【目的】 观察控油祛屑散（由侧柏叶、凤仙透骨草、皂角刺等中药组成）外洗治疗头皮脂溢性皮炎的临床疗效。 【方法】 选取2023年9月至2024年6月就诊于广州中医药大学附属宝安中医院（深圳市宝安区中医院）皮肤科门诊的72例头皮 脂溢性皮炎脾胃湿热证患者，采用随机数字表法将患者随机分为治疗组和对照组，每组各36例。治疗组给予控油祛屑散外 洗治疗，对照组给予2%酮康唑洗剂治疗，治疗频率为每周2次，疗程为4周。观察2组患者治疗前后头皮临床症状（包括红 斑、鳞屑、油脂、瘙痒）评分和头皮靶皮损部位的皮肤屏障功能指标以及皮肤病生活质量指数（DLQI）评分的变化情况，并 评价 2 组患者的临床疗效和用药安全性。【结果】（1）临床疗效方面，治疗4周后，治疗组的总有效率为97.22%（35/36），对照 组为75.00%（27/36），组间比较（χ2 检验），治疗组的疗效明显优于对照组（P＜0.05）。（2）临床症状方面，治疗后，2组患者的 头皮红斑、鳞屑、油脂、瘙痒程度评分均较治疗前改善（P＜0.05），且治疗组的改善程度均明显优于对照组（P＜0.05或 P＜ 0.01）。（3）皮肤屏障功能方面，治疗后，2 组患者头皮靶皮损部位的角质层含水量和角质层油脂含量均较治疗前改善（P＜ 0.05），且治疗组的改善程度均明显优于对照组（P＜0.05或P＜0.01）。（4）生活质量方面，治疗后，2组患者的DLQI评分均较 治疗前明显下降（P＜0.05），且治疗组的下降程度明显优于对照组（P＜0.01）。（5）安全性方面，治疗期间，2 组患者均未发生 严重不良反应，具有较高的安全性。【结论】 控油祛屑散外洗治疗头皮脂溢性皮炎脾胃湿热证患者疗效确切，可有效缓解头 皮红斑、鳞屑、油脂、瘙痒症状，显著改善皮肤屏障功能，提高患者生活质量，且无明显不良反应。

Objective To observe the clinical efficacy of external herbal washing with Kongyou Quxie San （composed of Platycladi Orientalis Folium，Impatiens Radix，and Gleditsiae Spinosae Spina） in treating scalp seborrheic dermatitis with spleen-stomach damp-heat syndrome. Methods Seventy-two patients with scalp seborrheic dermatitis diagnosed with spleen-stomach damp-heat syndrome from the Dermatology Clinic of Bao’an Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine （Shenzhen Bao’an Traditional Chinese Medicine Hospital Group） between September 2023 and June 2024 were randomly divided into a treatment group （n=36） and a control group （n=36） using a random number table. The treatment group received topical application of Kongyou Quxie San，while the control group was treated with 2% ketoconazole shampoo， both administered twice weekly for 4 weeks. Changes in scalp clinical symptoms （erythema，scaling，greasiness， itching）， skin barrier function parameters， and Dermatology Life Quality Index （DLQI） scores were observed before and after treatment. Clinical efficacy and safety were also evaluated. Results（1） Clinical efficacy：After 4 weeks，the total effective rate was 97.22% （35/36） in the treatment group and 75.00% （27/36） in the control group， the intergroup comparison （by Chi-square test） showed that the efficacy in the treatment group was superior to the control group （P＜0.05）.（2） Clinical symptoms： Both groups showed improvements in scalp erythema， scaling， oiliness， and pruritus scores （P＜0.05） compared to those before treatment， with the treatment group exhibiting significantly greater improvement （P＜0.05 or P＜0.01）.（3） Skin barrier function： Both groups demonstrated increased stratum corneum hydration and lipid content （P＜0.05），with the treatment group showing superior enhancement （P＜0.05 or P＜0.01）.（4） Quality of life：DLQI scores decreased in both groups （P＜0.05）compared to those before treatment，with a more pronounced reduction in the treatment group （P＜0.01）.（5） Safety：No severe adverse events were reported in either group，with relatively high safety profile. Conclusion The external application of Kongyou Quxie San exerts certain therapeutic effect in treating patients with scalp seborrheic dermatitis of spleen-stomach damp-heat type. It effectively alleviates the symptoms of scalp erythema，scaling，greasiness，and itching，significantly improves skin barrier function，and enhances patients’ quality of life，with no significant adverse reactions.

R275.9

广东省中医药局科研项目（编号：20231293）；深圳市“医疗卫生三名工程”禤国维国医大师皮肤研究团队资助项目（编号： SZZYSM202106008）