益气养阴活血方治疗系统性红斑狼疮的探讨

Research on Strengthening Qi,Nourishing Yin and Acting Blood Principle for Systemic Lupus Erythematosus

目的探讨益气养阴活血方对系统性红斑狼疮患者治疗的免疫学基础和临床变化。方法利用实时荧光定量PCR技术检测SLE患者治疗前后外周血单核细胞(PBMC)中Foxp3 mRNA的表达;用酶联免疫吸附试验(ELISA)检测SLE患者治疗前后血清中IL-10和TGF-β水平变化;观察SLE患者治疗前后临床症状和实验室指标的改善情况。治疗组应用糖皮质激素加用益气养阴活血方;对照组应用糖皮质激素。结果治疗组治疗后Foxp3 mRNA和TGF-β表达较对照组上升明显,差异有统计学意义(P均<0.05),IL-10表达较对照组下降明显,差异有统计学意义(P<0.05)。治疗组治疗后患者皮损、关节痛、乏力的症状较对照组改善明显,差异有统计学意义(P均<0.05);而光敏感和脱发两组间差异无统计学意义。治疗组治疗后ESR较对照组降低明显,差异有统计学意义(P<0.05);Hb,WBC两组治疗后均上升,差异有统计学意义,但组间比较无差别;补体C3两组治疗前后均无明显变化。患者激素的用量及复发率治疗组均较对照组明显减少,差异有统计学意义(P<0.05和P<0.01)。结论加用益气养阴活血方可通过调节SLE相关的转录因子及细胞因子的分泌,调动了机体免疫系统,发挥其临床治疗效应。

Objective To explore the basics of immunology and clinical changes of Systemic Lupus Erythematosus treated by Strengthening Qi,Nourishing Yin and Acting Blood Principle.Methods The expression of Foxp3mRNA in PBMC with SLE before and after treatment were deteced by real-time quantitative PCR,while detect the expression of IL-10 and TGF-β in serum from patients by ELISA.The improvement of clinical symptoms and laboratory index with SLE before and after the treatment were observed.Treatment group were given Glucocorticoid with Lang-1 granules while control group were given glucocorticoids only.Results The expression of Foxp3 mRNA and TGF-β in the treatment group were obviously increased compared to the control group after treatment,it has statistical significance（P all〈0.05）.The expression of IL-10 in the treatment group was significantly decreased compared to the control group after treatment,it has statistical significance（P〈0.05）.The lesion,arthralgia and fatigue were significantly improved after treatment in the treatment group compared the control group,it has statistical significance（P all〈0.05）.There was no difference between light sensitive symptoms and alopecia.ESR was reduced significantlyafter treatment in the treatment group compared to the control group,it has statistical significance（P〈0.05）.Hb and WBC were increased after treatment in two groups,it has statistical significance,but there was no difference between two groups.C3 showed no difference between two groups before and after treatment.The hormone dosage and the rate of relapse were significantly decreased in the treated group compared to the control group,it has statistical significance（P〈0.05,P〈0.01）.Conclusion Addition of Strengthening Qi,Nourishing Yin and Acting Blood Principle can mobilize the body’s immune system and exert clinical curative effect through adjusting the secretion of some transcription factors and cytokines.