注射用丹参治疗局限型系统性硬化病的临床疗效及其作用机制

目的探讨注射用丹参静脉滴注治疗系统性硬化病的临床疗效和作用机制。方法 46例系统性硬化病患者分成2组:治疗组予丹参冻干粉针0.8 g,iv,gtt,qod,口服青霉胺0.375 g,qd,沙利度胺100 mg,qd,积雪苷72 mg,qd,泼尼松10 mg,qd;对照组予前列地尔100μg,iv,gtt,qod,其他治疗同治疗组,连续治疗3 mo,比较2组患者治疗前后皮肤损害的Rodnan修定评分、Furst’s内脏评分、全血黏度、血浆黏度、相对黏度、聚集指数、过氧化脂质(LPO)、超氧化物岐化酶(SOD)的变化以判断疗效及作用机制。结果治疗组皮肤损害的Rodnan修定评分、Furst’s内脏评分(3.5±2.2、4.8±6.4)显著低于对照组(6.8±6.3、6.7±3.8)(P<0.01,0.05)。治疗组血液流变学指标显著改善,优于对照组(P<0.01,0.05);LPO明显降低,SOD明显上升与对照组比较有显著差异(P<0.01)。结论丹参冻干粉针能显著改善皮肤损害和减轻内脏受累,其作用机制可能与血液流变学的显著改善、LPO降低、SOD上升有关。

Clinical study of Salvia miltiorrhiza injection in patients with systemic sclerosis

AIM To study the curative effects and probable mechanisms of Salvia miltiorrhiza injection in patients with systemic sclerosis.METHODS A total of 46 systemic sclerosis patients were randomized into two groups.All patients were orally administered with bellacilline 0.375 g·d-1,thalidomide 100 mg·d-1,madecasso-side 72 mg·d-1 and prednisone 10 mg·d-1.The patients in the treatment group and the control group were respectively treated with Salvia miltiorrhiza injection(0.8 g,iv,gtt,qod)and alprostadil(100 μg,iv,gtt,qod)for 3 months.Modified Rodnan skin score and Furst’s internal organs score were determined,and whole blood viscosity,blood plasma viscosity,relative viscosity,aggregation index,LPO and SOD were tested.RESULTS Modified Rodnan skin score and Furst’s internal organs score in the treatment group(3.5 ± 2.2,4.8 ± 6.4)were lower than those in the control group(6.8 ± 6.3,6.7 ± 3.8)(P < 0.01,0.05).Hemorheological parameters in the treatment group were better than those in the control group(P < 0.05,P < 0.01).CONCLUSION Salvia miltiorrhiza injection can obviously reduce the alterations in the skin and visceral organs in the patients with systemic sclerosis,which might be related to the improvement of hemorheology,decrease of LPO and increase of SOD.