中西医结合治疗以骨髓增生不良为特征的系统性红斑狼疮疗效观察

目的 探讨丙种球蛋白、激素、免疫抑制剂联合中药治疗骨髓增生不良的系统性红斑狼疮（SLE）患者的疗效：方法 19例确诊为SLE骨髓增生不良的患者随机分为两组，中西医组（10例）先使用丙种球蛋白冲击后续行激素、环磷酰胺（CTX）治疗，整个疗程中配合中药狼疮方治疗；对照组（9例）使用激素及CTX。观察两组患者骨髓增生不良及外周血白细胞（WBC）恢复情况及补体C3、24h尿蛋白定量、狼疮活动指数（LAI）的改善情况；随访1年。结果中西医组治疗1个月后骨髓增生不良即有明显改善（P〈0．05，P〈0．01），与同期对照组比较差异有显著性（P〈0．05，P〈0．01）；治疗3个月后中西医组补体C3明显升高（P〈0．01），24h尿蛋白定量、LAI明显下降（P〈0．05），其中补体C3及24h尿蛋白定量与对照组比较差异有显著性（P〈0．05，P〈0．01）：随访过程中对照组有3例因感染退出观察，有4例发生满月脸、痤疮，中西医组无1例发生。结论 中西医结合治疗能有效改善SLE患者的骨髓增生不良和临床症状，控制狼疮活动，明显降低治疗副反应，较单纯激素联合CTX治疗有更大的优越性。

Integrated Chinese and Western Medicinal Treatment on Systemic Lupus Erythematosus Characterized by Hypoplastic Bone Marrow

OBJECTIVE: To study the clinical effect of combined treatment with gamma-globulin, corticosteroids, immunosuppressor and Chinese medicines on systemic lupus erythematosus (SLE) patients characterized by hypoplastic bone marrow (HBM). METHODS: Nineteen patients were randomly assigned to two groups, the treated group (10 cases) received combined therapy of prednisone and cyclophosphamide (CTX) plus Chinese medicine Langchuang Recipe after being treated impactively with gamma-globulin. The control group (9 cases) was treated with prednisone and CTX. Changes of hypoplastic bone marrow, peripheral white blood cell (WBC), complement C3, 24 h urinary protein excretion, and lupus activity index (LAI) were observed, and a follow-up was carried out for one year. RESULTS: After one-month treatment, the bone marrow hypoplasia was relieved significantly in the treated group (P < 0.05, P < 0.01), showing an improvement superior to that in the control group (P < 0.05, P < 0.01); after three months treatment, the level of complement C3 increased (P < 0.01), while the 24 h urinary protein excretion and LAI decreased in the treated group (P < 0.05), showing significant difference as compared with those in the control group (P < 0.05, P < 0.01). In the follow-up period, 3 cases withdrew from the trial because of infection and 4 cases manifested full moon-face and acne in the control group, while no adverse reaction was found in the treated group. CONCLUSION: Treatment with integrated Chinese and Western medicine could effectively improve bone marrow hypoplasia, alleviate the clinical symptoms, suppress the activity of lupus in patients, and reduce the adverse reaction of treatment, showing a superiority to the treatment with prednisone combining with CTX.