温阳化浊通络方对系统性硬化病患者血清BAFF,PⅢ NP等指标的影响

Effects of Wenyang Huazhuo Tongluo Recipe on Serum BAFF and P Ⅲ NP in Patients with Systemic Sclerosis

目的:观察温阳化浊通络方治疗系统性硬化病(systemic sclerosis,SSc)的临床疗效及其可能作用机制。方法:82例SSc患者随机分为两组,对照组(41例)予甲氨蝶呤、泼尼松口服治疗,治疗组(41例)予温阳化浊通络方联合甲氨蝶呤、泼尼松口服治疗,均连续6个月。分别采取酶联免疫吸附法和免疫散射比浊法检测血清B细胞激活因子(B-cell activating factor,BAFF),Ⅲ型前胶原氨基端原肽(aminoterminal propeptide of typeⅢprocollagen,PⅢNP),Ig G和Ig M水平,同时观察皮肤积分和疾病活动指数等。结果:治疗组疗效优于对照组,差异具有统计学意义(P<0.05)。两组治疗后BAFF,Ig G,Ig M和PⅢNP水平均较治疗前明显降低(P<0.05,P<0.01),但治疗组对上述指标的改善优于对照组(P<0.05)。同时两组治疗后SSc患者皮肤积分、疾病活动指数亦较治疗前降低(P<0.05,P<0.01),且治疗组改善更明显(P<0.05)。SSc患者治疗前、后BAFF水平与皮肤积分,疾病活动指数,PⅢNP水平呈正相关性(P<0.01)。结论:温阳化浊通络方可以降低皮肤积分、疾病活动指数,改善临床症状,其机制可能与降低SSc患者血清BAFF水平,抑制免疫反应,减少PⅢNP含量有关。

Objective： To observe the effect and mechanism of Wenyang Huazhuo Tongluo recipe （WYHZTLR） in treating patients with systemic sclerosis （SSc）. Method： Eighty-two patients with SSc were randomly divided into two groups. Control group （41cases） was treated with methotrexate （MTX） and prednisone. Treatment group （41cases） were treated with WYHZTLR combined with MTX and prednisone. All SSe patients were treated for six months. The serum levels of B-cell activating factor （BAFF） and aminoterminal propeptide of type Ⅲ procollagen （PⅢ NP） were measured by ELISA. The levels of IgG and IgM were detected by immune scatter turbidimetry. The skin score and disease activity index were assessed at the same time. Result： The treatment group was superior to the control group in efficacy, with a statically significant difference （P 〈 0.05）. The levels of BAFF, IgG, IgM and PⅢ NP in two groups after treatment were significantly lower than those of before treatment （P 〈 0. 05, P 〈 0. 01 ）. The above indexes were improved more significantly in the treatment group compared with the control group （P 〈0. 05 ）. Meanwhile, skin score and disease activity index significantly decreased in two groups from that of before the treatment, particularly for the the treatment group （P 〈 0. 05, P 〈 0.01）. There were positive linear correlations between BAFF and skin score, disease activity index and P Ⅲ NPbefore and after treatment （P 〈 0.01 ）. Conclusion ： WYHZTLR can reduce skin score and disease activity index and relieve clinical symptoms by reducing the serum levels of BAFF and P ⅢNP and inhibiting the immunoreaction.