升麻鳖甲汤治疗阴虚内热型系统性红斑狼疮90例临床观察

目的:观察升麻鳖甲汤治疗阴虚内热型系统性红斑狼疮的临床疗效。方法:将90例阴虚内热型系统性红斑狼疮患者随机分为治疗组和对照组,每组45例。对照组予甲泼尼龙片治疗,治疗组在对照组治疗基础上加服升麻鳖甲汤,2组均治疗12周。比较2组患者治疗后临床疗效,治疗前后中医证候评分和患者焦虑、抑郁心理状态的变化,检测2组治疗前后自身抗体、细胞因子表达水平、补体C3的变化情况。结果:2组患者治疗后,治疗组总效率为88. 89%,对照组为75. 56%,治疗组明显优对照组(P<0. 05); 2组治疗前后中医证候评分均显著降低,且治疗组优于对照组,差异有统计学意义(P<0. 05);焦虑自评量表(SAS)、汉密尔顿抑郁量表(HAMD)治疗前后评分比较,差异有统计学意义(P<0. 05),且治疗组优于对照组;与对照组比较,治疗组ANA、抗ds DNA抗体、抗Sm抗体、Auu A、抗r RNP抗体阳性率水平明显下降,血清IL-2、IL-6、IL-10、TNF-α水平明显下降,差异有统计学意义(P<0. 05);补体C3水平显著升高,差异有统计学意义(P<0. 05)。结论:升麻鳖甲汤治疗阴虚内热型系统性红斑狼疮疗效显著,通过降低自身抗体的阳性率,改善细胞因子的变化,提高C3水平,从而维持机体的免疫平衡,且改善患者的心理状态。

Clinical observation of Using Shengma Biejia Decoction in the Treatment of 90 Cases of Systemic Lupus Erythematosus with Yin Deficiency and Internal Heat Type

Objective:To observe the clinical efficacy of Shengma Biejia Decoction in treating systemic lupus erythematosus with Yin deficiency and internal heat.Methods:90 patients with systemic lupus erythematosus due to Yin deficiency and internal heat were randomly divided into treatment group and controlled group,45 cases in each group.The controlled group was treated with Methylene Nylon Tablets,and the treatment group was additionally given Shengma Biejia Decoction on the basis of the controlled group.The 2 groups were treated for 12 weeks.The clinical effects of the 2 groups were compared,TCM syndrome score before and after treatment and changes in the state of anxiety and depression in patients,the changes of autoantibody,cytokine expression and complement C3 were detected before and after treatment in the 2 groups.Results:After treatment,the total effective rate of the 2 groups was 88.89%and 77.78%respectively,and the treatment group was significantly better than that of the controlled group(P<0.05).The scores of TCM syndromes in the 2 groups before and after treatment were significantly decreased,and the treatment group was better than the controlled group,with a statistically significant difference(P<0.05).There was a statistically significant difference between the self rating Anxiety Scale(SAS)and the Hamilton Depression Scale(HAMD)before and after treatment(P<0.05).Compared with the controlled group,the positive rate of ANA,anti ds DNA antibody,anti Sm antibody,Auu A and anti r RNP antibody in the treatment group decreased significantly,serum levels of IL-2,IL-6,IL-10 and TNF-alpha decreased significantly(P<0.05).The level of complement C3 increased significantly,and the difference was statistically significant(P<0.05).Conclusion:The therapeutic effect of Shengma Biejia Tang is significant in treating systemic lupus erythematosus with Yin deficiency and internal heat.By reducing the positive rate of autoantibodies,improving the change of cytokine and improving the level of C3,so as to maintain the immune balance of the body and improve the psychological state of the patients.