加味知柏地黄汤治疗系统性红斑狼疮52例

Clinical Study on Treatment of Systemic Lupus Erythematosus by Modified Zhibai Dihuang Decoction

目的:探讨加味知柏地黄汤治疗阴虚内热型系统性红斑狼疮(SLE)患者的临床疗效。方法:将98例伴有阴虚内热证的活动期SLE患者随机分为对照组46例和治疗组52例。对照组予常规糖皮质激素治疗,单独使用糖皮质激素无效者给予环磷酰胺治疗。治疗组在对照组治疗基础上服用加味知柏地黄汤,随辨证加减,1剂/d,疗程均为12周。观察治疗前后SLE疾病活动指数(SLEDAI)、血清补体C3,C4和循环免疫复合物(CIC)水平及激素用量。结果:治疗后8,12周治疗组SLEDAI积分低于对照组(P<0.05,P<0.01);治疗后对照组C3及C4较治疗前降低(P<0.05),治疗组变化不明显;两组治疗后CIC明显升高(P<0.05),对照组升高更显著(P<0.01);治疗后治疗组患者每日强的松用量及使用总量均少于对照组(P<0.05,P<0.01)。结论:采用加减知柏地黄汤配合常规西药治疗活动期SLE患者,疗效优于单用西药治疗,且能提高机体免疫力,减少糖皮质激素用量。

Objective： To investigate the clinical effects of modified Zhibai Dihuang decoction for patients of systemic lupus erythematosus （SLE） with Yin deficiency. Method： Ninety-eight patients of active SLE with Yin deficiency were randomly divided into two groups. Fifty-two patients in treatment group were treated with modified Zhibai Dihuang Decoction combined with conventional glucocorticoid treatment for 12 weeks, while 46 cases in control group received conventional glucocorticoid treatment, when glucocorticoid showed invalid cyclophosphamide therapy was given. Systemic lupus erythematosus diseaseactivity index （SLEDAI）, serum complement （ C3 and C4） , circulating immunocomplex （ CIC ） and consumption of hormones were investigated before and after the treatments. Result： After treatment for 8 weeks and 12 weeks, the scores of SLEDA! of treatment group were lower than that in the control group （P 〈 0.05, P 〈 0.01 ） ; C3 and C4 value of control group were lower than those before treatment （P 〈 0.05 ） , but those in the treatment group did not change significantly. In both groups, CIC was higher after treatment （ P 〈 0.05 ）, the increase in the control group was more significant （ P 〈 0.01 ）. The daily and the total consumption of prednisone in the treatment group was less than those in the control group （P 〈 0.05, P 〈 0.01 ）. Conclusion： Combination of modified Zhibai Dihuang decoction with western medicine is more effective compared with western medicine alone for treating active SLE patients with Yin deficiency. The combined therapy can improve the immune system, reduce the amount of glucocorticoids.