【目的】 观察毫火针联合清补化痤饮治疗脾虚湿热证痤疮的临床疗效和安全性。【方法】 将2023年5月至2024年3月于广 州中医药大学第七临床医学院就诊的 70例脾虚湿热证痤疮患者，按随机数字表法随机分为观察组和对照组，每组各 35例。 2组患者均给予健康宣教，对照组给予毫火针联合盐酸多西环素片口服治疗，观察组给予毫火针联合清补化痤饮口服治疗， 疗程均为 6 周。治疗 6 周后，评价 2 组临床疗效，观察 2 组患者治疗前后痤疮综合分级系统（GAGS）评分与面部痤疮特异 性生活质量量表（Qol-Acne）评分的变化情况，以及中医证候积分的情况。比较 2组患者治疗前后皮肤屏障功能指标经表皮 水分丢失（TEWL）含量、皮肤水分含量、皮脂含量的变化情况。并评价2组的安全性及不良反应的发生情况。【结果】（1）治疗 后，2 组患者的 GAGS 评分明显改善（P < 0.05），且观察组在改善 GAGS 评分方面明显优于对照组，差异有统计学意义 （P < 0.05）。（2）治疗后，2 组患者的 Qol-Acne 评分均明显改善（P < 0.05），且观察组在改善自我感知、情感功能、自我评 估 3 个方面明显优于对照组，差异有统计学意义（P < 0.05），观察组在改善社会功能方面稍优于对照组，但差异无统计学 意义（P > 0.05）。（3）治疗后，2组患者的 TEWL、皮肤水分、皮脂含量均明显改善（P < 0.05），且观察组在改善 TEWL、皮肤 水分、皮脂含量方面明显优于对照组，差异有统计学意义（P < 0.05）。（4）治疗后，2组患者的中医证候积分明显改善（P < 0.05），且观 察组在改善中医证候积分方面明显优于对照组，差异有统计学意义（P < 0.05）。（5）观察组总有效率为94.29%（33/35），对照组为 74.29%（26/35）。观察组疗效优于对照组，差异有统计学意义（P < 0.05）。（6）观察组和对照组的不良反应发生率比较，差异无 统计学意义（P > 0.05）。【结论】 毫火针联合清补化痤饮治疗脾虚湿热证痤疮，能明显改善患者的临床症状，从而提高患者生 活质量，疗效显著，且安全性好。

Objective To observe the clinical efficacy and safety of filiform-heated needle combined with Qingbu Huacuo Decoction in the treatment of acne of damp-heat due to spleen deficiency syndrome. Methods Seventy patients with acne of damp-heat due to spleen deficiency syndrome admitted to the seventh clinical Medical School of Guangzhou University of Chinese Medicine from May 2023 to March 2024 were randomly divided into the observation group and the control group according to random number table method，with 35 patients in each group. Health education was given to the patients in both groups. The control group was given oral administration of Doxycycline Hyclate Tablets combined with filiform-heated needle for treatment，and the observation group was treated with filiform-heated needle combined with Qingbu Huacuo Decoction orally，the course of treatment for the two groups covered six weeks. After six weeks of treatment，the clinical efficacy of the two groups was evaluated， and the changes in Global Acne Grading System（GAGS）score and Quality of Life-Acne（Qol-Acne）score，as well as the traditional Chinese medicine（TCM）syndrome scores before and after treatment were observed. The changes of skin barrier function indicators such as trans epidermal water loss（TEWL）content， skin moisture content， and sebum content before and after treatment were compared between the two groups of patients. Moreover，the safety of the two groups and the occurrence of adverse reactions were evaluated. Results（1）After treatment， the GAGS scores of patients in the two groups were improved significantly（P < 0.05）， and the improvement in the observation group was significantly superior to that in the control group，with a statistically significant difference（P < 0.05）.（2）After treatment，the Qol-Acne scores of the patients in the two groups were significantly improved（P < 0.05），and the observation group was significantly superior to the control group in improving the three aspects of self-perception，emotional functioning，and self-assessment，with a statistically significant difference（P < 0.05），and the observation group was slightly superior to the control group in improving social functioning，but the difference being not statistically significant（P > 0.05）.（3）After treatment，the content of TEWL，skin moisture，and sebum of patients in the two groups were significantly improved（P < 0.05），and the improvement in the observation group was significantly superior to that in the control group， the difference being statistically significant（P < 0.05）.（4）After treatment， the TCM syndrome scores of the two groups of patients were improved significantly（P < 0.05），and the improvement in the observation group was significantly superior to that in the control group，with a statistically significant difference（P < 0.05）.（5）The total effective rate was 94.29%（33/35）in the observation group and 74.29%（26/35）in the control group. The clinical efficacy of the observation group was superior to that of the control group，the difference being statistically significant（P < 0.05）.（6）Comparison of the incidence of adverse reactions between the two groups， the difference being not statistically significant（P > 0.05）. Conclusion Filiform-heated needle combined with Qingbu Huacuo Decoction in the treatment of acne of damp-heat due to spleen deficiency syndrome can significantly improve the clinical symptoms of patients，thus improving their quality of life，with good safety.

R246.9

深圳市政府“医疗卫生三名工程”广东省中医院禤国维国医大师皮肤研究团队资助项目（编号：SZZYSM202106008）