羟氯喹联合六味地黄丸治疗系统性红斑狼疮活动合并妊娠患者疗效观察

目的应用泼尼松、羟氯喹和六味地黄丸联合治疗系统性红斑狼疮活动合并妊娠,观察其疗效、安全性及妊娠结局。方法 32例SLE活动合并妊娠患者,根据治疗方案分为激素组(12例)、羟氯喹组(11例)和中西医结合组(9例)。观察患者妊娠结局、胎儿结局和狼疮活动情况。结果妊娠6个月和妊娠末期羟氯喹组和中西医结合组SLEDAI评分较激素组下降明显(P<0.05),治疗性终止妊娠率、早产率和胎儿宫内发育迟缓率也比激素组要低,但差异无统计学意义。新生儿体重、1min和5min Apgar评分羟氯喹组和中西医结合组均高于激素组,但差异无统计学意义。三组耐受性良好,不良反应发生率低,无眼部损害和畸胎等严重不良反应。结论泼尼松、羟氯喹和六味地黄丸中西医联合治疗SLE活动合并妊娠患者有显著的疗效和良好的安全性。

Effect of Hydroxychloroquine and Liuwei Dihuang Wan in the treatment of systemic lupus erythematosus complicated with pregnancy

Objective To examine clinical efficacy,safety,and pregnancy outcomes in pregnant women with systemic lupus erythematosus(SLE) treated with prednisone,Hydroxychloroquine(HCQ) and Liuwei Dihuang Wan.Methods Thirty-two pregnant SLE patients were divided into three groups based on treatment:glucocorticoid group(12 cases),HCQ group(11 cases) and integrated traditional and western medicine group(9 cases).The pregnancy outcomes,fetal outcomes,and lupus activity during pregnancy were evaluated.Results Compared with glucocorticoid group,SLEDAI scores significantly reduced in HCQ group and integrated traditional and western medicine group at six months of pregnancy and the end of pregnancy.The rates of therapeutic abortion,premature delivery and intrauterine growth retardation were slightly lower in HCQ group and integrated traditional and western medicine group than glucocorticoid group,with no statistically significant difference.Newborn weight,one minute and five minute Apgar scores were higher but not significantly in HCQ group and integrated traditional and western medicine group.Patients in the three groups had similar complications.All the groups had no ophthalmic damage and fetal abnormality.Conclusion The treatment with prednisone,HCQ and Liuwei Dihuang Wan in pregnant women with SLE has significant curative effect and nicer security.