中西医结合治疗系统性红斑狼疮的增效减毒作用研究

目的]观察中西医结合激素治疗SLE的临床疗效,并探讨其对副作用或并发症的防治作用。方法]212例SLE患者随机分为中西结合组（123例）和西药组（89例）,西药组以激素为主,中西结合组在激素基础上结合中医解毒祛瘀滋阴法治疗。两组均连续治疗观察6个月,并对西药组16例、中西结合组25例随访观察2年。观察主要临床表现和实验室指标变化,对比总结临床疗效,并统计激素用量、副作用发生率和劳动力恢复情况。结果]治疗6个月后,副作用及并发症方面,中西结合组完全缓解率、显效率和总有效率（分别为11.38%、30.08%和92.68%）均显著高于西药组（分别为5.62%、22.47%和86.52%）（P〈0.05）,且在改善发热、红斑、口腔溃疡、脱发、关节痛、光过敏、雷诺现象、月经失调、肾脏病变、神经系统异常等临床表现和白细胞、血小板、血沉、血红蛋白、抗ds-DNA阳性率、IgG、补体C3等实验室指标方面均显著优于西药组（分别为P〈0.05或P〈0.01）。中西结合组治疗后强的松日用量（12.8±7.6mg）显著低于西药组（21.6±12.5mg）（P〈0.05）,单例6个月治疗中强的松总量也显著低于西药组（P〈0.01）。中西医结合组高血压、高血糖、高血脂或柯兴氏征、骨质疏松、痤疮或多毛等皮肤症状、失眠或抑郁等情绪异常、继发真菌或病毒感染等副作用的发生率显著低于西药组,家务劳动恢复率显著高于西药组（P〈0.05）;随访两年比较,中西结合组家务劳动和正常劳动的恢复率均显著高于西药组（P〈0.05或P〈0.01）。结论]中西医结合治疗SLE具有显著的协同作用,既能提高其临床疗效,改善临床症状和实验室指标,减轻激素用量,又能有效降低各种副作用或并发症的发生率,促进劳动力的恢复,且治疗时间越长综合疗效越显著。因此值得SLE患者长期使用和临床推广。

Investigation on the Adding Curative Effect and Reducing Poisonous or Side Effect of Integrated Traditional Chinese and Western Medicine in Treating Systemic Lupus Erythematosus

Objective]： To observe the clinical curative effect of Integrated Traditional Chinese and Western Medicine on systemic lupus erythematosus （SLE）, its effect on preventing and treating side-effect and syndrome, and investigate its mechanism. Methods]： 212 cases of SLE were divided into the integrated traditional Chinese and western medicine（ITCWM）group（123 cases） and the western medicine group（WM） （89 cases）. The WM group was treated mainly with prednisone only, while the ITCWM group with Jieduquyuziyin methods on the basis of normal western medicine. Both groups were kept on treating for 6 months. 16 cases in the WM group and 25 cases in the ITCWM group were chosen for therapy and observation for 2 years. The main clinical symptom and lab＇s indexes were observed, the clinical curative effect being compared and summarized, the dosage of prednisone,occurrence ratios of side effect and comeback ratios of labor force being added up. Results] On the aspect of clinical curative effect, the completely catabatic ratio, markedly effective ratio and total effective ratio in the ITCWM group（11. 38%,30. 08%and 92.68% respectively）were higher significantly than those in the WM group（5.62 %, 22.47 % and 86.52 % respectively）（P〈0.05）, and the improvement of clinical symptom such as mouth ulcer, arthralgia, sunlight hypersusceptibility, kidney harm, neural abnormal, fever, erythema, hair lost, Leinuo＇s symptom, inordinate menses and lab＇ s indexes such as ESR, HB, Anti- ds- DNA, WBC, PLT, IgG and C3 in the ITCWM group were better obviously than those in the WM group（P〈0. 05 or P〈0.01）. The daily dosage of prednisone in the ITCWM group group（12.8±7.6mg） was lower significantly than that in the WM group（21.6±12.5mg） （P〈0. 05）,and so was the total dosage of prednisone during the 6 months lower significantly than that in the WM group too（P〈 0. 01）. The occurrence ratios of side effect such as hypertension, hyperblood-sugar, hyperblood-lipoprotein or Kexing?