解毒通络生津方对阴虚型干燥综合征患者外周血PD-1及其配体表达影响的临床研究

目的观察解毒通络生津方联合西药治疗阴虚型干燥综合征的临床疗效及其对外周血单核细胞程序性死亡分子-1(PD-1)和配体表达的影响。方法将60例阴虚型干燥综合征患者随机分为治疗组与对照组,每组30例。对照组予醋酸泼尼松加羟基氯喹治疗,治疗组在对照组治疗措施基础上,加用解毒通络生津方。两组疗程均为3个月,观察中医证候积分、疾病损害评分、疾病活动度评分、生活质量评分及外周血单核细胞PD-1、PD-L1、PD-L2、CD20的表达情况。结果 1治疗前后组内比较,两组中医证候积分差异均有统计学意义(P0.05);治疗组治疗前后中医证候积分的差值大于对照组(P0.05)。2治疗前后组内比较,两组SSDDI评分差异均有统计学意义(P0.05);组间治疗后比较,SSDDI评分的差值差异无统计学意义(P0.05)。3治疗前后组内比较,两组ESSDAI评分差异均有统计学意义(P0.05);组间治疗后比较,ESSDAI评分差异无统计学意义(P0.05)。4治疗前后组内比较,两组生活质量评分总分(PCS)差异均有统计学意义(P0.05);组间治疗前后,PCS评分差值差异无统计学意义(P0.05)。5治疗前后组内比较,对照组PD-1、PD-L1、PD-L2、CD20的差异无统计学意义(P0.05),而治疗组有统计学意义(P0.05);组间PD-1、PD-L1、PD-L2、CD20治疗前后差值差异有统计学意义,治疗组优于对照组(P0.05)。结论解毒通络生津方联合西药治疗阴虚型干燥综合征,可显著改善患者的临床症状,可能与提高外周血单核细胞PD-1及其配体表达有关。

Clinical study on the regulatory effect of “Jiedu Tongluo Shengjin Formula”on peripheral blood expression of PD-1 and its ligands in patients with sj？grens syndrome due to yin deficiency

Objective To observe the effect of＂Jiedu Tongluo Shengjin Formula＂on peripheral blood expression of monocyte procedurally dead molecule（ PD-1）and its ligands in patients with Sjogren＇s syndrome due to yin deficiency. Methods A total of 60 patients with Sj？gren＇s syndrome due to yin deficiency were randomly divided into the treatment group and control group,30 patients in each group. The control group and the treatment group were given prednisone acetate plus hydroxychloroquine,while the treatment group were also given＂Jiedu Tongluo Shengjin Formula＂. After treatment for three months,TCM syndrome score,disease damage score,disease activity score,life quality score and peripheral blood expression of monocyte PD-1,PD-L1,PD-L2 and CD20 were observed.Results ① After treatment,differences of TCM symptom score within the group were statistically significant（ P〈0. 05）; differences of TCM symptom score between the treatment group and the control group were statistically significant（ P〈0. 05）,the treatment group lower than the control group. ② After treatment,differences of SSDDI score within the group were statistically significant（ P〈0. 05）; differences of SSDDI score between the treatment group and the control group were not statistically significant（ P〉0. 05）. ③ After treatment,differences of ESSDAI score within the group were statistically significant（ P〈0. 05）; differences of ESSDAI score between the treatment group and the control group were not statistically significant（ P〉0. 05）. ④ After treatment,differences of life quality score（ PCS） within the group were statistically significant（ P〈0. 05）; differences of PCS between the treatment group and the control group were not statistically significant（ P〉0. 05）. ⑤ After treatment,differences of PD-1,PD-L1,PD-L2,CD20 within differences the control group were not statistically significant（ P〈0. 05）,while differences of those within the treatment group were statistically significant（ P