英(Wen-Yin Chen) ； 施惠珍(Hui-Chen Shih) ； 陳旺全(Wang-Chuan Chen) ； 璩大成(Da-Chen Chu)

《北市醫學雜誌》 2卷9期 (2005/09) Pp. 820-828

https://doi.org/10.6200/TCMJ.2005.2.9.07

摘要

目的：如意金黃散為中醫常用的外用藥之一，臨床上多以酒、蜂蜜或水來調製如意金黃散藥膏，但是貼敷如意金黃散藥膏後引發皮膚過敏或接觸性皮膚炎不時發生，推測可能與調製之基質有關。本研究目的為比較三種基質（酒、蜜、水）調製之中醫外敷藥膏（如意金黃散藥膏）引發皮膚過敏之差異，藉由改變基質以減低貼敷如意金黃散藥膏引發皮膚過敏或接觸性皮膚炎之發生，進而能增加貼敷時間達到加速損傷恢復。方法：本研究以非隨機取樣方式，共計收有受試者30人，其中女性12人，男性18人，年齡介於23至62歲，平均年齡為38.40±11.20歲。用貼布試驗(Patch Test)來檢測不同基質調製的藥膏是否會對皮膚造成刺激而引發接觸性皮膚炎，以DASI(The Dyshidrotic Eczema Area and Severity Index)量表來評估藥膏所引發之接觸性皮膚炎之輕重程度。用Friedman二因子變異數分析分別來分析三種基質（酒、蜜、水）調製之如意金黃散藥膏在做貼布試驗後48小時及72小時皮膚表面變化狀況（DASI值）之差異。結果：在貼布試驗後48小時，以蜜調製的如意金黃散藥膏之DASI值(0.00±0.00)較以酒調製的如意金黃散藥膏之DASI值(1.80±3.53)和以水調製的如意金黃散藥膏之DASI值(1.20±2.07)明顯為低(p=0.01)。在貼布試驗後72小時，以蜜調製的如意金黃散藥膏之DASI值(0.40±2.19)較以酒調製的如意金黃散藥膏之DASI值(4.00±6.60)和以水調製的如意金黃散藥膏之DASI值(3.67±7.91)明顯為低(p=0.00)。結論：根據本研究受試者特質所做出來的結果看來，以蜜調製的如意金黃散藥膏比以酒或水調製的如意金黃散藥膏較不會引發接觸性皮膚炎，這樣的結果可以提供中醫臨床外敷如意金黃散藥膏的參考。

關鍵字

如意金黃散 ； 基質 ； 接觸性皮膚炎 ； 貼布試驗

並列摘要

Background and Purpose: Ru Yi Jin Huang San is one of the commonest plasters in traditional Chinese medicine that is used externally. The plaster compound of Ru Yi Jin Huang San is often mixed with rice wine, honey, or water for clinical use. Allergic reactions or contact dermatitis caused by Ru Yi Jin Huang San are not unusual and often result in the premature end of treatment. The purpose of the research was to compare the differences of skin allergic reaction caused by Ru Yi Jin Huang San mixed in the three different medium bases: rice wine, honey or water. Knowing which mixture gives rise to the least reactive complications may help the Chinese medicine doctor select the best base to increase the contact time-span of the plaster and speed up the recovery from injury. Methods: The study comprised a convenience sample of 30 subjects (18 men and 12 women). The mean age was 38.40 ± 11.2 years. The individual components and the Ru Yi Jin Huang San compound in 3 different medium bases were patch tested using a Finn Chamber (Epitest Ltd, Tuusula, Finland). The severity of contact dermatitis was measured by DASI (Dyshidrotic Eczema Area and Severity Index). Nonparametric Friedman two-way analyses of variance were used to analyze the variation in skin reaction among the three mixtures after 48 hours and 72hours of the patch test. Results: The results of the study revealed that the plaster compound of Ru Yi Jin Huang San mixed with honey gave the lowest scores for skin reaction as compared to the other two medium bases after both 48 and 72 hours of the patch test (p＜0.01). Conclusions: These results indicated that honey is superior to rice wine or water as a base for clinical use of Ru Yi Jin Huang San because it induced a lower level of adverse skin reaction. The results provide a reference for clinical decision making when Ru Yi Jin Huang San is used in traditional Chinese medicine.

並列關鍵字

Ru Yi Jin Huang San ； medium base ； contact dermatitis ； patch test